Anike Olivia, Zhang Qi, Bhasin Shalender, Flanders W Dana, Getahun Darios, Haw J Sonya, Huybrechts Krista F, Lash Timothy L, McCracken Courtney E, Roblin Douglas, Silverberg Michael J, Suglia Shakira F, Tangpricha Vin, Vupputuri Suma, Goodman Michael
Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2024 Dec 18;110(1):289-296. doi: 10.1210/clinem/dgae353.
The long-term effect of gender-affirming hormone therapy (GAHT) on glucose metabolism is an area of priority in transgender health research.
To evaluate the relation between GAHT and changes in fasting blood glucose (FG) and glycosylated hemoglobin (HbA1c) in transmasculine (TM) and transfeminine (TF) persons relative to the corresponding temporal changes in presumably cisgender persons (ie, without any evidence of gender diversity).
Retrospective cohort study.
Three large integrated health systems.
A total of 2148 TF and 1679 TM persons compared with 28 036 cisgender males and 32 548 cisgender females enrolled in the same health plans.
OUTCOMES/MEASURES: Temporal changes in FG and HbA1c levels examined using linear mixed models with main results expressed as ratios-of-ratios.
The pre- vs post-GAHT ratios-of-ratio (95% CI) estimates adjusted for age, race/ethnicity, study site, and body mass index in the model comparing TF and cisgender males groups were 1.05 (1.01-1.09) for FG and 1.03 (0.99-1.06) for HbA1c. By contrast, the corresponding results in the models contrasting TM and cisgender cohort members were in the 0.99 to 1.00 range. The ratio-of-ratios comparing post-GAHT changes among transgender and cisgender persons were close to the null and without a discernable pattern.
Though the within-transgender cohort data suggest an increase in the levels of FG and HbA1c following feminizing GAHT initiation, these changes were no longer evident when compared with the corresponding changes in cisgender referents. Based on these results, clinically important effects of GAHT on routine laboratory markers of glucose metabolism appear unlikely.
性别确认激素疗法（GAHT）对糖代谢的长期影响是跨性别健康研究中的一个优先领域。
评估相对于假定的顺性别者（即没有任何性别多样性证据的人）的相应时间变化，GAHT与跨男性（TM）和跨女性（TF）人群空腹血糖（FG）和糖化血红蛋白（HbA1c）变化之间的关系。
回顾性队列研究。
三个大型综合卫生系统。
共有2148名TF和1679名TM人群，与参加相同健康计划的28036名顺性别男性和32548名顺性别女性进行比较。
结果/测量：使用线性混合模型检查FG和HbA1c水平的时间变化，主要结果以比率比表示。
在比较TF和顺性别男性组的模型中，经年龄、种族/族裔、研究地点和体重指数调整后的GAHT前后比率比（95%CI）估计值，FG为1.05（1.01-1.09），HbA1c为1.03（0.99-1.06）。相比之下，在对比TM和顺性别队列成员的模型中，相应结果在0.99至1.00范围内。比较跨性别者和顺性别者GAHT后变化的比率比接近零，且无明显模式。
尽管跨性别者队列数据表明女性化GAHT开始后FG和HbA1c水平有所升高，但与顺性别对照者的相应变化相比，这些变化不再明显。基于这些结果，GAHT对糖代谢常规实验室指标的临床重要影响似乎不太可能。
