title: Prevalence of low bone mass in relation to estrogen treatment and body composition in male-to-female transsexual persons.
abstract: Bone health is a parameter of interest in the daily follow-up of male-to-female (M --> F) transsexual persons both before and after sex reassignment surgery (SRS) due to an intensely changing hormonal milieu. We have studied body composition, areal, geometric, and volumetric bone parameters, using DXA and peripheral quantitative computed tomography at different sites in 50 M --> F transsexual persons, at least 3 yr after the start of the hormonal treatment and 1 yr after SRS. In this cross-sectional study, hormone levels and markers of bone metabolism were assessed using immunoassays. Prevalence of low bone mass as defined by a Z-score < or = -2.0 according to DXA criteria was 26% at lumbar spine and 2% at the total hip. We found no major differences in hormonal parameters between participants with a Z-score < or = or > -2.0. Markers of bone turnover were comparable between subjects with or without low bone mass, indicating a stable bone turnover at the time of investigation. No significant differences in bone size or density were observed between patients on transdermal vs. oral estrogens. Low bone mass is not uncommon in M --> F transsexual persons. Smaller bone size, and a strikingly lower muscle mass compared with men appear to underlie these findings.
authors.affiliation: Department of Endocrinology, Ghent University Hospital, Belgium. guy.tsjoen@ugent.be
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
authors.forename: Youri
authors.initials: Y
authors.lastname: Taes
authors.forename: Bruno
authors.initials: B
authors.lastname: Lapauw
authors.forename: Kaatje
authors.initials: K
authors.lastname: Toye
authors.forename: S
authors.initials: S
authors.lastname: Goemaere
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Kaufman
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage; D001823:Body Composition; D016723:Bone Remodeling / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004967:Estrogens / Q000008:administration & dosage*; D005262:Feminization / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D014189:Transsexualism / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000726:Androgen Antagonists; D004967:Estrogens