Abstract:
Sex steroids are important regulators of bone development before puberty and of bone homeostasis throughout adulthood. Gender-affirming therapies with sex steroids are used in transgender and gender diverse persons for treatment of gender dysphoria, which may have profound impacts on their bone metabolism. Many studies have described variable changes in bone density and geometry in transgender cohorts. In order to provide informed guidance on the effect of gender-affirming therapy, the International Society of Clinical Densitometry issued official position statements in 2019 for the performance and interpretation of dual-energy x-ray absorptiometry in transgender and gender-diverse patients. We review the effects of gender-affirming hormone therapy on bone physiology and the changes in bone modulation that have been reported in the literature in transgender patients who have received gender-affirming therapy. We also summarize the recent guidelines for interpretation of dual energy x-ray absorptiometry as an update for the radiologist.
摘要:
性类固醇是青春期前骨骼发育和整个成年期骨骼稳态的重要调节剂。变性者和不同性别的人使用性类固醇的性别确认疗法来治疗性别不安,这可能会对他们的骨骼代谢产生深远的影响。许多研究已经描述了跨性别队列中骨密度和几何形状的可变变化。为了就性别确认疗法的效果提供知情指导,国际临床密度测定学会于2019年发布了官方立场声明,对跨性别患者和不同性别患者的双能X线骨密度仪的表现和解释.我们回顾了性别确认激素治疗对骨生理的影响以及接受性别确认治疗的变性患者的文献中报道的骨调节变化。我们还总结了最近的双能X射线吸收法解释指南,作为放射科医生的更新。