Lips P, Asscheman H, Uitewaal P, Netelenbos J C, Gooren L
Department of Endocrinology, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
J Bone Miner Res. 1989 Oct;4(5):657-62. doi: 10.1002/jbmr.5650040503.
A deficiency of sex hormones leads in both sexes to increased bone loss, and hormonal substitution can prevent this. The effect of the change of hormonal environment on bone metabolism in transsexuals is unknown. Transilial bone biopsies were obtained from 23 male-to-female transsexuals (mean age +/- SD, 38.0 +/- 11.7 years) after estrogen (ethinylestradiol, 100 micrograms/day) and antiandrogen treatment (cyproterone acetate, 100 mg/day) for 8-41 months. Histomorphometric data were compared with those from 11 healthy men (39.6 +/- 9.4 years). There was no difference in bone volume, bone surface, or trabecular thickness between transsexuals and controls. Eroded surface and osteoclast number were not different between the groups. The osteoid volume, surface, and thickness were significantly lower in the transsexuals than in the controls. The mineral apposition rate and adjusted apposition rate were normal, but mineralizing surface and bone formation rate were suppressed in the transsexuals compared with data reported from the literature. The results indicate that antiandrogen and estrogen treatment in male-to-female transsexuals may suppress bone turnover and is not associated with bone loss.
性激素缺乏会导致两性骨质流失增加，而激素替代疗法可以预防这种情况。激素环境变化对变性者骨代谢的影响尚不清楚。对23名接受雌激素（炔雌醇，每日100微克）和抗雄激素治疗（醋酸环丙孕酮，每日100毫克）8至41个月后的男变女变性者进行了髂骨活检（平均年龄±标准差，38.0±11.7岁）。组织形态计量学数据与11名健康男性（39.6±9.4岁）的数据进行了比较。变性者与对照组在骨体积、骨表面积或小梁厚度方面没有差异。两组之间的侵蚀表面和破骨细胞数量没有差异。变性者的类骨质体积、表面积和厚度明显低于对照组。矿化沉积率和调整后的沉积率正常，但与文献报道的数据相比，变性者的矿化表面和骨形成率受到抑制。结果表明，男变女变性者接受抗雄激素和雌激素治疗可能会抑制骨转换，且与骨质流失无关。
