Roy Micaela K, Bothwell Samantha, Kelsey Megan M, Ma Nina S, Moreau Kerrie L, Nadeau Kristen J, Rothman Micol S, Nokoff Natalie J
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
J Endocr Soc. 2024 Mar 12;8(5):bvae045. doi: 10.1210/jendso/bvae045.
Some transgender youth are treated with gonadotropin-releasing hormone agonists (GnRHa) followed by testosterone or estradiol, which may impact bone mineral density (BMD). This cross-sectional study of transgender youth (n = 56, aged 10.4-19.8 years, 53% assigned female at birth [AFAB]) utilized total body dual-energy x-ray absorptiometry to evaluate BMD Z-scores, and associations between GnRHa duration, body mass index (BMI), and BMD. Participants on GnRHa alone (n = 19, 14 assigned male at birth [AMAB], 5 AFAB) at the time of the study visit were 13.8 [12.8, 15.3] (median [IQR]) years old, had been on GnRHa for 10 [5.5, 19.5] months, and began GnRHa at age 12 [10.4, 12.6] years. Total body BMD Z-score for individuals on GnRHa monotherapy was -0.10 [-0.8, 0.4] (AFAB, female norms) and -0.65 [-1.4, 0.22] (AMAB, male norms). AFAB participants (n = 21) on testosterone were age 16.7 [15.9, 17.8] years, had been on testosterone for 11 [7.3, 14.5] months, and started testosterone at age 16 [14.8, 16.8] years; total body BMD Z-score -0.2 [-0.5, 0] (male norms) and 0.4 [-0.2, 0.7] (female norms). AMAB participants (n = 16) were age 16.2 [15.1, 17.4] years, had been on estradiol for 11 [5.6, 13.7] months, and started estradiol at age 16 [14.4, 16.7] years; total body BMD Z-score -0.4 [-1.1, 0.3] (male norms) and -0.2 [-0.7, 0.6] (female norms). BMD Z-score was negatively correlated with GnRHa duration (male norms: = -0.5, = .005; female norms: = -0.4, = .029) and positively correlated with BMI (male norms: = 0.4, = .003; female norms: = 0.4, = .004). In this cross-sectional cohort, total body BMD Z-scores were slightly below average, but lowest in the AMAB group on GnRHa monotherapy.
一些跨性别青少年会接受促性腺激素释放激素激动剂（GnRHa）治疗，随后使用睾酮或雌二醇，这可能会影响骨矿物质密度（BMD）。这项针对跨性别青少年的横断面研究（n = 56，年龄10.4 - 19.8岁，53%出生时被指定为女性[AFAB]）利用全身双能X线吸收法评估BMD Z分数，以及GnRHa使用时长、体重指数（BMI）与BMD之间的关联。在研究访视时，仅接受GnRHa治疗的参与者（n = 19，14名出生时被指定为男性[AMAB]，5名AFAB）年龄为13.8[12.8, 15.3]（中位数[四分位间距]）岁，已接受GnRHa治疗10[5.5, 19.5]个月，于12[10.4, 12.6]岁开始使用GnRHa。接受GnRHa单一疗法的个体的全身BMD Z分数为 -0.10[-0.8, 0.4]（AFAB，女性标准）和 -0.65[-1.4, 0.22]（AMAB，男性标准）。接受睾酮治疗的AFAB参与者（n = 21）年龄为16.7[15.9, 17.8]岁，已接受睾酮治疗11[7.3, 14.5]个月，于年龄为十六岁[14.8, 16.8]岁开始使用睾酮；全身BMD Z分数为 -0.2[-0.5, 0]（男性标准）和0.4[-0.2, 0.7]（女性标准）。接受雌二醇治疗的AMAB参与者（n = 16）年龄为16.2[15.1, 17.4]岁，已接受雌二醇治疗11[5.6, 13.7]个月，于16[14.4, 16.7]岁开始使用雌二醇；全身BMD Z分数为 -0.4[-1.1, 0.3]（男性标准）和 -0.2[-0.7, 0.6]（女性标准）。BMD Z分数与GnRHa使用时长呈负相关（男性标准：r = -0.5，p = .005；女性标准：r = -0.4，p = .029），与BMI呈正相关（男性标准：r = 0.4，p = .003；女性标准：r = 0.4，p = .004）。在这个横断面队列中，全身BMD Z分数略低于平均水平，但在接受GnRHa单一疗法的AMAB组中最低。
