Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study
ABSTRACT Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross‐sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first‐year effects...
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| Veröffentlicht in: | Journal of bone and mineral research 2017-06, Vol.32 (6), p.1252-1260 |
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| creator | Wiepjes, Chantal M Vlot, Mariska C Klaver, Maartje Nota, Nienke M de Blok, Christel JM de Jongh, Renate T Lips, Paul Heijboer, Annemieke C Fisher, Alessandra D Schreiner, Thomas T'Sjoen, Guy den Heijer, Martin |
| description | ABSTRACT
Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross‐sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first‐year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual‐energy X‐ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMD before and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p |
| doi_str_mv | 10.1002/jbmr.3102 |
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Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross‐sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first‐year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual‐energy X‐ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMD before and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p < 0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p < 0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p < 0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p < 0.001). No changes were observed in FN BMD (–0.46%, 95% CI –1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged ≥50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol. © 2017 American Society for Bone and Mineral Research.</description><identifier>ISSN: 0884-0431</identifier><identifier>EISSN: 1523-4681</identifier><identifier>DOI: 10.1002/jbmr.3102</identifier><identifier>PMID: 28370342</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>17β-Estradiol ; Adult ; Age ; Age Factors ; Alcohol Drinking - adverse effects ; Body Weight - drug effects ; Bone density ; Bone Density - drug effects ; Bone Density - physiology ; Bone mineral density ; Bone turnover ; Cigarette Smoking - adverse effects ; CROSS‐SEX HORMONAL TREATMENT ; Cyproterone acetate ; Dual energy X-ray absorptiometry ; DXA ; Estradiol - pharmacology ; Female ; Femur ; Hip ; Homeostasis ; Humans ; Male ; Observational studies ; Oral cavity ; OSTEOPOROSIS ; Post-menopause ; Prospective Studies ; Sex ; SEX STEROIDS ; Spine (lumbar) ; Steroid hormones ; Testosterone ; Testosterone - pharmacology ; Transgender Persons ; Vitamin D - pharmacology ; Young Adult</subject><ispartof>Journal of bone and mineral research, 2017-06, Vol.32 (6), p.1252-1260</ispartof><rights>2017 American Society for Bone and Mineral Research</rights><rights>2017 American Society for Bone and Mineral Research.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3882-1cc2320913c7a8a3c3d12d2cbd169ba3490b0bb185310df9da8ef2792d54714e3</citedby><cites>FETCH-LOGICAL-c3882-1cc2320913c7a8a3c3d12d2cbd169ba3490b0bb185310df9da8ef2792d54714e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjbmr.3102$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjbmr.3102$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28370342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wiepjes, Chantal M</creatorcontrib><creatorcontrib>Vlot, Mariska C</creatorcontrib><creatorcontrib>Klaver, Maartje</creatorcontrib><creatorcontrib>Nota, Nienke M</creatorcontrib><creatorcontrib>de Blok, Christel JM</creatorcontrib><creatorcontrib>de Jongh, Renate T</creatorcontrib><creatorcontrib>Lips, Paul</creatorcontrib><creatorcontrib>Heijboer, Annemieke C</creatorcontrib><creatorcontrib>Fisher, Alessandra D</creatorcontrib><creatorcontrib>Schreiner, Thomas</creatorcontrib><creatorcontrib>T'Sjoen, Guy</creatorcontrib><creatorcontrib>den Heijer, Martin</creatorcontrib><title>Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study</title><title>Journal of bone and mineral research</title><addtitle>J Bone Miner Res</addtitle><description>ABSTRACT
Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross‐sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first‐year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual‐energy X‐ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMD before and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p < 0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p < 0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p < 0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p < 0.001). No changes were observed in FN BMD (–0.46%, 95% CI –1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged ≥50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol. © 2017 American Society for Bone and Mineral Research.</description><subject>17β-Estradiol</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Alcohol Drinking - adverse effects</subject><subject>Body Weight - drug effects</subject><subject>Bone density</subject><subject>Bone Density - drug effects</subject><subject>Bone Density - physiology</subject><subject>Bone mineral density</subject><subject>Bone turnover</subject><subject>Cigarette Smoking - adverse effects</subject><subject>CROSS‐SEX HORMONAL TREATMENT</subject><subject>Cyproterone acetate</subject><subject>Dual energy X-ray absorptiometry</subject><subject>DXA</subject><subject>Estradiol - pharmacology</subject><subject>Female</subject><subject>Femur</subject><subject>Hip</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Male</subject><subject>Observational studies</subject><subject>Oral cavity</subject><subject>OSTEOPOROSIS</subject><subject>Post-menopause</subject><subject>Prospective Studies</subject><subject>Sex</subject><subject>SEX STEROIDS</subject><subject>Spine (lumbar)</subject><subject>Steroid