Metabolic and cardiovascular risks of hormone treatment for transgender individuals

IF 6.1 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-09-01 DOI:10.1016/j.beem.2024.101907

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Abstract

Identifying metabolic and cardiovascular risks of gender-affirming hormone therapy (GAHT) is challenging due to other confounding variables that affect patient outcomes and the diversity of treatment regimes. Masculinising hormone therapy produces atherogenic lipid profiles, while effects on other metabolic parameters are not consistent. There is insufficient evidence to conclude if cardiovascular disease risk among transmen is increased. The effects of feminising hormone therapy on metabolic parameters do not demonstrate a consistent pattern in the available literature. However, the risk of venous thromboembolism is greater in transwomen than in cis-gender men and women with a possible increase in cardiovascular disease risk. It is recommended to discuss the potential effects of GAHT on cardiovascular health and encourage patients seeking GAHT to adopt a healthy lifestyle. Performing baseline and periodic assessments of cardiovascular risk factors would enable early identification and interventions. In high-risk individuals, the cardiovascular effects of hormonal regimes might impact the treatment decision.

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变性人接受激素治疗的代谢和心血管风险。

由于影响患者预后的其他混杂变量以及治疗方案的多样性，确定性别确认激素疗法（GAHT）的代谢和心血管风险具有挑战性。男性化激素疗法会产生致动脉粥样硬化的血脂谱，而对其他代谢参数的影响并不一致。目前还没有足够的证据来断定变性人患心血管疾病的风险是否会增加。在现有文献中，女性化激素疗法对新陈代谢参数的影响并未显示出一致的模式。不过，变性女性罹患静脉血栓栓塞症的风险高于同性别的男性和女性，可能会增加心血管疾病风险。建议讨论变性手术对心血管健康的潜在影响，并鼓励寻求变性手术的患者采取健康的生活方式。对心血管风险因素进行基线评估和定期评估将有助于早期识别和干预。对于高危人群，激素疗法对心血管的影响可能会影响治疗决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best practice & research. Clinical endocrinology & metabolism 医学-内分泌学与代谢

CiteScore

11.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.