跨性别群体的骨骼健康
Bone Health in the Transgender Population.
作者信息
Rothman Micol S, Iwamoto Sean J
机构信息
Division of Endocrinology, Metabolism & Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, 12801 East 17th Avenue, Mail Stop: 8106, Aurora, CO 80045, USA.
Division of Endocrinology, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.
出版信息
Clin Rev Bone Miner Metab. 2019 Jun;17(2):77-85. doi: 10.1007/s12018-019-09261-3. Epub 2019 Jul 2.
Abstract
It is well known that sex steroids, particularly estrogen, play a crucial role in the attainment and maintenance of peak bone density in all people. Transgender (trans) women have been frequently observed to have low bone density prior to initiation of gender-affirming hormone therapy, while trans men generally do not. With pharmacologic estrogen, many studies show improving bone density in trans women. With pharmacologic testosterone, bone density in trans men remains largely unchanged although androgens have indirect effects on bone health via changes in fat and lean mass. Much remains unknown about best practices to optimize bone health, interpret DXA scans and assess fracture risk in trans adults.
摘要
众所周知，性类固醇，尤其是雌激素，在所有人达到和维持峰值骨密度方面起着关键作用。人们经常观察到，跨性别（trans）女性在开始性别确认激素治疗之前骨密度较低，而跨性别男性通常并非如此。许多研究表明，使用药物雌激素可改善跨性别女性的骨密度。使用药物睾酮时，尽管雄激素通过脂肪和瘦体重的变化对骨骼健康有间接影响，但跨性别男性的骨密度基本保持不变。关于优化跨性别成年人骨骼健康、解读双能X线吸收测定（DXA）扫描结果和评估骨折风险的最佳做法，仍有许多未知之处。
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