Hamid Rauf, Güllüce Abdulkadir, Kargın Osman A, Karagöz Seyfullah H, Adaletli İbrahim, Çepni İsmail, Tüten Abdullah
Department of Radiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul TR-34320, Turkey.
Department of Obstetrics and Gynecology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul TR-34320, Turkey.
J Clin Med. 2024 Oct 9;13(19):6001. doi: 10.3390/jcm13196001.
Transgender men use exogenous androgen for male pattern virilization. Hysterectomy and bilateral salpingo-oophorectomy (HBSO) is performed to stop the endogenous estrogen secretion. Cardiovascular disease (CVD) risk has been shown to increase with long-term use of androgens and the removal of estrogen. We aimed to investigate the CVD risk in these individuals by measuring internal and common carotid artery intima-media thicknesses (CIMT). In this cohort study, data were collected from transgender men who had undergone HBSO and used androgens for at least two years (median treatment duration was 5 years in our research). Cisgender women in the same age range were selected as the control group. Demographics, vital signs, and hematological values of transgender patients and cisgender women subjects in the control group were noted. CVD markers were compared with sonographically measured CIMT values. The mean age and body mass index (BMI) of the study group were 32.6 and 25.3, respectively. Weight, systolic-diastolic blood pressure, hemoglobin, hematocrit, low-density lipoprotein (LDL), serum triglyceride (TG), HbA1c levels, internal CIMT, and common CIMT values of the study group were higher, while the high-density lipoprotein (HDL) level was significantly lower compared the control group (p1 = 0.025, p2 = 0.010, p3 = 0.002, p4 = 0.001, p5 = 0.001, p6 = 0.012, p7 = 0.008, p8 = 0.007, p9 = 0.013, and p10 = 0.001). There was also an increase in the body weight, BMI, LDL, and TG levels of the study group after the testosterone treatment (p1 = 0.025, p2 = 0.019, p3 = 0.001, p4 = 0.001, and p5 = 0.001). We demonstrated that the use of testosterone therapy in transgender men is associated with higher CIMT values. While further investigation is needed to assess morbidity and mortality rates, we recommend that regular clinical and radiological examinations be performed in these individuals to accurately evaluate the risk of CVD.
跨性别男性使用外源性雄激素来实现男性化特征。进行子宫切除术和双侧输卵管卵巢切除术（HBSO）以停止内源性雌激素分泌。长期使用雄激素和去除雌激素已被证明会增加心血管疾病（CVD）风险。我们旨在通过测量颈内动脉和颈总动脉内膜中层厚度（CIMT）来调查这些个体的CVD风险。在这项队列研究中，收集了接受HBSO且使用雄激素至少两年（我们研究中的中位治疗持续时间为5年）的跨性别男性的数据。选择相同年龄范围的顺性别女性作为对照组。记录了跨性别患者和对照组中顺性别女性受试者的人口统计学、生命体征和血液学值。将心血管疾病标志物与超声测量的CIMT值进行比较。研究组的平均年龄和体重指数（BMI）分别为32.6和25.3。研究组的体重、收缩压 - 舒张压、血红蛋白、血细胞比容、低密度脂蛋白（LDL）、血清甘油三酯（TG）、糖化血红蛋白（HbA1c）水平、颈内CIMT和颈总CIMT值均较高，而高密度脂蛋白（HDL）水平与对照组相比显著较低（p1 = 0.025，p2 = 0.010，p3 = 0.002，p4 = 0.001，p5 = 0.001，p6 = 0.012，p7 = 0.008，p8 = 0.007，p9 = 0.013，p10 = 0.001）。睾酮治疗后，研究组的体重、BMI、LDL和TG水平也有所增加（p1 = 0.025，p2 = 0.019，p3 = 0.001，p4 = 0.001，p5 = 0.001）。我们证明，跨性别男性使用睾酮治疗与较高的CIMT值相关。虽然需要进一步调查以评估发病率和死亡率，但我们建议对这些个体进行定期的临床和放射学检查，以准确评估心血管疾病风险。
