EYES2024 ESE Young Endocrinologists and Scientists (EYES) 2024 Reproductive Endocrinology (10 abstracts)
Short-term changes in bone metabolism among transgender men starting gender affirming hormone therapy: a systematic review and meta-analysis
Lorenzo Marinelli 1,2 , Daniele Tienforti 3 , Jeroen Vervalcke 2 , Andreina Bichiri 1 , Guy T’Sjoen 2 , Giovanna Motta 1 & Arcangelo Barbonetti 3
1Division of Endocrinology, Diabetes, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy; 2Department of Endocrinology, Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium; 3Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy.
Introduction: Transgender and gender diverse (TGD) people experience a gender identity which is different from the sex assigned at birth. Some transgender men (TM) can ask for testosterone to induce virilization and its effects on bone health are still to be fully elucidated. The aim of this systematic review and meta-analysis was to evaluate the changes on bone metabolism in a short-term period among TM starting testosterone.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library. The articles of interest had to report longitudinal evaluation before starting testosterone and after 12 and 24 months of testosterone among TM. 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.
Results: Fourteen studies met the inclusion criteria, including 1484 TM. 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 markers, only P1NP showed a statistically significant increase after 12 months of T therapy, in absence of heterogeneity (SMD 0.61 mg/l; 95% CI: 0.40-0.83; P < 0.0001; I2=0%, Pforheterogeneity=0.48).
Conclusion: Testosterone therapy among TM seems not to disrupt bone health after 12 and 24 months. A statistically significant increase in P1NP after 12 months of therapy may indicate a positive anabolic effect of testosterone in the short term.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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