hormones</subject><subject>Testosterone</subject><subject>Testosterone - pharmacology</subject><subject>Transgender Persons</subject><subject>Vitamin D - pharmacology</subject><subject>Young Adult</subject><issn>0884-0431</issn><issn>1523-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9P3DAQxa2qVVloD3wBZKmXcgiM7fxxelsoFCpWoHZ74BQ5zkTyKrG3tkO1R745XhZ6qNTTaKTfe5p5j5BDBicMgJ-u2tGfCAb8DZmxgossLyV7S2YgZZ5BLtge2Q9hBQBlUZbvyR6XogKR8xl5PHMW6cJY9GqgX9EGEzf02mqPKmCgxtKlVzbQO_TBpTnvI3rK6D0qT11Pr5wfnU3aZVLEEW38Qud0MQ3R6LQk9s67sEYdzQPS2zagf1DRPEt-xqnbfCDvejUE_PgyD8ivy4vl-VV2c_vt-nx-k2khJc-Y1lxwqJnQlZJKaNEx3nHddqysWyXyGlpoWyaLFETX152S2POq5l2RVyxHcUA-73zX3v2eMMRmNEHjMCiLbgoNS2GxUgKHhH76B125yaeLE1VDVRSyYGWijneUTg8Gj32z9mZUftMwaLa9NNtemm0viT16cZzaEbu_5GsRCTjdAX_MgJv_OzXfzxY_ni2fAJPFl3c</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Wiepjes, Chantal M</creator><creator>Vlot, Mariska C</creator><creator>Klaver, Maartje</creator><creator>Nota, Nienke M</creator><creator>de Blok, Christel JM</creator><creator>de Jongh, Renate T</creator><creator>Lips, Paul</creator><creator>Heijboer, Annemieke C</creator><creator>Fisher, Alessandra D</creator><creator>Schreiner, Thomas</creator><creator>T'Sjoen, Guy</creator><creator>den Heijer, Martin</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201706</creationdate><title>Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study</title><author>Wiepjes, Chantal M ; Vlot, Mariska C ; Klaver, Maartje ; Nota, Nienke M ; de Blok, Christel JM ; de Jongh, Renate T ; Lips, Paul ; Heijboer, Annemieke C ; Fisher, Alessandra D ; Schreiner, Thomas ; T'Sjoen, Guy ; den Heijer, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3882-1cc2320913c7a8a3c3d12d2cbd169ba3490b0bb185310df9da8ef2792d54714e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>17β-Estradiol</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Alcohol Drinking - adverse effects</topic><topic>Body Weight - drug effects</topic><topic>Bone density</topic><topic>Bone Density - drug effects</topic><topic>Bone Density - physiology</topic><topic>Bone mineral density</topic><topic>Bone turnover</topic><topic>Cigarette Smoking - adverse effects</topic><topic>CROSS‐SEX HORMONAL TREATMENT</topic><topic>Cyproterone acetate</topic><topic>Dual energy X-ray absorptiometry</topic><topic>DXA</topic><topic>Estradiol - pharmacology</topic><topic>Female</topic><topic>Femur</topic><topic>Hip</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Male</topic><topic>Observational studies</topic><topic>Oral cavity</topic><topic>OSTEOPOROSIS</topic><topic>Post-menopause</topic><topic>Prospective Studies</topic><topic>Sex</topic><topic>SEX STEROIDS</topic><topic>Spine (lumbar)</topic><topic>Steroid hormones</topic><topic>Testosterone</topic><topic>Testosterone - pharmacology</topic><topic>Transgender Persons</topic><topic>Vitamin D - pharmacology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wiepjes, Chantal M</creatorcontrib><creatorcontrib>Vlot, Mariska C</creatorcontrib><creatorcontrib>Klaver, Maartje</creatorcontrib><creatorcontrib>Nota, Nienke M</creatorcontrib><creatorcontrib>de Blok, Christel JM</creatorcontrib><creatorcontrib>de Jongh, Renate T</creatorcontrib><creatorcontrib>Lips, Paul</creatorcontrib><creatorcontrib>Heijboer, Annemieke C</creatorcontrib><creatorcontrib>Fisher, Alessandra D</creatorcontrib><creatorcontrib>Schreiner, Thomas</creatorcontrib><creatorcontrib>T'Sjoen, Guy</creatorcontrib><creatorcontrib>den Heijer, Martin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and mineral research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wiepjes, Chantal M</au><au>Vlot, Mariska C</au><au>Klaver, Maartje</au><au>Nota, Nienke M</au><au>de Blok, Christel JM</au><au>de Jongh, Renate T</au><au>Lips, Paul</au><au>Heijboer, Annemieke C</au><au>Fisher, Alessandra D</au><au>Schreiner, Thomas</au><au>T'Sjoen, Guy</au><au>den Heijer, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study</atitle><jtitle>Journal of bone and mineral research</jtitle><addtitle>J Bone Miner Res</addtitle><date>2017-06</date><risdate>2017</risdate><volume>32</volume><issue>6</issue><spage>1252</spage><epage>1260</epage><pages>1252-1260</pages><issn>0884-0431</issn><eissn>1523-4681</eissn><abstract>ABSTRACT
Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross‐sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first‐year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual‐energy X‐ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMD before and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p < 0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p < 0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p < 0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p < 0.001). No changes were observed in FN BMD (–0.46%, 95% CI –1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged ≥50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol. © 2017 American Society for Bone and Mineral Research.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28370342</pmid><doi>10.1002/jbmr.3102</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 17β-Estradiol Adult Age Age Factors Alcohol Drinking - adverse effects Body Weight - drug effects Bone density Bone Density - drug effects Bone Density - physiology Bone mineral density Bone turnover Cigarette Smoking - adverse effects CROSS‐SEX HORMONAL TREATMENT Cyproterone acetate Dual energy X-ray absorptiometry DXA Estradiol - pharmacology Female Femur Hip Homeostasis Humans Male Observational studies Oral cavity OSTEOPOROSIS Post-menopause Prospective Studies Sex SEX STEROIDS Spine (lumbar) Steroid hormones Testosterone Testosterone - pharmacology Transgender Persons Vitamin D - pharmacology Young Adult |
| title | Bone Mineral Density Increases in Trans Persons After 1 Year of Hormonal Treatment: A Multicenter Prospective Observational Study |
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