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Impact of cross‐sex hormone therapy on bone mineral density and body composition in transwomen
Author(s) -
Fighera Tayane Muniz,
da Silva Eliane,
Lindenau Juliana DalRi,
Spritzer Poli Mara
Publication year - 2018
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.13607
Subject(s) - lean body mass , bone mineral , densitometry , medicine , endocrinology , bone density , appendicular skeleton , osteoporosis , dual energy x ray absorptiometry , femur , surgery , anatomy , body weight
Summary Objective Cross‐sex hormone therapy ( CSHT ) has been associated with changes in bone and lean/fat mass. This study assessed bone mineral density ( BMD ), appendicular lean mass ( ALM ), and total fat mass in transwomen undergoing CSHT . Patients and Design We evaluated 142 transwomen (mean age: 33.7 ± 10.3 years; BMI : 25.4 ± 4.6; 86.6% with previous CSHT ) during the first 3 months of regular oestrogen treatment (with or without anti‐androgens). A reference group including 22 men and 17 cis women was also studied. Measurements Clinical and hormonal evaluation and dual‐energy X‐ray absorptiometry ( DXA ). Results Bone mineral density was similar in trans and reference women, and lower at all sites in transwomen vs men. Low bone mass for age was observed in 18% of transwomen at baseline vs none of the reference women or men. Appendicular lean mass and total fat mass were positively correlated with L1‐L4 BMD , explaining 14.9% of the observed variation in lumbar spine BMD and 20.6% of the variation in total femur BMD . Appendicular lean mass was similar in trans and reference women, and lower in transwomen vs men. Total fat mass was lower in trans vs reference women. Densitometry was repeated after a mean of 31.3 ± 6.5 months in 46 transwomen. There was a significant increase in total fat mass and a significant decrease in ALM . Bone mineral density remained stable over time. Conclusions The fairly high prevalence of low bone mass in this sample of transwomen from southern Brazil seems to be related to lower ALM . Non‐pharmacological lifestyle‐related strategies for preventing bone loss could be beneficial for transgender women receiving long‐term CSHT .