TY - JOUR
T1 - Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study
T2 - A Multicenter Prospective Observational Study
AU - Wiepjes, Chantal M.
AU - Vlot, Mariska C.
AU - Klaver, Maartje
AU - Nota, Nienke M.
AU - de Blok, Christel J. M.
AU - de Jongh, Renate T.
AU - Lips, Paul
AU - Heijboer, Annemieke C.
AU - Fisher, Alessandra D.
AU - Schreiner, Thomas
AU - T'Sjoen, Guy
AU - den Heijer, Martin
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross-sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first- year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual-energy X-ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMDbefore and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p <0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p <0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p <0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p <0.001). No changes were observed in FN BMD (- 0.46%, 95% CI - 1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged >= 50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol. (C) 2017 American Society for Bone and Mineral Research
AB - Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross-sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first- year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual-energy X-ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMDbefore and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p <0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p <0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p <0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p <0.001). No changes were observed in FN BMD (- 0.46%, 95% CI - 1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged >= 50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol. (C) 2017 American Society for Bone and Mineral Research
KW - CROSS-SEX HORMONAL TREATMENT
KW - DXA
KW - OSTEOPOROSIS
KW - SEX STEROIDS
KW - TRANSGENDER
UR - http://www.scopus.com/inward/record.url?scp=85018944521&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/jbmr.3102
DO - https://doi.org/10.1002/jbmr.3102
M3 - Article
C2 - 28370342
SN - 0884-0431
VL - 32
SP - 1252
EP - 1260
JO - Journal of bone and mineral research
JF - Journal of bone and mineral research
IS - 6
ER -