在接受青春期抑制治疗的变性青少年的骨矿物质密度和随后的性别确认激素
Maria Anna Theodora Catharina van der Loos1,2, Mariska Caroline Vlot3, Daniel Tatting Klink4
1Department of Endocrinology and Metabolism, Amsterdam University Medical Center (UMC) at Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
JAMA pediatrics
|October 30, 2023
概括
经过青春期抑制并接受性别确认激素 (GAH) 的跨性别成年人的骨矿物质密度通常恢复到治疗前的水平. 然而,接受雌激素的跨性别个体的骨健康需要进一步调查和优化治疗.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 跨性别者健康 跨性别者健康
背景情况:
- 使用性腺激素释放激素 (GnRH) 激动剂抑制青春期可以降低跨性别青少年的骨矿物质密度 (BMD) z分数.
- 以前的短期研究表明,性别肯定激素 (GAH) 并没有完全恢复治疗前的z分数.
- 在青春期抑制和GAH治疗后,跨性别成年人对BMD的长期随访数据有限.
研究的目的:
- 在经过长期性别确认激素 (GAH) 治疗后,评估跨性别成年人的骨矿物质密度 (BMD).
- 在接受GAH之前,在青春期接受青春期抑制的个体中评估BMD变化.
主要方法:
- 一个单一中心的队列研究跟踪了75名跨性别人士长达15年.
- 参与者接受了用GnRH激动剂抑制青春期的治疗,随后至少接受了9年的长期GAH治疗.
- 骨矿物质密度 (BMD) 和z分数被测量在腰椎,部和大腿部部在不同的时间点.
主要成果:
- 在青春期抑制期间,BMD z分数下降.
- 在长期的GAH后,z分数通常恢复到治疗前的水平.
- 与治疗前水平相比,在接受丸激素的出生时被分配为男性的个体表现出持续的下腰椎z分数.
- 在接受雌激素的出生时被分配为女性的个体,在所有测量地点显示BMD z得分与预治疗水平相当.
结论:
- 在青春期抑制后的长期性别肯定激素 (GAH) 治疗似乎对接受丸激素的跨性别个体的骨健康是安全的.
- 接受雌激素治疗的跨性别个体的骨健康需要进一步关注,可能需要优化治疗和生活方式咨询.
- 需要进一步的研究,以了解和优化经过激素治疗的跨性别个体的骨发育.
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