ESPE Abstracts

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.

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.