《稳定接受激素治疗的跨性别男性的生殖内分泌参考区间》

Reproductive Endocrinology Reference Intervals for Transgender Men on Stable Hormone Therapy.

机构信息

Department of Laboratory Medicine, University of Washington, Seattle, WA.

Department of Pathology, University of Utah, Salt Lake City, UT.

出版信息

J Appl Lab Med. 2021 Jan 12;6(1):41-50. doi: 10.1093/jalm/jfaa169.

DOI:10.1093/jalm/jfaa169

PMID:33241847

Abstract

BACKGROUND

Gender-affirming therapy with testosterone is commonly prescribed to aid in the masculinization of transgender men. Sex-hormone concentrations are routinely measured, but interpretation of results can be difficult due to the lack of published reference intervals.

METHODS

Healthy transgender individuals who had been prescribed testosterone (n = 82) for at least a year were recruited from internal medicine and primary care clinics that specialize in transgender medical care. Total testosterone and estradiol were measured using immunoassay and mass spectrometry; LH, FSH, SHBG, prolactin, progesterone, anti-Müllerian hormone (AMH), and dehydroepiandrosterone sulfate (DHEAS) were measured using immunoassay; free testosterone was calculated. Reference intervals (central 95%) were calculated according to Clinical Laboratory Standards Institute guidelines.

RESULTS

When evaluating general endocrine laboratory tests in people using masculinizing hormones, reference intervals for cisgender men can be applied for total and free testosterone and SHBG and reference intervals for cisgender women can be applied for prolactin. Reference intervals for estradiol, LH, FSH, AMH, and DHEAS differ from those used for cisgender men and cisgender women, and therefore should be interpreted using intervals specific to the transmasculine population. For testosterone and estradiol, results from immunoassays were clinically equivalent to mass spectrometry.

CONCLUSION

Masculinizing hormones will alter the concentrations of commonly evaluated endocrine hormones. Providers and laboratories should use appropriate reference intervals to interpret the results of these tests.

摘要

背景

为了帮助跨性别男性实现男性化，通常会开处睾丸激素的性别肯定治疗。经常测量性激素浓度，但由于缺乏已发表的参考区间，因此结果的解释可能很困难。

方法

从专门从事跨性别医疗保健的内科和初级保健诊所招募了至少服用一年睾丸激素（n = 82）的健康跨性别个体。使用免疫测定法和质谱法测量总睾酮和雌二醇；使用免疫测定法测量 LH、FSH、SHBG、催乳素、孕酮、抗苗勒氏管激素（AMH）和硫酸脱氢表雄酮（DHEAS）；计算游离睾酮。根据临床实验室标准协会指南计算参考区间（中央 95％）。

结果

在评估使用男性化激素的人群中的一般内分泌实验室检查时，可以将 cisgender 男性的总睾酮和游离睾酮以及 SHBG 的参考区间应用于 cisgender 女性的催乳素。雌二醇、LH、FSH、AMH 和 DHEAS 的参考区间与 cisgender 男性和 cisgender 女性的参考区间不同，因此应使用特定于跨男性群体的区间进行解释。对于睾酮和雌二醇，免疫测定法的结果与质谱法具有临床等效性。