Steininger Jojo, Widmann Katalin, Kaufmann Ulrike, Hager Marlene, Marculescu Rodrig, Krysiak Robert, Ott Johannes
Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
Department of Laboratory Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
Biomedicines. 2024 Dec 30;13(1):66. doi: 10.3390/biomedicines13010066.
Gender-affirming hormone therapy (GAHT) is known to influence the lipid profiles of trans men and transmasculine individuals. Recent data show that moderate prolactin (PRL) elevations might exert beneficial metabolic effects ("HomeoFIT-PRL model"). The aim of this study is to investigate changes in PRL levels and possible associations between PRL and lipid profiles in this population after a year of GAHT. In a retrospective cohort study, 97 participants, who received GAHT with testosterone, were included. Blood lipids, PRL, and sex steroid hormone levels were evaluated prior to and at 10-14 months after treatment started. The difference in PRL levels between baseline and follow-up was significant ( = 0.007) with a median difference of +2.3 ng/mL. Concerning blood lipids, the decline in high-density lipoprotein cholesterol (HDL-C) reached statistical significance (median 56 mg/dL versus 50 mg/dL; < 0.001), and low-density lipoprotein cholesterol (LDL-C) and triglyceride levels increased ( = 0.023 and = 0.045, respectively). Individuals with a PRL > 25 ng/mL at follow-up (n = 20, 20.6%) revealed increases in total cholesterol and LDL-C significantly less often. Overall, participants frequently displayed unfavorable changes in their lipid profile after 10-14 months of GAHT, as well as a slight but significant increase in PRL. About 20% of patients showed mild-to-moderate hyperprolactinemia (PRL > 25 ng/mL). However, such changes were associated with potentially beneficial dynamics in the lipid profile, at least for triglycerides. These findings seem in line with the HomeoFIT-PRL model suggesting that moderate elevations in PRL levels might exert beneficial metabolic effects. Increases in PRL after testosterone were common.
已知性别肯定激素疗法（GAHT）会影响跨性别男性和具有男性特征的个体的血脂水平。最近的数据表明，催乳素（PRL）适度升高可能会产生有益的代谢作用（“HomeoFIT-PRL模型”）。本研究的目的是调查GAHT治疗一年后该人群中PRL水平的变化以及PRL与血脂水平之间可能存在的关联。在一项回顾性队列研究中，纳入了97名接受睾酮GAHT治疗的参与者。在治疗开始前以及开始治疗10 - 14个月时评估血脂、PRL和性类固醇激素水平。基线和随访之间PRL水平的差异具有统计学意义（P = 0.007），中位数差异为 +2.3 ng/mL。关于血脂，高密度脂蛋白胆固醇（HDL-C）的下降达到统计学意义（中位数从56 mg/dL降至50 mg/dL；P < 0.001），低密度脂蛋白胆固醇（LDL-C）和甘油三酯水平升高（分别为P = 0.023和P = 0.045）。随访时PRL > 25 ng/mL的个体（n = 20，20.6%）总胆固醇和LDL-C升高的情况明显较少。总体而言，参与者在接受GAHT治疗10 - 14个月后血脂谱经常出现不利变化，同时PRL有轻微但显著的升高。约20%的患者出现轻度至中度高催乳素血症（PRL > 25 ng/mL）。然而，这些变化与血脂谱中潜在的有益动态相关，至少对于甘油三酯是如此。这些发现似乎与HomeoFIT-PRL模型一致，表明PRL水平适度升高可能会产生有益的代谢作用。睾酮治疗后PRL升高很常见。
