Abstract：
BACKGROUND: Endogenous sex steroids influence the pubertal growth spurt and adult height. However, the impact of puberty suppression and sex steroids on growth in transgender adolescents is sparsely studied.
OBJECTIVE: We investigated pubertal growth, serum IGF-I and IGFBP-3, and adult height of transgender adolescents receiving hormone therapy.
METHODS: Observational study of a national cohort (2016-2023) comprising 219 transgender adolescents <18 years of age. Treatment consisted of gonadotropin-releasing hormone agonist (GnRHa) combined with estradiol or testosterone (adjusted to serum concentrations between 0 and +2 standard deviations (SDs) corresponding to the gender identity).
RESULTS: Adult height was within ±2 SD for sex assigned at birth.Most trans girls reached adult height within references of girls. For trans girls (bone age ≤15 years before treatment), a growth spurt was observed during estradiol therapy. IGF-I and height SDS declined during oral estradiol administration (-0.13 SDS per month, p=0.059, and -0.02 SDS, p=0.001, respectively). We observed significantly lower adult height compared to target height for trans girls (-2.7 cm, p=0.01), and significant differences between height SDS before treatment and at adult height (-0.35 SDS, p<0.001).Half of the trans boys remained short (<-2 SD) compared to references for boys, and most completed growth spurt before initiation of treatment. IGFBP-3 declined following testosterone treatment. There was a significant difference between height SDS before treatment and at adult height (-0.17 SDS, p<0.001).
CONCLUSIONS: The minor reduction in adult height of trans girls after hormone treatment may be beneficial to some, whereas trans boys did not experience height gain.
OBJECTIVE: We investigated pubertal growth, serum IGF-I and IGFBP-3, and adult height of transgender adolescents receiving hormone therapy.
METHODS: Observational study of a national cohort (2016-2023) comprising 219 transgender adolescents <18 years of age. Treatment consisted of gonadotropin-releasing hormone agonist (GnRHa) combined with estradiol or testosterone (adjusted to serum concentrations between 0 and +2 standard deviations (SDs) corresponding to the gender identity).
RESULTS: Adult height was within ±2 SD for sex assigned at birth.Most trans girls reached adult height within references of girls. For trans girls (bone age ≤15 years before treatment), a growth spurt was observed during estradiol therapy. IGF-I and height SDS declined during oral estradiol administration (-0.13 SDS per month, p=0.059, and -0.02 SDS, p=0.001, respectively). We observed significantly lower adult height compared to target height for trans girls (-2.7 cm, p=0.01), and significant differences between height SDS before treatment and at adult height (-0.35 SDS, p<0.001).Half of the trans boys remained short (<-2 SD) compared to references for boys, and most completed growth spurt before initiation of treatment. IGFBP-3 declined following testosterone treatment. There was a significant difference between height SDS before treatment and at adult height (-0.17 SDS, p<0.001).
CONCLUSIONS: The minor reduction in adult height of trans girls after hormone treatment may be beneficial to some, whereas trans boys did not experience height gain.
摘要：
背景：内源性类固醇影响青春期生长突增和成人身高。然而,青春期抑制和性类固醇对跨性别青少年生长的影响研究很少。
目的：我们调查了青春期生长，血清IGF-I和IGFBP-3，以及接受激素治疗的变性青少年的成年身高。
方法：全国队列（2016-2023年）的观察性研究，包括219名年龄<18岁的变性青少年。治疗包括促性腺激素释放激素激动剂（GnRHa）与雌二醇或睾丸激素的组合（调整至对应于性别认同的0至2个标准偏差（SD）之间的血清浓度）。
结果：出生时按性别分配，成人身高在±2SD以内。大多数跨性别女孩在女孩的参考范围内达到成人身高。对于跨性别女孩（治疗前骨龄≤15岁），雌二醇治疗期间观察到生长突增。口服雌二醇期间IGF-I和身高SDS下降（-0.13SDS/月，p=0.059，和-0.02SDS，分别为p=0.001)。我们观察到，与跨性别女孩的目标身高相比，成人身高显着降低（-2.7厘米，p=0.01),治疗前身高SDS和成人身高SDS之间存在显着差异（-0.35SDS，p<0.001)。与男孩的参考相比，一半的跨性别男孩仍然很短（<-2SD），治疗开始前大部分完成生长突增。睾酮治疗后IGFBP-3下降。治疗前身高SDS与成人身高之间存在显着差异（-0.17SDS，p<0.001)。
结论：激素治疗后，跨性别女孩的成年身高略有下降可能对某些人有益，而跨性别男孩没有经历身高增长。
目的：我们调查了青春期生长，血清IGF-I和IGFBP-3，以及接受激素治疗的变性青少年的成年身高。
方法：全国队列（2016-2023年）的观察性研究，包括219名年龄<18岁的变性青少年。治疗包括促性腺激素释放激素激动剂（GnRHa）与雌二醇或睾丸激素的组合（调整至对应于性别认同的0至2个标准偏差（SD）之间的血清浓度）。
结果：出生时按性别分配，成人身高在±2SD以内。大多数跨性别女孩在女孩的参考范围内达到成人身高。对于跨性别女孩（治疗前骨龄≤15岁），雌二醇治疗期间观察到生长突增。口服雌二醇期间IGF-I和身高SDS下降（-0.13SDS/月，p=0.059，和-0.02SDS，分别为p=0.001)。我们观察到，与跨性别女孩的目标身高相比，成人身高显着降低（-2.7厘米，p=0.01),治疗前身高SDS和成人身高SDS之间存在显着差异（-0.35SDS，p<0.001)。与男孩的参考相比，一半的跨性别男孩仍然很短（<-2SD），治疗开始前大部分完成生长突增。睾酮治疗后IGFBP-3下降。治疗前身高SDS与成人身高之间存在显着差异（-0.17SDS，p<0.001)。
结论：激素治疗后，跨性别女孩的成年身高略有下降可能对某些人有益，而跨性别男孩没有经历身高增长。
