ESPE Abstracts (2021) 94 P2-407

1Pediatric Endocrinology, Gender Identity Unit, GIDSEEN, Research Institute BioCruces Bizkaia, Osakidetza, Cruces University Hospital, CIBERER, Bizkaia, Spain; 2Pediatric Endocrinology, Cruces University Hospital, Bizkaia, Spain; 3Pediatric Endocrinology, Gender Identity Unit, Research Institute BioCruces Bizkaia, Osakidetza, Cruces University Hospital, Bizkaia, Spain; 4Child and Adolescent Psychiatry, Gender Identity Unit, GIDSEEN, Osakidetza, Cruces University Hospital, Bizkaia, Spain


Objective: To study the impact of dual therapy on BMD and Inhibin B in a group of transsexual male adolescents who initiate treatment with advanced pubertal development.

Patients and methodology: Retrospective study of 16 male minors who initiated treatment (Triptorelin and later Testosterone) with complete pubertal development. Variables included: age, weight and height at baseline and at the last visit (calculated in SDS for assigned age and sex), BMD in L1L4 and total body (GE HealthCare’s LUNAR Densitometer: in g/cm2 and calculated in SDS for assigned age and sex), vitamin D and Inhibin B (Enzyme Immunoassay, normal range 25-325 pg/ml) as a marker of ovarian reserve. Statistical analysis with SPSS V25 software.

Results: Initial data: age 13.6±1.6 years, weight-SDS 0.96±1.7, height-SDS 0.1±1.4, BMD L1L4 1.12±0.18 g/cm2 (SDS 0.5±1.3), BMD total body 1.06±0.08 g/cm2 (SDS 0.84±1.03), Inhibin B 32.6±37.5 pg/ml. The determinations were repeated after 14±6 months of Triptorelin therapy (dose 60 µg/kg/4 weeks) and 13.2±8 months, after associating Testosterone (mean dose 113±52 mg/4 weeks). The results are shown in the table. BMD values are normal at baseline and during therapy. BMD-SDS decrease progressively throughout the treatment. The mean initial level of Inhibin B is normal, seems to decrease during Triptorelin therapy and to normalize when Testosterone is associated, (differences are not statistically significant). Vitamin D levels remain low despite replacement therapy. Weight-SDS in the last visit is, on average, in the limits of overweight.

BASELINE TRIPTORELINTESTOSTERONEP
Age (years) 13.6±1.6 14.8±1.3 15.8±0.9 -
BMD L1L4 (g/cm2) 1.12±0.18 1.14±0.16 1.12±0.14 ns
BMD L1L4 (SDS) 0.5±1.3 0.26±1.5 - 0.37±0.94 0.002
BMD total body (g/cm2) 1.06±0.08 1.02±0.09 1.05±0.08 ns
BMD total body (SDS) 0.84±1.03 0.66±1.08 0.33±1.04 0.006
Inhibin B (pg/ml) 32.6±37.5 14.4±15.7 31.0±29.2ns
BASELINELAST VISIT
Age (years)13.6±1.617.2±1.3 -
Vitamin D (ng/ml)18.2±7.121.1±6.1 ns
Weight (kg) -70.6±19.9 -
Weight (SDS)0.96±1.71.64±2.1 ns
Height (cm) -163.6±10.1 -
Height (SDS)0.1±1.450.02±1.7 ns
Test Wilcoxon

Conclusions: The physiological increase in BMD (g/cm2) at this age it´s not observed but a significant decrease doesn´t appear. Inhibin B doesn´t undergo relevant modifications. Long-term studies are required to ensure the safety of dual therapy.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

Online,
22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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