Rahman Saad Ur, Manasrah Nouraldeen, Kumar Nomesh, Hamza Mohammad, Sharma Aakanksha, Patel Neel, Patel Bansari, Naseem Masooma, Razzaq Saman, Gill Seemab Imtiaz, Naveed Hamza, Harmouch Khaled M, Bahar Yasemin, Aamir Muhammad, Sattar Yasar, Alraies M Chadi
Division of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
Division of Cardiovascular Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
JACC Adv. 2024 Sep 9;3(10):101265. doi: 10.1016/j.jacadv.2024.101265. eCollection 2024 Oct.
Gender-affirming hormone therapy (GAHT) is common among transgender individuals, but its impact on lipid profile and cardiovascular health is not well studied.
The authors performed a systematic review and meta-analysis of existing literature to assess the impact of GAHT on lipid profiles and metabolic cardiovascular risk factors in transgender individuals.
Online databases including MEDLINE/PubMed, Embase, and Cochrane Central registry were searched to find studies on lipid profile changes in women who are transgender, also referred to as transfeminine (TF), and men who are transgender, also referred to as transmasculine (TM) before and after GAHT. Baseline comorbidities were analyzed using descriptive statistics, and R-statistical software was used to analyze the mean difference in lipid profile change between the two cohorts (pre- and post-GAHT therapy) including transgender patients.
Overall, 1,241 TM and 992 TF patients were included from 12 observational studies and 12 randomized controlled trials. The mean age among TM and TF was 28 years and 30 years, respectively. The mean follow-up duration (including pre- and post-GAHT therapy) was 28 months in TM patients and 39 months in TF patients. When compared to baseline measures, TM patients had a significant increase in low-density lipoprotein, triglyceride levels, and total cholesterol while high-density lipoprotein levels decreased. In TF patients, there was a significant increase in triglyceride levels.
GAHT affects lipid profiles in transgender patients; however, additional studies are needed to determine how these changes impact clinical outcomes.
性别确认激素疗法（GAHT）在跨性别者中很常见，但其对血脂谱和心血管健康的影响尚未得到充分研究。
作者对现有文献进行了系统评价和荟萃分析，以评估GAHT对跨性别者血脂谱和代谢性心血管危险因素的影响。
检索包括MEDLINE/PubMed、Embase和Cochrane中心注册库在内的在线数据库，以查找关于跨性别女性（也称为女性向男性转变者，TF）和跨性别男性（也称为男性向女性转变者，TM）在GAHT前后血脂谱变化的研究。使用描述性统计分析基线合并症，并使用R统计软件分析包括跨性别患者在内的两个队列（GAHT治疗前和治疗后）血脂谱变化的平均差异。
总体而言，12项观察性研究和12项随机对照试验纳入了1241名TM患者和992名TF患者。TM和TF的平均年龄分别为28岁和30岁。TM患者的平均随访时间（包括GAHT治疗前和治疗后）为28个月，TF患者为39个月。与基线测量值相比，TM患者的低密度脂蛋白、甘油三酯水平和总胆固醇显著升高，而高密度脂蛋白水平降低。在TF患者中，甘油三酯水平显著升高。
GAHT会影响跨性别患者的血脂谱；然而，需要更多的研究来确定这些变化如何影响临床结局。
