Pattar Badal S B, Harrison Tyrone G, Saad Nathalie, Dumanski Sandra M, Lowik A J, Ronksley Paul E, Greene Dina N, Whitley Cameron T, Rytz Chantal L, Turino Miranda Keila, Peace Lindsay, Newbert Amelia M, Sola Darlene Y, Ahmed Sofia B
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada.
Biol Sex Differ. 2025 Jun 17;16(1):44. doi: 10.1186/s13293-025-00726-3.
Gender-affirming testosterone therapy (GATT) use may be associated with increased systolic blood pressure (SBP). The association between serum testosterone and cardiovascular health in individuals using GATT is unknown. The objective of this study was to estimate the association between serum testosterone and validated measures of cardiovascular health, including SBP and arterial stiffness, in persons assigned female sex at birth using GATT.
Healthy participants assigned female sex at birth on a stable GATT regimen for ≥ 4 months were recruited to this community-partnered exploratory cross-sectional study. Exposures of interest were total and free serum testosterone concentration. As our primary outcome, SBP was measured by an automated sphygmomanometer, and carotid-radial pulse wave velocity (PWVcr) and aortic augmentation index (AIx) were used to measure arterial stiffness via applanation tonometry.
Participants (n = 18, median age 28 years, range: 18, 50) who predominantly self-identified as white (94%) and had been using GATT for a median of 48 months (range: 5, 84) were studied. Resting SBP, PWVcr, and AIx were 113 mmHg (range: 102, 129), 7 m/s (range: 4, 9), and 9% (range: - 10, 23), respectively. Total and free serum testosterone were not significantly associated with SBP or PWVcr. Free, but not total, serum testosterone was positively associated with AIx (p = 0.03). Sensitivity analyses did not modify any results.
In healthy transgender individuals, serum testosterone concentrations may not be associated with measures of cardiovascular health. However, these results need to be interpreted with caution given the limited sample size.
使用性别肯定性睾酮治疗（GATT）可能与收缩压（SBP）升高有关。使用GATT的个体中血清睾酮与心血管健康之间的关联尚不清楚。本研究的目的是估计在出生时被指定为女性且使用GATT的人群中，血清睾酮与心血管健康的有效测量指标（包括SBP和动脉僵硬度）之间的关联。
招募在稳定的GATT方案下使用≥4个月、出生时被指定为女性的健康参与者，进行这项社区合作的探索性横断面研究。感兴趣的暴露因素是血清总睾酮和游离睾酮浓度。作为我们的主要结局，使用自动血压计测量SBP，并通过压平式眼压计使用颈-桡脉搏波速度（PWVcr）和主动脉增强指数（AIx）来测量动脉僵硬度。
对主要自我认定为白人（94%）、使用GATT的中位时间为48个月（范围：5至84个月）的参与者（n = 18，中位年龄28岁，范围：18至50岁）进行了研究。静息SBP、PWVcr和AIx分别为113 mmHg（范围：102至129）、7 m/s（范围：4至9）和9%（范围：-10至23）。血清总睾酮和游离睾酮与SBP或PWVcr均无显著关联。游离血清睾酮而非总血清睾酮与AIx呈正相关（p = 0.03）。敏感性分析未改变任何结果。
在健康的跨性别个体中血清睾酮浓度可能与心血管健康指标无关。然而，鉴于样本量有限，这些结果需要谨慎解释。
