Vink, P. (Patti) (2015) Botdichtheid bij transgenders na gonadectomie en langdurige behandeling met hormoontherapie. thesis, Medicine.
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Abstract
Purpose: This retrospective cohortstudy studied the effect of longterm hormonal therapy and gonadetomy on bone mineral density (BMD) in transgenders. Materials & Methods: 56 male-to-female (M-F) and 32 female-to-male (F-M) transgenders were included in this study. They had all been treated with hormonal substitution (HT) had undergone gonadectomy, and one or more Dual energy X-ray absorptiometry (DEXA)- scans had been performed to evaluate BMD. M-F transgenders were treated with estrogens, some combined with anti-androgens, F-M transgenders were treated with androgens. A total of 169 DEXA-scans were analysed, with a median duration of HT of 135 months (with a minimum of 26 months and a maximum of 373 months) at the time the DEXA-scan was performed. We distinguished between the group as a whole, in which at least 1 DEXA-scan had been performed, and the follow-up group, in which 2 or more DEXA-scans had been performed. We only used the first DEXA-scan while analysing the group as a whole, while for the follow-up group the first and last DEXA-scan were compared. BMD was measured at the radius, lumbar spine (LS) and proximal femur. Laboratory values that had been established within 3 months of perfoming a DEXA-scan were analysed. Demographic variables were collected from patient statuses. Results: M-F teansgenders were significantly older and taller than F-M transgenders. M-F transgenders had a significantly higher BMD at the radius than F-M transgenders. F-M transgenders had a significantly higher BMD at the lumbar spine than M-F transgenders. 22,4% of M-F transgenders had osteoporosis for the male gender during the first DEXA-scan, compared to 8% of F-M transgenders with osteoporosis for the female gender. In the M-F follow-up group a significant increase in BMD was found at the radius and the LS. In the F-M follow-up group a significant increase in BMD was found at the radius. By performing linear regression analyses no significant correlations were found between duration of HT and time since SRS, and BMD for both M-F and F-M transgenders. An inverse correlation was found between Luteinizing hormone (LH) and follicle stimulating hormone (FSH), and BMD for both M-F and F-M transgenders. Conclusion: This study supports previously described findings that BMD is maintained or increases in transgenders who have undergone SRS and are adequately substituted with sex hormones. A high prevalence of osteoporosis was found in M-F transgenders at the first DEXAscan (22,4%) which justifies the performance of DEXA-scans in transgenders. LH and FSH values were found to be good markers for establishing whether adequate hormonal substition was present.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Weijmar Schultz, Prof. dr. W.C.M. and Slart, Prof. dr. R.H.J.A. and Tuuk, Mevr. dr. K. v/d and Berg, Mevr. dr. M. v/d |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1302 |
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