跨性别者保健:代谢结果和心血管风险
Dorte Glintborg1,2, Louise L Christensen3,4, Marianne S Andersen3,4
1Department of Endocrinology, Odense University Hospital, Odense, Denmark. dorte.glintborg@rsyd.dk.
Diabetologia
|July 3, 2024
概括
性别确认激素治疗 (GAHT) 在变性人群中显示出不同的代谢和心血管效应. 密切监测和个性化护理对于在GAHT期间管理胰岛素抵抗和心血管疾病等风险至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 跨性别者健康 跨性别者健康
背景情况:
- 变性人身份与性别障碍症和少数民族压力有关.
- 性激素对 cisgender 个体的新陈代谢和心血管疾病 (CVD) 有不同的影响.
- 激素替代性治疗可以增加血管风险,特别是在老年人群中.
研究的目的:
- 审查与性别肯定激素治疗 (GAHT) 相关的代谢和心血管结果.
- 建议在GAHT期间监测代谢和心血管疾病风险标志物的建议.
- 为个人化患者护理和风险管理策略提供信息.
主要方法:
- 对经过GAHT的跨性别队伍中代谢和心血管结果现有证据的叙述性综述.
- 分析风险因素,包括年龄,出生时的性别和特定药物.
- 对性别肯定护理对健康结果的潜在益处的评估.
主要成果:
- 没有观察到2型糖尿病的风险增加.
- 雄性化的GAHT增加了肌肉质量;女性化的GAHT增加了脂肪质量和胰岛素抵抗力.
- 变性人群中心血管疾病的风险较高,特别是女性化GAHT,对脂质,血红素,血压和凝血有特定的不良影响.
- 出生时被分配的男性性别,高高特激素发作时的年龄,以及酸的使用是不良心血管疾病标志物的危险因素.
结论:
- 在GAHT期间代谢和心血管疾病的结果需要仔细,个性化监测.
- 代谢和心血管疾病健康的潜在改善可能来自减少少数群体压力和加强医疗监测.
- 高血压治疗方案应根据个体风险因素量身定制,主动管理生活方式和预防药物,以减轻心血管风险.
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