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Bone mineral density in complete androgen insensitivity syndrome and the timing of gonadectomy
Author(s) -
King Thomas F. J.,
Wat Winnie Z. M.,
Creighton Sarah M.,
Conway Gerard S.
Publication year - 2017
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13368
Subject(s) - medicine , bone mineral , testosterone (patch) , androgen , endocrinology , lumbar spine , urology , osteoporosis , hormone , surgery
Summary Objective Low bone mineral density ( BMD ) has been reported in complete androgen insensitivity syndrome ( CAIS ), but the impact of timing of gonadectomy is not known. We aimed to assess the relationship between age of gonadectomy and BMD in women with CAIS .Design Retrospective analysis of pre‐ and post‐gonadectomy parameters in women with CAIS attending an adult Disorders of Sex Development ( DSD ) clinic in a tertiary centre. Patients One hundred and thirteen women with CAIS . Measurements Dual‐energy X‐ray absorptiometry ( DXA ) before and after gonadectomy; and pre‐gonadectomy hormone profile. Results Mean BMD was reduced (95% confidence interval ); T‐score −1.34 (−1.55 to −1.13; P <.001) at the lumbar spine and −0.3 (−0.49 to −0.12; P =.001) at the hip. There was no relationship between age of gonadectomy and BMD . Thirty‐two subjects had BMD measured before or within 2 years of gonadectomy, and mean BMD was reduced (95% CI ) at the lumbar spine; T‐score: −1.05 (−1.54 to −0.57; P <.001), but was normal at the hip; T‐score −0.04 (−0.35 to 0.28; P =.8). There was no relationship between BMD and history of hernia, testosterone, oestradiol or follicle stimulating hormone levels. Twelve subjects had DXA both before and after gonadectomy, and after 4.3 (1.7‐12.8) years, there was no change in BMD . Conclusions We found reduced BMD at the spine and hip in subjects with CAIS . We found no relationship between age of gonadectomy and BMD , and we also found no drop in BMD in subjects followed up after gonadectomy.