性别确认激素治疗对血清激素结合蛋白浓度的影响。

IF 5.3 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Theresa A Stangl, Chantal M Wiepjes, Annemieke C Heijboer, Martin den Heijer
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引用次数: 0

摘要

背景:皮质类固醇结合球蛋白(CBG)、甲状腺结合球蛋白(TBG)、性激素结合球蛋白(SHBG)和胰岛素样生长因子结合蛋白3 (IGF-BP3)调节激素的生物利用度和转运,影响激素浓度测量和治疗计划。本研究调查了性别确认激素治疗(GAHT)在多大程度上影响这些结合蛋白的血清浓度。方法:本前瞻性研究包括41名跨性别者口服或经皮使用17β-雌二醇联合醋酸环丙孕酮(CPA)或促性腺激素释放激素类似物(GnRHa), 38名跨性别者使用睾酮凝胶或注射。测定血清CBG (mg/L)、TBG (nmol/L)、SHBG (nmol/L)和IGF-BP3 (mg/L)在基线和3、12个月后的浓度。使用混合模型分析变化,并以百分比变化报告。结果:在口服雌二醇和CPA使用者中,CBG增加29% (95% CI, 16, 44%), TBG增加24% (95% CI, 16, 32%), SHBG增加81% (95% CI, 61, 105%),口服雌二醇和GnRHa使用者分别增加47% (95% CI, 7, 101%), 48% (95% CI, 9, 101%)和242% (95% CI, 104, 474%)。IGF-BP3保持不变。在经皮雌二醇使用者中,当联合使用GnRHa时,只有SHBG改变(+63% [95% CI, 3,157%])。在跨性别参与者中,CBG, TBG, SHBG和IGF-BP3分别下降13% (95% CI, -21, -4%), 11% (95% CI, -15, -6%), 43% (95% CI, -48, -36%)和10% (95% CI, -18, -2%),凝胶和注射没有差异。结论:GAHT导致雌二醇使用者(更具体地说是口服雌二醇)的CBG、TBG和SHBG升高,而睾酮使用者的SHBG、CBG、TBG和IGF-BP3降低。认识到这些变化对于确保准确的激素测量和最佳的患者护理至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The influence of gender-affirming hormone therapy on serum concentrations of hormone-binding proteins.

Background: Corticosteroid-binding globulin (CBG), thyroid-binding globulin (TBG), sex hormone-binding globulin (SHBG), and insulin-like growth factor-binding protein 3 (IGF-BP3) regulate the bioavailability and transport of hormones, affecting hormone concentration measurements and therapy plans. This study investigates to what extent gender-affirming hormone therapy (GAHT) impacts serum concentrations of these binding proteins.

Methods: This prospective study included 41 transfeminine persons starting oral or transdermal 17β-estradiol in combination with cyproterone acetate (CPA) or gonadotropin-releasing hormone analogs (GnRHa) and 38 transmasculine persons starting testosterone gel or injections. Serum concentrations of CBG (mg/L), TBG (nmol/L), SHBG (nmol/L), and IGF-BP3 (mg/L) were measured at baseline and after 3 and 12 months. Changes were analyzed using mixed models and reported as percentage change.

Results: In oral estradiol and CPA users, CBG increased by 29% (95% CI, 16, 44%), TBG by 24% (95% CI, 16, 32%), SHBG by 81% (95% CI, 61, 105%) and in oral estradiol and GnRHa users by 47% (95% CI, 7, 101%), 48% (95% CI, 9, 101%), and 242% (95% CI, 104, 474%), respectively. The IGF-BP3 remained unchanged. In transdermal estradiol users, only SHBG changed (+63% [95% CI, 3, 157%]), when combined with GnRHa. In transmasculine participants, CBG, TBG, SHBG, and IGF-BP3 decreased by 13% (95% CI, -21, -4%), 11% (95% CI, -15, -6%), 43% (95% CI, -48, -36%), and 10% (95% CI, -18, -2%) respectively, with no difference in gel vs injections.

Conclusion: The GAHT led to an increase of CBG, TBG, and SHBG in estradiol users, more specifically oral estradiol, and to a decrease of SHBG, CBG, TBG, and IGF-BP3 in testosterone users. Recognizing these alterations is crucial for ensuring accurate hormone measurements and optimal patient care.

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来源期刊
European Journal of Endocrinology
European Journal of Endocrinology 医学-内分泌学与代谢
CiteScore
9.80
自引率
3.40%
发文量
354
审稿时长
1 months
期刊介绍: European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.
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