Tatarian Joshua, Walcott Quinnlyn, Richardson Kimberly
University of Kansas School of Medicine, Kansas City, Kansas, USA.
Department of Internal Medicine, Division of General, Geriatric & Hospital Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
LGBT Health. 2023 Jan;10(1):72-79. doi: 10.1089/lgbt.2022.0027. Epub 2022 Aug 3.
The goal of this study was to evaluate contributing factors and management strategies for polycythemia in transmasculine patients on testosterone therapy. A retrospective analysis of medical records was performed for transmasculine patients on testosterone for at least 12 months. Data collected from each patient included age, body mass index (BMI), nicotine dependence, pulmonary disease status, obstructive sleep apnea (OSA) status, oophorectomy status, and testosterone route of administration. For patients who developed polycythemia, polycythemia management strategy data were collected. Five-hundred-eleven patients were evaluated and 113 (22%) experienced an episode of polycythemia. Within the polycythemia group, 77% of patients were younger than age 40, 56% had a BMI >30.0, 44% had current or former nicotine dependence, 12% had a pulmonary disease, 12% had OSA, and 47% had received an oophorectomy. The polycythemia group had a significantly higher average age, BMI, and dose of testosterone, and also had a higher proportion of patients with OSA and an oophorectomy. These results revealed that polycythemia is a common side effect for transmasculine patients on testosterone. Importantly, previous oophorectomy may be associated with polycythemia which appears to be a novel finding. This finding requires further research but provides the potential to be an important screening consideration for transmasculine patients after oophorectomy. Polycythemia will continue to be a major concern for patients on testosterone therapy, and this study provided important information for clinical practice and future research that will lead to improved outcomes.
本研究的目的是评估接受睾酮治疗的男性跨性别患者发生红细胞增多症的相关因素及管理策略。对接受睾酮治疗至少12个月的男性跨性别患者的病历进行了回顾性分析。从每位患者收集的数据包括年龄、体重指数（BMI）、尼古丁依赖情况、肺部疾病状况、阻塞性睡眠呼吸暂停（OSA）状况、卵巢切除术状况以及睾酮给药途径。对于发生红细胞增多症的患者，收集了红细胞增多症的管理策略数据。共评估了511例患者，其中113例（22%）发生过红细胞增多症。在红细胞增多症组中，77%的患者年龄小于40岁，56%的患者BMI>30.0，44%的患者有当前或既往尼古丁依赖，12%的患者有肺部疾病，12%的患者有OSA，47%的患者接受过卵巢切除术。红细胞增多症组的平均年龄、BMI和睾酮剂量显著更高，且OSA患者和接受卵巢切除术的患者比例也更高。这些结果表明，红细胞增多症是接受睾酮治疗的男性跨性别患者的常见副作用。重要的是，既往卵巢切除术可能与红细胞增多症有关，这似乎是一个新发现。这一发现需要进一步研究，但有可能成为男性跨性别患者卵巢切除术后重要的筛查考虑因素。红细胞增多症仍将是接受睾酮治疗患者的主要关注点，本研究为临床实践和未来研究提供了重要信息，将有助于改善治疗结果。
