一些变性青年用促性腺激素释放激素激动剂(GnRHa)治疗,然后用睾酮或雌二醇治疗。这可能会影响骨矿物质密度(BMD)。这项跨性别青年的横断面研究(n=56,年龄10.4-19.8岁,53%的指定女性出生时[AFAB])使用全身双能X射线骨密度仪来评估BMDZ评分,和GnRHa持续时间之间的关联,体重指数(BMI),和BMD。单独使用GnRHa的参与者(n=19,14名出生时被分配为男性[AMAB],5AFAB)在研究访问时为13.8[12.8,15.3](中位数[IQR])岁,已经使用GnRHa10[5.5,19.5]个月,并在12岁[10.4,12.6]岁时开始GnRHa。GnRHa单药治疗个体的总体BMDZ评分为-0.10[-0.8,0.4](AFAB,女性规范)和-0.65[-1.4,0.22](AMAB,男性规范)。服用睾酮的AFAB参与者(n=21)年龄为16.7[15.9,17.8]岁,服用睾酮11[7.3,14.5]个月,在16[14.8,16.8]岁时开始使用睾酮;总体BMDZ评分-0.2[-0.5,0](男性标准)和0.4[-0.2,0.7](女性标准)。AMAB参与者(n=16)年龄为16.2[15.1,17.4]岁,已经服用雌二醇11[5.6,13.7]个月,并在16岁[14.4,16.7]岁时开始使用雌二醇;总体BMDZ评分-0.4[-1.1,0.3](男性标准)和-0.2[-0.7,0.6](女性标准)。BMDZ评分与GnRHa病程呈负相关(男性规范:r=-0.5,P=.005;女性规范:r=-0.4,P=.029),与BMI呈正相关(男性规范:r=0.4,P=.003;女性规范:r=0.4,P=.004)。在这个横截面队列中,全身BMDZ评分略低于平均水平,但在GnRHa单一疗法的AMAB组中最低。
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: r = -0.5, P = .005; female norms: r = -0.4, P = .029) and positively correlated with BMI (male norms: r = 0.4, P = .003; female norms: r = 0.4, P = .004). In this cross-sectional cohort, total body BMD Z-scores were slightly below average, but lowest in the AMAB group on GnRHa monotherapy.