Mueller A, Zollver H, Kronawitter D, Oppelt P G, Claassen T, Hoffmann I, Beckmann M W, Dittrich R
Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany.
Exp Clin Endocrinol Diabetes. 2011 Feb;119(2):95-100. doi: 10.1055/s-0030-1255074. Epub 2010 Jul 12.
In transsexual people, cross-sex hormone therapy is an important component of medical treatment and results in a complete change in the sex hormone environment. Steroid hormones plays an important role in developing and maintaining bone mass and body composition in both sexes. The aim of this study was to evaluate changes in body composition and bone mineral density (BMD) during cross-sex hormone therapy in transsexuals using gonadotrophin-releasing hormone agonists and intramuscular oestrogens.
84 male-to-female transsexuals (MtFs) were treated with 10 mg oestradiol-17β valerate every 10 days. The study population was treated with subcutaneous injections of 3.8 mg goserelin acetate every 4 weeks to suppress endogenous sex hormone secretion completely. Endocrine parameters, body composition and BMD after 12 months and after 24 months were compared with baseline values.
There was a significant decline in gonadotrophins and testosterone, while oestradiol, sex hormone-binding globulin, and high-density lipoprotein levels increased significantly after 12 and 24 months. There was a significant increase in body mass index (BMI), fat mass, and lumbar spine bone mineral density in MtFs during the study period, while lean mass decreased significantly and no effect was observed on femoral bone mineral density.
There was an increase in BMI associated with a shift from lean mass to fat mass. There appears to be no risk of osteoporosis developing in MtFs when there is adequate oestrogen substitution, even in the absence of testosterone. Furthermore in comparison with hormone regimes using oral medications, the complication rates appear to be lower in patients receiving gonadotrophin-releasing hormone agonists and intramuscular oestrogens.
在变性人群中，跨性别激素治疗是医学治疗的重要组成部分，会导致性激素环境发生彻底改变。类固醇激素在两性骨骼质量和身体成分的发育及维持中起着重要作用。本研究的目的是评估使用促性腺激素释放激素激动剂和肌肉注射雌激素进行跨性别激素治疗期间，变性者身体成分和骨矿物质密度（BMD）的变化。
84名男性变女性的变性者（MtF）每10天接受10毫克戊酸雌二醇-17β治疗。研究人群每4周接受皮下注射3.8毫克醋酸戈舍瑞林，以完全抑制内源性性激素分泌。将12个月和24个月后的内分泌参数、身体成分和BMD与基线值进行比较。
促性腺激素和睾酮显著下降，而雌二醇、性激素结合球蛋白和高密度脂蛋白水平在12个月和24个月后显著升高。在研究期间，MtF的体重指数（BMI）、脂肪量和腰椎骨矿物质密度显著增加，而瘦体重显著下降，股骨骨矿物质密度未观察到变化。
BMI增加与瘦体重向脂肪量的转变有关。即使在没有睾酮的情况下，当有足够的雌激素替代时，MtF似乎没有发生骨质疏松的风险。此外，与使用口服药物的激素治疗方案相比，接受促性腺激素释放激素激动剂和肌肉注射雌激素的患者并发症发生率似乎更低。
