Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy.
Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy.
复制标题
DOI：
10.1210/jendso/bvaa119
复制
发表时间：
2020-11-01
影响因子：
4.1
通讯作者：
Goodman M
中科院分区：
文献类型：
--
作者：
Antun A;Zhang Q;Bhasin S;Bradlyn A;Flanders WD;Getahun D;Lash TL;Nash R;Roblin D;Silverberg MJ;Tangpricha V;Vupputuri S;Goodman M
性别确认激素治疗（HT）对红细胞生成的影响是跨性别健康研究的一个重点领域。比较跨性别者与顺性别对照者血液学参数、红细胞增多和贫血率的变化。纵向观察研究。我们比较了在3个综合医疗保健系统登记的559名跨性别者（TF）和424名跨性别者（TM）与匹配的顺性别参照物。激素治疗收据是从处方中确定的。血红蛋白（Hb）和红细胞压积（Hct）水平检测从第一次血液测试到HT开始，从HT开始到最近的血液测试。通过计算校正风险比和95%置信区间（CI）比较跨性别参与者和参照者的红细胞增加率和贫血率。在TF组中，Hb和Hct均呈下降趋势。在TM队列中，相应的变化方向相反。TM研究参与者的红细胞增多率比匹配的顺性男性高7倍（95% CI: 4.1-13.4），比顺性女性高83倍（95% CI: 36.1-191.2）。TF患者相应的贫血率升高，但主要与顺性男性相关（危险比5.9;95% CI: 4.6-7.5）。我们的研究结果支持了先前的建议，即接受HT治疗的变性人的血液学参数应该根据他们确认的性别来解释，而不是根据他们出生时记录的性别。睾酮治疗后红细胞增多和女性化HT后贫血的临床意义有待进一步研究。
The effect of gender-affirming hormone therapy (HT) on erythropoiesis is an area of priority in transgender health research. To compare changes in hematologic parameters and rates of erythrocytosis and anemia among transgender people to those of cisgender controls. Longitudinal observational study. We compared 559 transfeminine (TF) and 424 transmasculine (TM) people enrolled in 3 integrated health care systems to matched cisgender referents. Hormone therapy receipt was ascertained from filled prescriptions. Hemoglobin (Hb) and hematocrit (Hct) levels were examined from the first blood test to HT initiation, and from the start of HT to the most recent blood test. Rates of erythrocytosis and anemia in transgender participants and referents were compared by calculating adjusted hazard ratios and 95% confidence intervals (CI). In the TF group, there was a downward trend for both Hb and Hct. The corresponding changes in the TM cohort were in the opposite direction. TM study participants experienced a 7-fold higher rate (95% CI: 4.1–13.4) of erythrocytosis relative to matched cisgender males, and an 83-fold higher rate (95% CI: 36.1–191.2) compared to cisgender females. The corresponding rates for anemia were elevated in TF subjects but primarily relative to cisgender males (hazard ratio 5.9; 95% CI: 4.6–7.5). Our results support previous recommendations that hematological parameters of transgender people receiving HT should be interpreted based on their affirmed gender, rather than their sex documented at birth. The clinical significance of erythrocytosis following testosterone therapy, as well as anemia following feminizing HT, requires further investigation.
登录
查看更多内容
影响因子：
5.8
作者：
Bhasin, Shalender;Brito, Juan P.;Yialamas, Maria A.
通讯作者：
Yialamas, Maria A.
影响因子：
5
作者：
Greene, Dina N.;McPherson, Gabrielle Winston;Krasowski, Matthew D.
通讯作者：
Krasowski, Matthew D.
影响因子：
5.8
作者：
Coviello, Andrea D.;Kaplan, Beth;Bhasin, Shalender
通讯作者：
Bhasin, Shalender
DOI：
10.1097/med.0000000000000231
发表时间：
2016-04
期刊：
Current opinion in endocrinology, diabetes, and obesity
影响因子：
--
作者：
Feldman J;Brown GR;Deutsch MB;Hembree W;Meyer W;Meyer-Bahlburg HF;Tangpricha V;TʼSjoen G;Safer JD
通讯作者：
Safer JD
影响因子：
2.9
作者：
Quinn VP;Nash R;Hunkeler E;Contreras R;Cromwell L;Becerra-Culqui TA;Getahun D;Giammattei S;Lash TL;Millman A;Robinson B;Roblin D;Silverberg MJ;Slovis J;Tangpricha V;Tolsma D;Valentine C;Ward K;Winter S;Goodman M
通讯作者：
Goodman M