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雌激素对跨性别女孩骨矿物质密度的剂量依赖作用
Lidewij Sophia Boogers1,2,3, Maria Anna Theodora Catharina van der Loos2,3, Chantal Maria Wiepjes2,3
1Department of Pediatric Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit, 1081 HZ, Amsterdam, The Netherlands.
European journal of endocrinology
|August 17, 2023
概括
在性别肯定护理期间,更高的雌激素剂量可以改善跨性别女孩的骨矿物质密度 (BMD). 标准雌二醇剂量不足,这表明大约需要4mg的雌二醇才能获得最佳的BMD结果.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 跨性别者健康 跨性别者健康
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 使用性腺激素释放激素激动剂 (GnRHa) 抑制青春期 (PS),然后用雌激素进行性别肯定性激素治疗 (GAHT) 是跨性别女孩的常见治疗方法.
- 骨矿物质密度 (BMD) Z-分数通常在PS期间下降,在GAHT期间保持低于最佳水平,可能是由于estradiol剂量不足.
- 调查不同雌激醇剂量对BMD的影响对于优化治疗方案至关重要.
研究的目的:
- 为了比较跨性别女孩在性别确认激素治疗 (GAHT) 期间接受不同剂量的雌激素的骨矿物质密度 (BMD) 结果.
- 评估不同雌激醇和乙雌激醇 (EE) 剂量的有效性,以改善高度调整的BMD Z-score (HAZ分数).
主要方法:
- 追溯研究包括87名跨性别女孩.
- 参与者在GAHT之前至少接受了GnRHa一年.
- GAHT疗法包括常规雌激醇 (逐渐增加到2毫克),6毫克雌激醇或100-200微克乙雌激醇 (EE);HAZ得分使用DXA进行评估.
主要成果:
- 腰椎HAZ得分在PS (0.69分) 期间下降.
- 在GAHT治疗2年期间,HAZ得分在正规雌激醇组增加了0.14,在6毫克雌激醇组增加了0.42,在EE组增加了0.68.
- 与常规雌激醇剂量相比,EE的HAZ得分增加明显高;6mg雌激醇和EE治疗使HAZ得分更接近基线水平.
结论:
- 与标准剂量相比,更高的雌激素剂量,特别是6毫克的雌激醇或EE,与腰椎BMDZ-score的更大改善有关.
- 高达2毫克的雌激素剂量不足以优化经过GAHT的跨性别女孩的BMD.
- 可能需要大约4毫克的雌激素来达到足够的血清度并优化BMD.
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