{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:15:40Z","timestamp":1791281740641,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T00:00:00Z","timestamp":1524528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["CNPq\/INCT 465482\/2014\u20107"],"award-info":[{"award-number":["CNPq\/INCT 465482\/2014\u20107"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cross\u2010sex hormone therapy (<jats:styled-content style=\"fixed-case\">CSHT<\/jats:styled-content>) has been associated with changes in bone and lean\/fat mass. This study assessed bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>), appendicular lean mass (<jats:styled-content style=\"fixed-case\">ALM<\/jats:styled-content>), and total fat mass in transwomen undergoing <jats:styled-content style=\"fixed-case\">CSHT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Design<\/jats:title><jats:p>We evaluated 142 transwomen (mean age: 33.7\u00a0\u00b1\u00a010.3\u00a0years; <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>: 25.4\u00a0\u00b1\u00a04.6; 86.6% with previous <jats:styled-content style=\"fixed-case\">CSHT<\/jats:styled-content>) during the first 3\u00a0months of regular oestrogen treatment (with or without anti\u2010androgens). A reference group including 22 men and 17 cis women was also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Clinical and hormonal evaluation and dual\u2010energy X\u2010ray absorptiometry (<jats:styled-content style=\"fixed-case\">DXA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bone mineral density was similar in trans and reference women, and lower at all sites in transwomen vs men. Low bone mass for age was observed in 18% of transwomen at baseline vs none of the reference women or men. Appendicular lean mass and total fat mass were positively correlated with L1\u2010L4 <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>, explaining 14.9% of the observed variation in lumbar spine <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> and 20.6% of the variation in total femur <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>. Appendicular lean mass was similar in trans and reference women, and lower in transwomen vs men. Total fat mass was lower in trans vs reference women. Densitometry was repeated after a mean of 31.3\u00a0\u00b1\u00a06.5\u00a0months in 46 transwomen. There was a significant increase in total fat mass and a significant decrease in <jats:styled-content style=\"fixed-case\">ALM<\/jats:styled-content>. Bone mineral density remained stable over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The fairly high prevalence of low bone mass in this sample of transwomen from southern Brazil seems to be related to lower <jats:styled-content style=\"fixed-case\">ALM<\/jats:styled-content>. Non\u2010pharmacological lifestyle\u2010related strategies for preventing bone loss could be beneficial for transgender women receiving long\u2010term <jats:styled-content style=\"fixed-case\">CSHT<\/jats:styled-content><jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13607","type":"journal-article","created":{"date-parts":[[2018,4,9]],"date-time":"2018-04-09T20:48:12Z","timestamp":1523306892000},"page":"856-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Impact of cross\u2010sex hormone therapy on bone mineral density and body composition in transwomen"],"prefix":"10.1111","volume":"88","author":[{"given":"Tayane Muniz","family":"Fighera","sequence":"first","affiliation":[{"name":"Gynecological Endocrinology Unit Division of Endocrinology Hospital de Cl\u00ednicas de Porto Alegre  Porto Alegre Brazil"},{"name":"Gender Identity Program Hospital de Cl\u00ednicas de Porto Alegre  Porto 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