Division of Endocrinology and Metabolism, Department of Medicine, Taipei. Veterans General Hospital, Taipei, Taiwan, ROC.
Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2021 Mar 1;84(3):267-272. doi: 10.1097/JCMA.0000000000000475.
Transgender individuals often require gender-affirming interventions, such as endogenous sex hormone inhibition or gender-affirming hormone therapy (HT), while there is discordance between their body and gender identity. However, a recent study found that the incidence of cardiovascular events is higher in transgender patients receiving cross-sex HT. The aim of this study was to investigate the metabolic effects of an altered sex hormone profile.
This retrospective study, conducted in a referral center in Northern Taiwan, analyzed metabolic changes over time in 65 trans masculine and 45 trans feminine persons. The transgender individuals were examined at 4 time points: before the gender affirming HT, as well as 3, 6, and 12 months following treatment.
Compared with baseline measurements, the trans masculine patients showed significant increases in body mass index (BMI) (22.6 ± 0.3 vs 23.3 ± 0.4 kg/m2; p < 0.001; t = 3M), low-density lipoprotein cholesterol (124.3 ± 3.7 vs 131.3 ± 3.9 mg/dL; p = 0.03; t = 12M), creatinine (0.75 ± 0.01 vs 0.83 ± 0.14 mg/dL; p < 0.001; t = 12M), and hemoglobin (13.5 ± 0.7 vs 15.2 ± 0.2 g/dL; p < 0.001; t = 12M), as well as decreased high-density lipoprotein cholesterol (57 ± 2.1 vs 51 ± 2.0 mg/dL; p < 0.001; t = 12M). The trans feminine patients had reduced low-density lipoprotein cholesterol (104.2 ± 3.2 vs 100.8 ± 3.5 mg/dL; p = 0.05; t = 3M), hemoglobin (14.0 ± 0.1 vs 13.5 ± 0.1 g/dL; p = 0.008; t = 12M), and creatinine (0.82 ± 0.01 vs 0.79 ± 0.14 mg/dL; p < 0.001; t = 3M) compared with baseline data. In addition, most of these metabolic effects persisted during the follow-up period.
This observational, retrospective study revealed that gender-affirming HT increased the relative cardiovascular risk in trans masculine individuals.
transgender 个体通常需要性别肯定干预，例如内源性性激素抑制或性别肯定激素治疗（HT），而他们的身体和性别认同之间存在不一致。然而，最近的一项研究发现，接受跨性别 HT 的 transgender 患者发生心血管事件的风险更高。本研究旨在探讨改变的性激素谱的代谢影响。
这项在台湾北部一个转诊中心进行的回顾性研究，分析了 65 名跨男性和 45 名跨女性个体随时间的代谢变化。 transgender 个体在 4 个时间点接受检查：在进行性别肯定 HT 之前，以及治疗后 3、6 和 12 个月。
与基线测量相比，跨男性患者的体重指数（BMI）（22.6 ± 0.3 与 23.3 ± 0.4 kg/m2；p < 0.001；t = 3M）、低密度脂蛋白胆固醇（124.3 ± 3.7 与 131.3 ± 3.9 mg/dL；p = 0.03；t = 12M）、肌酐（0.75 ± 0.01 与 0.83 ± 0.14 mg/dL；p < 0.001；t = 12M）和血红蛋白（13.5 ± 0.7 与 15.2 ± 0.2 g/dL；p < 0.001；t = 12M）均显著增加，高密度脂蛋白胆固醇（57 ± 2.1 与 51 ± 2.0 mg/dL；p < 0.001；t = 12M）则降低。跨女性患者的低密度脂蛋白胆固醇（104.2 ± 3.2 与 100.8 ± 3.5 mg/dL；p = 0.05；t = 3M）、血红蛋白（14.0 ± 0.1 与 13.5 ± 0.1 g/dL；p = 0.008；t = 12M）和肌酐（0.82 ± 0.01 与 0.79 ± 0.14 mg/dL；p < 0.001；t = 3M）与基线数据相比均降低。此外，这些代谢影响中的大多数在随访期间持续存在。
这项观察性、回顾性研究表明，性别肯定 HT 增加了跨男性个体的相对心血管风险。
