跨性别男性在接受睾酮治疗期间的身体成分、骨转换和骨量：一项前瞻性病例对照研究（ENIGI）的 1 年随访数据。
Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case-controlled study (ENIGI).
机构信息
Department of EndocrinologyGhent University Hospital, De Pintelaan 185, 9000 Ghent, BelgiumEuropean Network for the Investigation of Gender Incongruence (ENIGI)Ghent, BelgiumDepartment of EndocrinologyRikshospitalet, Oslo University Hospital, Sognsvannvn 20, Oslo, NorwayCenter for Sexology and Gender ProblemsGhent University Hospital, De Pintelaan 185, Ghent, Belgium Department of EndocrinologyGhent University Hospital, De Pintelaan 185, 9000 Ghent, BelgiumEuropean Network for the Investigation of Gender Incongruence (ENIGI)Ghent, BelgiumDepartment of EndocrinologyRikshospitalet, Oslo University Hospital, Sognsvannvn 20, Oslo, NorwayCenter for Sexology and Gender ProblemsGhent University Hospital, De Pintelaan 185, Ghent, Belgium
Department of EndocrinologyGhent University Hospital, De Pintelaan 185, 9000 Ghent, BelgiumEuropean Network for the Investigation of Gender Incongruence (ENIGI)Ghent, BelgiumDepartment of EndocrinologyRikshospitalet, Oslo University Hospital, Sognsvannvn 20, Oslo, NorwayCenter for Sexology and Gender ProblemsGhent University Hospital, De Pintelaan 185, Ghent, Belgium Department of EndocrinologyGhent University Hospital, De Pintelaan 185, 9000 Ghent, BelgiumEuropean Network for the Investigation of Gender Incongruence (ENIGI)Ghent, BelgiumDepartment of EndocrinologyRikshospitalet, Oslo University Hospital, Sognsvannvn 20, Oslo, NorwayCenter for Sexology and Gender ProblemsGhent University Hospital, De Pintelaan 185, Ghent, Belgium.
出版信息
Eur J Endocrinol. 2015 Feb;172(2):163-71. doi: 10.1530/EJE-14-0586.
PURPOSE
To assess the evolution of body composition and bone metabolism in trans men during the first year of cross-sex hormonal therapy.
METHODS
In a prospective controlled study, we included 23 trans men (female-to-male trans persons) and 23 age-matched control women. In both groups, we examined grip strength (hand dynamometer), biochemical markers of bone turnover (C-terminal telopeptides of type 1 collagen (CTX) and procollagen 1 aminoterminal propeptide (P1NP)), total body fat and lean mass, and areal bone mineral density (aBMD) by dual-X-ray absorptiometry (DXA) and fat and muscle area at the forearm and calf, bone geometry, and volumetric bone mineral density (vBMD) by peripheral quantitative computed tomography (pQCT), before treatment and after 1 year of treatment with undecanoate (1000 mg i.m./12 weeks).
RESULTS
Before hormonal treatment, trans men had similar bone and body composition compared with control women. Testosterone treatment induced in trans men a gain in muscle mass (+10.4%) and strength and loss of fat mass (-9.7%) (all P<0.001) and increased the levels of P1NP and CTX (both P<0.01). Areal and volumetric bone parameters remained largely unchanged apart from a small increase in trabecular vBMD at the distal radius and in BMD at the total hip in trans men (P=0.036 and P=0.001 respectively). None of these changes were observed in the control group.
CONCLUSIONS
Short-term testosterone treatment in trans men increased muscle mass and bone turnover. The latter may rather reflect an anabolic effect of testosterone treatment rather than bone loss.
目的
评估跨性别男性在接受跨性别激素治疗的第一年中身体成分和骨代谢的变化。
方法
在一项前瞻性对照研究中，我们纳入了 23 名跨性别男性（男变女）和 23 名年龄匹配的对照组女性。在两组中，我们均通过双能 X 线吸收法（DXA）检测握力（手持测力计）、骨转换的生化标志物（Ⅰ型胶原 C 端肽（CTX）和前胶原 1 氨基端前肽（P1NP））、全身脂肪和瘦体重、以及前臂和小腿的面积骨密度（aBMD），通过外周定量计算机断层扫描（pQCT）检测脂肪和肌肉面积、骨几何结构和体积骨密度（vBMD），并在治疗前和治疗 1 年后（1000mg 肌内注射/12 周）用十一酸睾酮进行治疗。
结果
在激素治疗前，跨性别男性的骨和身体成分与对照组女性相似。睾酮治疗使跨性别男性的肌肉质量增加（+10.4%）和力量增加（+10.4%），脂肪质量减少（-9.7%）（均 P<0.001），并增加了 P1NP 和 CTX 的水平（均 P<0.01）。除了桡骨远端小梁 vBMD 和全髋骨密度略有增加外（分别为 P=0.036 和 P=0.001），面积和体积骨参数基本没有变化。对照组中没有观察到这些变化。
结论
短期睾酮治疗使跨性别男性的肌肉质量和骨转换增加。后者可能反映了睾酮治疗的合成代谢作用，而不是骨丢失。
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