评估变性人和不同性别人群的静脉血栓栓塞风险：回顾性分析。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2024-11-01 DOI:10.1016/j.eprac.2024.08.014

Daniel J. Slack MD , Nithya Krishnamurthy BA , Derek Chen MS , Felix G. Contreras-Castro BA , Joshua D. Safer MD

{"title":"评估变性人和不同性别人群的静脉血栓栓塞风险：回顾性分析。","authors":"Daniel J. Slack MD , Nithya Krishnamurthy BA , Derek Chen MS , Felix G. Contreras-Castro BA , Joshua D. Safer MD","doi":"10.1016/j.eprac.2024.08.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The risk of venous thromboembolism (VTE) with feminizing gender-affirming hormone therapy is an area of concern. This analysis aimed to assess whether gender-affirming hormone therapy and other potential risk factors are associated with VTE in transfeminine and gender diverse individuals.</div></div><div><h3>Methods</h3><div>We conducted a chart review of 2126 transfeminine and gender diverse adults receiving care within a large urban health system. The primary outcomes were the prevalence of VTE and odds ratios for the association of VTE with insurer, use of estrogen, and select comorbidities.</div></div><div><h3>Results</h3><div>A history of VTE was documented in 0.8% of the cohort. Those with a history of VTE were older (<em>P</em> < .001), more often self-identified as Hispanic or Black compared to White or Asian (<em>P</em> < .05) and were more likely to have Medicaid or Medicare (<em>P</em> < .01) when compared to those without a history of VTE. The prevalence of hyperlipidemia (<em>P</em> < .001), diabetes mellitus (<em>P</em> < .05), and hypercoagulable conditions (<em>P</em> < .001) were all greater in the positive VTE group. Hyperlipidemia (<em>P</em> < .001), diabetes mellitus (<em>P</em> < .05), and insurer (<em>P</em> < .05) were associated with increased odds of VTE in univariate analyses. None of the exposure variables analyzed were associated with VTE when controlling for age, race, and the number of comorbidities.</div></div><div><h3>Conclusions</h3><div>The prevalence of VTE in our cohort was lower than previously observed. VTE was not associated with any one risk factor, including estrogen use, when controlling for age, race, and the number of comorbidities. Those of advanced age and those with multiple cardiometabolic comorbidities may benefit from increased surveillance and mitigation of modifiable risk factors.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"30 11","pages":"Pages 1066-1072"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis\",\"authors\":\"Daniel J. Slack MD , Nithya Krishnamurthy BA , Derek Chen MS , Felix G. Contreras-Castro BA , Joshua D. Safer MD\",\"doi\":\"10.1016/j.eprac.2024.08.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>The risk of venous thromboembolism (VTE) with feminizing gender-affirming hormone therapy is an area of concern. This analysis aimed to assess whether gender-affirming hormone therapy and other potential risk factors are associated with VTE in transfeminine and gender diverse individuals.</div></div><div><h3>Methods</h3><div>We conducted a chart review of 2126 transfeminine and gender diverse adults receiving care within a large urban health system. The primary outcomes were the prevalence of VTE and odds ratios for the association of VTE with insurer, use of estrogen, and select comorbidities.</div></div><div><h3>Results</h3><div>A history of VTE was documented in 0.8% of the cohort. Those with a history of VTE were older (<em>P</em> < .001), more often self-identified as Hispanic or Black compared to White or Asian (<em>P</em> < .05) and were more likely to have Medicaid or Medicare (<em>P</em> < .01) when compared to those without a history of VTE. The prevalence of hyperlipidemia (<em>P</em> < .001), diabetes mellitus (<em>P</em> < .05), and hypercoagulable conditions (<em>P</em> < .001) were all greater in the positive VTE group. Hyperlipidemia (<em>P</em> < .001), diabetes mellitus (<em>P</em> < .05), and insurer (<em>P</em> < .05) were associated with increased odds of VTE in univariate analyses. None of the exposure variables analyzed were associated with VTE when controlling for age, race, and the number of comorbidities.</div></div><div><h3>Conclusions</h3><div>The prevalence of VTE in our cohort was lower than previously observed. VTE was not associated with any one risk factor, including estrogen use, when controlling for age, race, and the number of comorbidities. Those of advanced age and those with multiple cardiometabolic comorbidities may benefit from increased surveillance and mitigation of modifiable risk factors.</div></div>\",\"PeriodicalId\":11682,\"journal\":{\"name\":\"Endocrine Practice\",\"volume\":\"30 11\",\"pages\":\"Pages 1066-1072\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1530891X24006633\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1530891X24006633","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

摘要

目的：女性化性别确认激素疗法（GAHT）的静脉血栓栓塞症（VTE）风险是一个值得关注的领域。本分析旨在评估GAHT和其他潜在风险因素是否与变性和性别多元化（TGD）人群的VTE相关：我们对一个大型城市医疗系统中接受治疗的 2,126 名 TGD 成人进行了病历审查。主要结果是 VTE 的患病率以及 VTE 与保险人、雌激素的使用和特定合并症相关的几率比：结果：0.8%的患者有 VTE 病史。有 VTE 病史的患者年龄较大（p 结论：该群体中 VTE 患病率为 0.8%：我们队列中的 VTE 患病率低于之前的观察结果。在控制年龄、种族和合并症数量的情况下，VTE 与包括使用雌激素在内的任何一个风险因素都无关。那些高龄和患有多种心脏代谢合并症的人可能会从加强监测和减少可改变的风险因素中获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis

Objective

The risk of venous thromboembolism (VTE) with feminizing gender-affirming hormone therapy is an area of concern. This analysis aimed to assess whether gender-affirming hormone therapy and other potential risk factors are associated with VTE in transfeminine and gender diverse individuals.

Methods

We conducted a chart review of 2126 transfeminine and gender diverse adults receiving care within a large urban health system. The primary outcomes were the prevalence of VTE and odds ratios for the association of VTE with insurer, use of estrogen, and select comorbidities.

Results

A history of VTE was documented in 0.8% of the cohort. Those with a history of VTE were older (P < .001), more often self-identified as Hispanic or Black compared to White or Asian (P < .05) and were more likely to have Medicaid or Medicare (P < .01) when compared to those without a history of VTE. The prevalence of hyperlipidemia (P < .001), diabetes mellitus (P < .05), and hypercoagulable conditions (P < .001) were all greater in the positive VTE group. Hyperlipidemia (P < .001), diabetes mellitus (P < .05), and insurer (P < .05) were associated with increased odds of VTE in univariate analyses. None of the exposure variables analyzed were associated with VTE when controlling for age, race, and the number of comorbidities.

Conclusions

The prevalence of VTE in our cohort was lower than previously observed. VTE was not associated with any one risk factor, including estrogen use, when controlling for age, race, and the number of comorbidities. Those of advanced age and those with multiple cardiometabolic comorbidities may benefit from increased surveillance and mitigation of modifiable risk factors.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.