Hematology reference intervals for transgender adults on stable hormone therapy
Hematology reference intervals for transgender adults on stable hormone therapy
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DOI：
10.1016/j.cca.2019.02.011
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发表时间：
2019-05-01
影响因子：
5
通讯作者：
Krasowski, Matthew D.
中科院分区：
文献类型：
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作者：
Greene, Dina N.;McPherson, Gabrielle Winston;Krasowski, Matthew D.
背景：全血细胞计数（CBC）是患者护理的基石。CBC的几个正常值因性别而异，因此，需要男性特异性和女性特异性参考区间来解释这些实验室结果。跨性别者通常会接受激素治疗来确认他们的性别，导致血清激素浓度与顺性别者相似。对于任何实验室测量（包括血液学），尚未建立跨性别男性和女性的性别特异性参考区间。我们建立了临床相关的血液学参考区间为变性人接受稳定的hormone therapeutic.Methods：健康的变性人处方睾酮（n = 79）或雌激素（n = 93）>= 12个月，从内科和初级保健诊所，专门从事变性人的医疗保健招募。评价血红蛋白、红细胞压积、MCV、MCHC和RDWCV的浓度以及红细胞、白色细胞和血小板计数。结果解释参考值的总体分布和相对于血清雌二醇和总睾酮浓度。将计算的参考区间与已建立的顺性参考区间进行比较。结果：无论血清激素浓度如何，个体处方睾酮或雌激素的血液学参数与顺性男性和女性分别没有临床差异。接受稳定激素治疗的跨性别男性和女性的血液学参数应根据顺性别男性和顺性别女性参考范围进行评价，并且不需要同时进行性激素分析。护理人员可以利用这一观察结果来帮助解释变性人的血液学实验室值。
Background: The complete blood count (CBC) is a cornerstone of patient care. Several of the normal values for the components of the CBC differ by sex and, therefore, male-specific and female-specific reference intervals are required to interpret these laboratory results. Transgender individuals are often prescribed hormone therapy to affirm their gender, with resulting serum hormone concentrations similar to those of cisgender individuals. Gender-specific reference intervals for transgender men and women have not been established for any laboratory measurements, including hematology. We established clinically relevant hematological reference intervals for transgender individuals receiving stable hormone therapy.Methods: Healthy transgender individuals prescribed testosterone (n = 79) or estrogen (n = 93) for >= 12 months were recruited from internal medicine and primary care clinics that specialize in transgender medical care. Concentrations for hemoglobin, hematocrit, MCV, MCHC, and RDWCV, as well as counts for red cells, white cells, and platelets, were evaluated. Results were interpreted in reference to the overall distribution of values and relative to serum estradiol and total testosterone concentrations. Calculated reference intervals were compared to established cisgender reference intervals.Results: Regardless of serum hormone concentration, individuals prescribed testosterone or estrogen had hematology parameters that were not clinically different from cisgender males and females, respectively.Conclusion: The hematology parameters for transgender men and women receiving stable hormone therapy should be evaluated against the cisgender male and cisgender female reference ranges, respectively and does not require concurrent sex hormone analysis. Care providers can utilize this observation to aid in interpretation of hematology laboratory values for transgender people.