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Testosterone restores body composition, bone mass, and bone strength following early puberty suppression in a mouse model mimicking the clinical strategy in trans boys

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Abstract
Transgender youth increasingly present at pediatric gender services. Some of them receive long-term puberty suppression with gonadotropin-releasing hormone analogues (GnRHa) before starting gender-affirming hormones (GAH). The impact of GnRHa use started in early puberty on bone composition and bone mass accrual is unexplored. It is furthermore unclear whether subsequent GAH fully restore GnRHa effects and whether the timing of GAH introduction matters. To answer these questions, we developed a mouse model mimicking the clinical strategy applied in trans boys. Prepubertal 4-week-old female mice were treated with GnRHa alone or with GnRHa supplemented with testosterone (T) from 6 weeks (early puberty) or 8 weeks (late puberty) onward. Outcomes were analyzed at 16 weeks and compared with untreated mice of both sexes. GnRHa markedly increased total body fat mass, decreased lean body mass, and had a modest negative impact on grip strength. Both early and late T administration shaped body composition to adult male levels, whereas grip strength was restored to female values. GnRHa-treated animals showed lower trabecular bone volume and reduced cortical bone mass and strength. These changes were reversed by T to female levels (cortical bone mass and strength) irrespective of the time of administration or even fully up to adult male control values (trabecular parameters) in case of earlier T start. The lower bone mass in GnRHa-treated mice was associated with increased bone marrow adiposity, also reversed by T. In conclusion, prolonged GnRHa use started in prepubertal female mice modifies body composition toward more fat and less lean mass and impairs bone mass acquisition and strength. Subsequent T administration counteracts GnRHa impact on these parameters, shaping body composition and trabecular parameters to male values while restoring cortical bone architecture and strength up to female but not male control levels. These findings could help guide clinical strategies in transgender care. (c) 2023 American Society for Bone and Mineral Research (ASBMR).
Keywords
GnRHa, body composition, bone, mouse model, testosterone, transgender, ANDROGEN DEFICIENCY, TRANSGENDER, ESTROGEN, DIFFERENTIATION, ADOLESCENTS, OSTEOBLAST, THERAPY, DENSITY, CELLS, STEM

