Department of Medicine, Section of Endocrinology, Yale School of Medicine, New Haven, CT, USA.
Yale Department of Obstetrics, Gynecology and Reproductive Sciences. and Gynecology, Yale School of Medicine, New Haven, CT, USA.
Clin Endocrinol (Oxf). 2020 Feb;92(2):138-144. doi: 10.1111/cen.14132. Epub 2019 Dec 13.
Transgender men (TGM) are persons assigned female gender at birth with a male gender identity and are routinely treated with testosterone. Androgen excess is associated with endothelial dysfunction among cisgender females (CGF) and is an early sign of atherosclerosis and hypertension.
To determine the effect of testosterone treatment on endothelial function in TGM.
The John B. Pierce Laboratory and Yale School of Medicine.
Eleven TGM (age 27 ± 5 years; BMI 24.4 ± 3.7 kg/m ) receiving testosterone (T) and 20 CGF (28 ± 5 years; BMI 26.0 ± 5.1 kg/m ) during the early follicular phase of their menstrual cycle.
We evaluated brachial vasodilatory responses following stimuli designed to elicit shear stress using 5-minute occlusion to determine endothelial function (flow-mediated vasodilation, FMD).
Total T was greater in the TGM compared to CGF (484.6 ± 122.5 vs 1.5 ± 0.7 ng/dL), as was free T (83.9 ± 32.4 vs 1.9 ± 0.8 pg/dL). FMD was markedly lower in the TGM (4.5 ± 2.7%) compared to the CGF (8.1 ± 2.9%, P = .002) indicating significantly diminished endothelial function in TGM.
We have shown for the first time that in TGM the androgen-dominant hormonal milieu was associated with impaired endothelial function. Endothelial dysfunction precedes clinically detectable atherosclerotic plaque in the coronary arteries, so is an important marker for clinical cardiovascular risk. Therefore, attention to cardiovascular risk factors should be integral to the care of transgender men.
跨性别男性（TGM）是指出生时被指定为女性性别但具有男性性别认同的人，他们通常接受睾酮治疗。在顺性别女性（CGF）中，雄激素过多与血管内皮功能障碍有关，是动脉粥样硬化和高血压的早期征象。
确定睾酮治疗对 TGM 内皮功能的影响。
约翰·B·皮尔斯实验室和耶鲁大学医学院。
11 名接受睾酮（T）治疗的 TGM（年龄 27 ± 5 岁；BMI 24.4 ± 3.7 kg/m ）和 20 名处于月经周期早期卵泡期的 CGF（28 ± 5 岁；BMI 26.0 ± 5.1 kg/m ）。
我们通过 5 分钟的闭塞来评估肱动脉舒张反应，以确定内皮功能（血流介导的血管舒张，FMD），从而评估刺激引起的剪切应力下的血管舒张反应。
与 CGF 相比，TGM 的总睾酮（484.6 ± 122.5 与 1.5 ± 0.7 ng/dL）和游离睾酮（83.9 ± 32.4 与 1.9 ± 0.8 pg/dL）更高。TGM 的 FMD 明显低于 CGF（4.5 ± 2.7%比 8.1 ± 2.9%，P =.002），表明 TGM 的内皮功能明显受损。
我们首次表明，在 TGM 中，雄激素占主导地位的激素环境与内皮功能障碍有关。内皮功能障碍先于冠状动脉中可检测到的动脉粥样硬化斑块，因此是临床心血管风险的重要标志物。因此，关注心血管危险因素应成为跨性别男性护理的重要组成部分。
