D Tienforti, G Savignano, L Spagnolo, F Di Giulio, M G Baroni, A Barbonetti
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引用次数: 0
摘要
目的：采用荟萃分析法评估基于睾酮（T）的性别平权激素疗法（GAHT）对出生时即被指定为女性的成年人肝脏血液检测（LBTs）的影响：方法：选取了报告生化肝损伤（BLD）发生率和激素治疗期间肝脏血液检测指标变化的前瞻性和回顾性研究。收集的数据包括治疗前和治疗期间丙氨酸-转氨酶（ALT）、天冬氨酸-转氨酶（AST）、γ-谷氨酰-转氨酶（GGT）和碱性磷酸酶（ALP）的平均浓度值：在对 1698 名受试者进行的 14 项研究中，BLD 的患病率为 1%（95% CI 0.00-3.00；I2 = 14.1%；P = 0.82）。在对 2758 名受试者进行的 17 项研究中，GAHT 与 12 个月时的谷草转氨酶、谷氨酰转肽酶和谷丙转氨酶以及 3-7 个月时的谷草转氨酶（MD：1.19 IU/l；95% CI 0.31，2.08；I2：0%），12 个月时（MD：2.31 IU/l；95% CI 1.41，3.21；I2：29%），但 24 个月时没有更显著的增加（MD：1.71 IU/l；95% CI -0.02，3.44；I2：0%）：对总体估计值的分析证实，在以 T 为基础的 GAHT 期间，发生 BLD 和 LBT 异常的风险较低，在大多数情况下是短暂的，因此表明对 AFAB 患者进行仔细肝脏监测的必要性有限。
Biochemical liver damage during gender affirming therapy in trans adults assigned female at birth: a meta-analysis.
Purpose: To assess the effects of testosterone (T)-based gender affirming hormone therapy (GAHT) on liver blood tests (LBTs) in assigned female at birth adults, using a meta-analytic approach.
Methods: Prospective and retrospective studies were selected that reported the prevalence of biochemical liver damage (BLD) and LBTs changes during T therapy. Data collected included pre-and-during therapy alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), gamma-glutamyl-transferase (GGT), and alkaline phosphatase (ALP) mean concentration values.
Results: The prevalence of BLD in 14 studies on 1698 subjects was 1% (95% CI 0.00-3.00; I2 = 14.1%; p = 0.82). In 17 studies on 2758 subjects, GAHT was associated with a statistically (but not clinically) significant increase in AST, GGT and ALP at 12 months and ALT at 3-7 (MD: 1.19 IU/l; 95% CI 0.31, 2.08; I2: 0%), at 12 (MD: 2.31 IU/l; 95% CI 1.41, 3.21; I2: 29%), but with no more significant increase at 24 months (MD: 1.71 IU/l; 95% CI -0.02, 3.44; I2: 0%).
Conclusions: Analysis of aggregate estimates confirms a low risk of BLD and abnormalities in LBTs, transient in most cases, during T-based GAHT, thus suggesting a limited need for careful liver monitoring in AFAB people.
期刊介绍：
The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
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