The Utility of Preclinical Models in Understanding the Bone Health of Transgender Individuals Undergoing Gender-Affirming Hormone Therapy.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Current Osteoporosis Reports Pub Date : 2023-12-01 Epub Date: 2023-09-14 DOI:10.1007/s11914-023-00818-2

Varun S Venkatesh, Tian Nie, Jeffrey D Zajac, Mathis Grossmann, Rachel A Davey

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Abstract

Purpose of review: To summarise the evidence regarding the effects of gender-affirming hormone therapy (GAHT) on bone health in transgender people, to identify key knowledge gaps and how these gaps can be addressed using preclinical rodent models.

Recent findings: Sex hormones play a critical role in bone physiology, yet there is a paucity of research regarding the effects of GAHT on bone microstructure and fracture risk in transgender individuals. The controlled clinical studies required to yield fracture data are unethical to conduct making clinically translatable preclinical research of the utmost importance. Novel genetic and surgical preclinical models have yielded significant mechanistic insight into the roles of sex steroids on skeletal integrity. Preclinical models of GAHT have the potential inform clinical approaches to preserve skeletal integrity and prevent fractures in transgender people undergoing GAHT. This review highlights the key considerations required to ensure the information gained from preclinical models of GAHT are informative.

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临床前模型对了解接受性别确认激素疗法的变性人骨骼健康的实用性。

综述目的：总结有关性别确认激素疗法（GAHT）对变性人骨骼健康影响的证据，找出关键的知识差距，以及如何利用临床前啮齿动物模型来弥补这些差距：最近的研究结果：性激素在骨骼生理学中起着至关重要的作用，但有关 GAHT 对变性人骨骼微观结构和骨折风险影响的研究却很少。获得骨折数据所需的临床对照研究是不道德的，因此临床前研究的临床转化至关重要。新的遗传和外科临床前模型对性类固醇对骨骼完整性的作用产生了重要的机理认识。GAHT的临床前模型有可能为临床方法提供参考，以保护接受GAHT的变性人的骨骼完整性并预防骨折。本综述强调了确保从GAHT临床前模型中获得的信息具有参考价值所需的关键考虑因素。

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Current Osteoporosis Reports Medicine-Endocrinology, Diabetes and Metabolism

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8.80

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2.30%

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期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.