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MLA
Dubois, Vanessa, et al. “Testosterone Restores Body Composition, Bone Mass, and Bone Strength Following Early Puberty Suppression in a Mouse Model Mimicking the Clinical Strategy in Trans Boys.” JOURNAL OF BONE AND MINERAL RESEARCH, vol. 38, no. 10, 2023, pp. 1497–508, doi:10.1002/jbmr.4832.
APA
Dubois, V., Ciancia, S., Doms, S., El Kharraz, S., Sommers, V., Kim, N. R., … Vanderschueren, D. (2023). Testosterone restores body composition, bone mass, and bone strength following early puberty suppression in a mouse model mimicking the clinical strategy in trans boys. JOURNAL OF BONE AND MINERAL RESEARCH, 38(10), 1497–1508. https://doi.org/10.1002/jbmr.4832
Chicago author-date
Dubois, Vanessa, Silvia Ciancia, Stefanie Doms, Sarah El Kharraz, Vera Sommers, Na Ri Kim, Karel David, et al. 2023. “Testosterone Restores Body Composition, Bone Mass, and Bone Strength Following Early Puberty Suppression in a Mouse Model Mimicking the Clinical Strategy in Trans Boys.” JOURNAL OF BONE AND MINERAL RESEARCH 38 (10): 1497–1508. https://doi.org/10.1002/jbmr.4832.
Chicago author-date (all authors)
Dubois, Vanessa, Silvia Ciancia, Stefanie Doms, Sarah El Kharraz, Vera Sommers, Na Ri Kim, Karel David, Jolien Van Dijck, Roger Valle Tenney, Christa Maes, Leen Antonio, Brigitte Decallonne, Geert Carmeliet, Frank Claessens, Martine Cools, and Dirk Vanderschueren. 2023. “Testosterone Restores Body Composition, Bone Mass, and Bone Strength Following Early Puberty Suppression in a Mouse Model Mimicking the Clinical Strategy in Trans Boys.” JOURNAL OF BONE AND MINERAL RESEARCH 38 (10): 1497–1508. doi:10.1002/jbmr.4832.
Vancouver
1.
Dubois V, Ciancia S, Doms S, El Kharraz S, Sommers V, Kim NR, et al. Testosterone restores body composition, bone mass, and bone strength following early puberty suppression in a mouse model mimicking the clinical strategy in trans boys. JOURNAL OF BONE AND MINERAL RESEARCH. 2023;38(10):1497–508.
IEEE
[1]
V. Dubois et al., “Testosterone restores body composition, bone mass, and bone strength following early puberty suppression in a mouse model mimicking the clinical strategy in trans boys,” JOURNAL OF BONE AND MINERAL RESEARCH, vol. 38, no. 10, pp. 1497–1508, 2023.
@article{01H1NZ8EEEPT82A4Z2VQ0K2K21,
  abstract     = {{Transgender youth increasingly present at pediatric gender services. Some of them receive long-term puberty suppression with gonadotropin-releasing hormone analogues (GnRHa) before starting gender-affirming hormones (GAH). The impact of GnRHa use started in early puberty on bone composition and bone mass accrual is unexplored. It is furthermore unclear whether subsequent GAH fully restore GnRHa effects and whether the timing of GAH introduction matters. To answer these questions, we developed a mouse model mimicking the clinical strategy applied in trans boys. Prepubertal 4-week-old female mice were treated with GnRHa alone or with GnRHa supplemented with testosterone (T) from 6 weeks (early puberty) or 8 weeks (late puberty) onward. Outcomes were analyzed at 16 weeks and compared with untreated mice of both sexes. GnRHa markedly increased total body fat mass, decreased lean body mass, and had a modest negative impact on grip strength. Both early and late T administration shaped body composition to adult male levels, whereas grip strength was restored to female values. GnRHa-treated animals showed lower trabecular bone volume and reduced cortical bone mass and strength. These changes were reversed by T to female levels (cortical bone mass and strength) irrespective of the time of administration or even fully up to adult male control values (trabecular parameters) in case of earlier T start. The lower bone mass in GnRHa-treated mice was associated with increased bone marrow adiposity, also reversed by T. In conclusion, prolonged GnRHa use started in prepubertal female mice modifies body composition toward more fat and less lean mass and impairs bone mass acquisition and strength. Subsequent T administration counteracts GnRHa impact on these parameters, shaping body composition and trabecular parameters to male values while restoring cortical bone architecture and strength up to female but not male control levels. These findings could help guide clinical strategies in transgender care. (c) 2023 American Society for Bone and Mineral Research (ASBMR).}},
  author       = {{Dubois, Vanessa and Ciancia, Silvia and  Doms, Stefanie and  El Kharraz, Sarah and  Sommers, Vera and  Kim, Na Ri and  David, Karel and  Van Dijck, Jolien and  Valle Tenney, Roger and  Maes, Christa and  Antonio, Leen and  Decallonne, Brigitte and  Carmeliet, Geert and  Claessens, Frank and Cools, Martine and Vanderschueren, Dirk}},
  issn         = {{0884-0431}},
  journal      = {{JOURNAL OF BONE AND MINERAL RESEARCH}},
  keywords     = {{GnRHa,body composition,bone,mouse model,testosterone,transgender,ANDROGEN DEFICIENCY,TRANSGENDER,ESTROGEN,DIFFERENTIATION,ADOLESCENTS,OSTEOBLAST,THERAPY,DENSITY,CELLS,STEM}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1497--1508}},
  title        = {{Testosterone restores body composition, bone mass, and bone strength following early puberty suppression in a mouse model mimicking the clinical strategy in trans boys}},
  url          = {{http://doi.org/10.1002/jbmr.4832}},
  volume       = {{38}},
  year         = {{2023}},
}

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