Bone Mass, Bone Geometry, and Body Composition in Female-to-Male Transsexual Persons after Long-Term Cross-Sex Hormonal Therapy

Caenegem, Eva Van; Wierckx, Katrien; Taes, Youri; Dedecker, David; Peer, Fleur Van de; Toye, Kaatje; Kaufman, Jean; T’Sjoen, Guy

doi:10.1210/jc.2012-1187

Cited by 120 publications

(131 citation statements)

References 33 publications

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“…Changes in body composition include protective metabolic features, including increases in muscle mass and reduction in total fat, as well as concerning features such as increases in visceral fat. 29,30 The effect of exogenous testosterone on carbohydrate metabolism is unclear. 13,31,32 No studies have demonstrated an increase in risk of cardiovascular events among transmen using testosterone.…”

Section: Cardiovascular Diseasementioning

confidence: 99%

“…The effects of exogenous sex hormones on BMD have been described in cross-sectional studies 29,30 and a longitudinal study, 39 but there is a need for large prospective studies using fracture as a clinical endpoint.…”

Section: Osteoporosismentioning

confidence: 99%

“…Some studies have found transwomen to have a higher prevalence of osteoporosis, while others have not. [28][29][30]39,40 Reassuringly, low-dose oestrogen use in hormone replacement therapy (HRT) among menopausal cisgender women is protective against osteoporosis, and the doses used for cross-hormone therapy in transgender women are typically higher than those used in HRT. Several authors have hypothesised that antiandrogens may inhibit bone mineralisation, 33 and lead to osteoporosis despite adequate oestrogen levels.…”

Section: Osteoporosismentioning

confidence: 99%

“…Several authors have hypothesised that antiandrogens may inhibit bone mineralisation, 33 and lead to osteoporosis despite adequate oestrogen levels. Many transgender women start endocrine therapy with lower bone mineral density than their age-matched peers, 30,40 so may be predisposed to osteoporosis.…”

Section: Osteoporosismentioning

confidence: 99%

“…The increased muscle mass observed among transmen provides further protection against osteoporosis. 29,30 Post SRS, transmen and transwomen become hypogonadal if exogenous hormones are ceased, and treatment should continue for life. 33 The effects of gonadotrophin-releasing hormone (GnRH) agonists on BMD in transgender adolescents are unknown, 42,43 but experience from using these drugs in the treatment of precocious puberty suggests that the small decreases observed in BMD during treatment are promptly reversed on cessation.…”

Section: Osteoporosismentioning

confidence: 99%

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The primary health care of transgender adults

Aitken¹

2017

Sex. Health

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Abstract. Gender dysphoria is associated with significant health disparity. Gender services perform specialised activities such as diagnosis, endocrine management and liaison with surgical services. Although providing these specialised transition services appears to be safe and improves well-being, significant health disparity remains. Engaging primary care providers is an important part of any strategy to improve the health care of transgender people. The relationships between gender dysphoria and a range of primary care issues such as mental health, cardiovascular disease and cancer are explored.

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Section: Cardiovascular Diseasementioning

confidence: 99%

Section: Osteoporosismentioning

confidence: 99%

Section: Osteoporosismentioning

confidence: 99%

Section: Osteoporosismentioning

confidence: 99%

Section: Osteoporosismentioning

confidence: 99%

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The primary health care of transgender adults

Aitken¹

2017

Sex. Health

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Diaphysator: An online application for the exhaustive cartography and user‐friendly statistical analysis of long bone diaphyses

