Short-Term Changes in Bone Metabolism Among Transgender Men Starting Gender-Affirming Hormone Therapy: A Systematic Review and Meta-analysis.

IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Calcified Tissue International Pub Date : 2024-11-01 Epub Date: 2024-10-02 DOI:10.1007/s00223-024-01296-z
Daniele Tienforti, Lorenzo Marinelli, Jeroen Vervalcke, Luca Spagnolo, Federica Antolini, Andreina Bichiri, Marco Giorgio Baroni, Giovanna Motta, Guy T'Sjoen, Arcangelo Barbonetti
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Abstract

Transgender and gender diverse individuals experience a gender identity that differs from the sex assigned at birth. Some transgender men may request testosterone to induce virilization; however, its impact on bone health remains to be fully elucidated. The objective of this systematic review and meta-analysis was to evaluate the modifications in bone metabolism over a short-term period among transgender men initiating testosterone therapy. A systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library. The articles of interest had to report longitudinal evaluation conducted among transgender men, before starting testosterone and after 12 and 24 months of therapy. The analyzed parameters were BMD, calcium, phosphate, 25OHD, PTH, P1NP, BAP, osteocalcin and CTx. Mean differences with 95% coefficient intervals were combined using random effects models. Funnel plot, Egger's test, and trim-and-fill analysis were used to assess publication bias. Fourteen studies met the inclusion criteria, including 1484 subjects. In absence of heterogeneity, BMD did not significantly change at lumbar spine, hip, femoral neck, and whole-body evaluations. Calcium, phosphate, 25OHD and PTH remained stable over time. Regarding bone turnover markers, only P1NP showed a statistically significant increase after 12 months of T therapy, in absence of heterogeneity (SMD 0.61 mcg/l; 95% CI: 0.40-0.83; p < 0.0001; I2 = 0%, Pforheterogeneity = 0.48). Testosterone therapy among transgender men seems not to disrupt bone health after 12 and 24 months. A statistically significant elevation in P1NP levels after 12 months of therapy may indicate a positive anabolic effect of testosterone in the short-term.

开始接受性别确认激素治疗的变性男性骨代谢的短期变化:系统回顾与元分析》。
变性人和性别多元化者的性别认同与出生时的性别不同。一些变性男性可能会要求使用睾酮来诱导男性化;然而,睾酮对骨骼健康的影响仍有待全面阐明。本系统综述和荟萃分析旨在评估开始接受睾酮治疗的变性男性在短期内骨代谢的变化情况。我们在 PubMed、Scopus、Web of Science 和 Cochrane Library 中进行了系统性检索。相关文章必须报告对变性男性在开始使用睾酮治疗前以及治疗 12 个月和 24 个月后进行的纵向评估。分析的参数包括 BMD、钙、磷酸盐、25OHD、PTH、P1NP、BAP、骨钙素和 CTx。使用随机效应模型合并了平均差和 95% 的系数区间。漏斗图、Egger 检验和修剪填充分析用于评估发表偏倚。14项研究符合纳入标准,包括1484名受试者。在没有异质性的情况下,腰椎、髋部、股骨颈和全身评估的 BMD 均无明显变化。钙、磷酸盐、25OHD 和 PTH 随时间保持稳定。在骨转换标志物方面,只有 P1NP 在接受睾酮治疗 12 个月后出现了统计学意义上的显著增加,且不存在异质性(SMD 0.61 mcg/l;95% CI:0.40-0.83;P 2 = 0%,异质性 P = 0.48)。变性男性接受睾酮治疗 12 个月和 24 个月后,似乎不会破坏骨骼健康。经过 12 个月的治疗后,P1NP 水平出现了统计学意义上的明显升高,这可能表明睾酮在短期内具有积极的合成代谢作用。
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来源期刊
Calcified Tissue International
Calcified Tissue International 医学-内分泌学与代谢
CiteScore
8.00
自引率
2.40%
发文量
112
审稿时长
4-8 weeks
期刊介绍: Calcified Tissue International and Musculoskeletal Research publishes original research and reviews concerning the structure and function of bone, and other musculoskeletal tissues in living organisms and clinical studies of musculoskeletal disease. It includes studies of cell biology, molecular biology, intracellular signalling, and physiology, as well as research into the hormones, cytokines and other mediators that influence the musculoskeletal system. The journal also publishes clinical studies of relevance to bone disease, mineral metabolism, muscle function, and musculoskeletal interactions.
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