Santos

Jeanson

2019

American J Phys Anthropol

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The cross-sectional geometry (CSG) of long bone diaphyses is used in bioanthropology to evaluate their resistance to biomechanical constraints and to infer life-historyrelated patterns such as mobility, activity specialization or intensity, sexual dimorphism, body mass and proportions. First limited by technical analytical constraints to the analysis of one or two cross sections per bone, it has evolved into the analysis of cross sections of the full length of the diaphyseal part of long bones. More recently, researchers have developed analytical tools to map the cortical thickness of entire diaphyses to evaluate locomotor signatures. However, none of these analytical tools are easy to use for scientists who are not familiar with computer programming, and some statistical procedures-such as mapping the correlation coefficients of the diaphyseal thickness with various parameters have yet to be made available. Therefore, we developed an automated and open-source application that renders those analyses (both CSG and cortical thickness) in a semiautomated and user friendly manner. This application, called "Diaphysator", is associated with another free software ("Extractor", presented in Dupej et al. (2017). American Journal of Physical Anthropology, 164, 868-876). Diaphysator can be used as an online application (https://diaphysator.shinyapps.io/maps) or as a package for R statistical software. Along with the mean maps of cortical thickness and mean CSG parameter graphs, the users can evaluate the correlations and partial correlations of both CSG parameters at every cross section along the diaphyseal length, and cortical thickness data points of the entire diaphysis, with any factor such as age, sex, stature, and body mass.

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Muscle area estimation from cortical bone

Slizewski

Schönaü

Shaw

et al. 2013

The Anatomical Record

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This article investigates the relationship between the cortical bone of the radius and the muscle area of the forearm. The aim of this study was to develop a method for muscle area estimation from cortical bone area at 65% of radius length where the muscle area at the forearm is largest. Muscle area and cortical area were measured directly in vivo by peripheral Quantitative Computed Tomography (pQCT). We found significant correlations between muscle area and cortical area (r 5 0.881) in the forearm that are in line with previous studies. We have set up a regression model by testing relevant parameters such as age, sex, forearm length, and stature that were all highly correlated to muscle area. The influence of age and sex on the proportion of muscle area to cortical area is strong and potentially related to the effects of testosterone and estrogen on the muscle-bone-unit. Muscle area estimation from cortical bone is possible with a Percent Standard Error of Estimate (%SEE) ranging from 12.03% to 14.83%, depending on the parameters available and the age and sex of the individual. Muscle area estimation from cortical bone can provide new information for the study of skeletal and/or fossil human remains. Anat Rec, 296:1695Rec, 296: -1707Rec, 296: , 2013. V C 2013 Wiley Periodicals, Inc.Key words: muscle-bone-unit; functional bone-tissue adaptation; pQCT; cortical bone; soft tissue reconstruction This article presents the results of a study that investigates the relationship between the cortical bone of the radius and the muscle area of the forearm. The underlying question of the study is whether it is possible to reasonably estimate muscular properties of the forearm from the cross sectional properties of the forearm bones, and if so, which parameters are required for such an estimation. We hypothesize that cortical bone crosssectional area can predict muscle cross-sectional area, and that such estimations of muscle area could provide valuable information for the study of human skeletal remains. Therefore, we aim to develop a prediction model for muscle area from cortical area.Paleoanthropologists, prehistoric human biologists, and forensic anthropologists almost always rely on skeletal material alone for the reconstruction of body shape and physical capabilities of fossil hominines, prehistoric humans, or unidentified recent skeletal human remains. The reconstruction of soft tissue properties from bone has therefore always been an aim in anthropology, from early attempts to assess the muscularity of Neanderthals from their postcranial dimensions (Klaatsch, 1901;Heim, 1976) to comparative studies on primates (e.g., Baumann, 1926;DeRousseau et al., 1983;Marzke et al., 1999) and modern in vivo studies on muscle activity using electromyography (Wall-Scheffler et al., 2010) or 3D neuromusculoskeletal models for fossil hominids (Nagano et al., 2005). It has also been recognized that data on postcranial muscle tissue might provide anthropologists with valuable information on physical strength, metabolic costs,...

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Bone Mass, Bone Geometry, and Body Composition in Female-to-Male Transsexual Persons after Long-Term Cross-Sex Hormonal Therapy

Abstract: Transsexual men on testosterone substitution therapy present with a different body composition with more muscle mass and strength and less fat mass as well as an altered bone geometry with larger bones compared with female controls.

Cited by 120 publications

References 33 publications

The primary health care of transgender adults

The primary health care of transgender adults

Diaphysator: An online application for the exhaustive cartography and user‐friendly statistical analysis of long bone diaphyses

Muscle area estimation from cortical bone

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