Abstract：
BACKGROUND: Approximately, 11% of trans men experience erythrocytosis diagnosis due to testosterone administration during the first year of the gender-affirming hormone treatment (GAHT).
OBJECTIVE: To identify and compare the effect of different testosterone formulations on hematocrit (Hct) and diagnose erythrocytosis in trans men.
METHODS: This systematic review was based on PRISMA guidelines. We performed an electronic search of PubMed, Embase, and Web of Science in January 2024. The Newcastle-Ottawa scale was used to evaluate the quality of evidence in the observational studies.
RESULTS: Of the 152 records retrieved, 18 met the eligibility criteria. Studies observed an increase of up to 5% in Hct in trans men using injectable testosterone undecanoate (TU), and up to 6.9% in trans men using intermediate injectable testosterone esters (TE). Trans men using TE experience a larger increase in serum Hct levels compared to those receiving TU. Erythrocytosis prevalence varies according to the cutoff used (50%, 52%, and 54%). Erythrocytosis was also associated with tobacco use, age at initiation of hormone therapy, body mass index (BMI), and pulmonary conditions. Studies that evaluated the effect of testosterone formulation on erythrocytosis diagnosis present conflicting result. Trans men have a hazard ratio of 7.4 (95% CI: 4.1, 13.4) of developing erythrocytosis compared to cisgender men, using a 52% hematocrit cutoff.
CONCLUSIONS: All testosterone formulations result in an increase in Hct, irrespective of dose, formulation, and administration method. Smoking, higher age at initiation of the testosterone therapy, higher BMI, and a predisposing medical history are associated with this increase in Hct. The difference in effect of TE and TU on Hct is conflicting, although it is important to point out that these data come from observational studies, retrospective, and with a small-sample size.
OBJECTIVE: To identify and compare the effect of different testosterone formulations on hematocrit (Hct) and diagnose erythrocytosis in trans men.
METHODS: This systematic review was based on PRISMA guidelines. We performed an electronic search of PubMed, Embase, and Web of Science in January 2024. The Newcastle-Ottawa scale was used to evaluate the quality of evidence in the observational studies.
RESULTS: Of the 152 records retrieved, 18 met the eligibility criteria. Studies observed an increase of up to 5% in Hct in trans men using injectable testosterone undecanoate (TU), and up to 6.9% in trans men using intermediate injectable testosterone esters (TE). Trans men using TE experience a larger increase in serum Hct levels compared to those receiving TU. Erythrocytosis prevalence varies according to the cutoff used (50%, 52%, and 54%). Erythrocytosis was also associated with tobacco use, age at initiation of hormone therapy, body mass index (BMI), and pulmonary conditions. Studies that evaluated the effect of testosterone formulation on erythrocytosis diagnosis present conflicting result. Trans men have a hazard ratio of 7.4 (95% CI: 4.1, 13.4) of developing erythrocytosis compared to cisgender men, using a 52% hematocrit cutoff.
CONCLUSIONS: All testosterone formulations result in an increase in Hct, irrespective of dose, formulation, and administration method. Smoking, higher age at initiation of the testosterone therapy, higher BMI, and a predisposing medical history are associated with this increase in Hct. The difference in effect of TE and TU on Hct is conflicting, although it is important to point out that these data come from observational studies, retrospective, and with a small-sample size.
摘要：
背景：大约，在性别确认激素治疗（GAHT）的第一年，有11％的跨性别男性因使用睾丸激素而被诊断为红细胞增多症。
目的：确定和比较不同睾酮制剂对跨性别男性红细胞压积（Hct）和红细胞增多症的影响。
方法：本系统综述基于PRISMA指南。我们对PubMed进行了电子搜索，Embase,和2024年1月的WebofScience。纽卡斯尔-渥太华量表用于评估观察性研究中的证据质量。
结果：在检索到的152条记录中，18符合资格标准。研究发现，使用可注射的睾酮十一烷酸酯（TU）的跨性别男性的Hct增加了高达5％，使用中间可注射睾酮酯（TE）的跨性别男性高达6.9％。与接受TU的人相比，使用TE的跨性别者的血清Hct水平增加更大。红细胞增多症的患病率根据所使用的截止值而有所不同(50%，52%,和54%）。红细胞增多症也与烟草使用有关，开始激素治疗的年龄，体重指数（BMI），和肺部疾病。评估睾酮制剂对红细胞增多症诊断的影响的研究呈现矛盾的结果。与顺式男性相比，跨性别男性发生红细胞增多的危险比为7.4（95％CI：4.1，13.4），使用52％的血细胞比容截止值。
结论：所有睾酮制剂均导致Hct升高，无论剂量如何，配方，和管理方法。吸烟,开始睾酮治疗的年龄较高，BMI较高,易感病史与Hct的增加有关。TE和TU对Hct的影响差异是矛盾的，尽管重要的是要指出这些数据来自观察研究，回顾性,样本量小。
目的：确定和比较不同睾酮制剂对跨性别男性红细胞压积（Hct）和红细胞增多症的影响。
方法：本系统综述基于PRISMA指南。我们对PubMed进行了电子搜索，Embase,和2024年1月的WebofScience。纽卡斯尔-渥太华量表用于评估观察性研究中的证据质量。
结果：在检索到的152条记录中，18符合资格标准。研究发现，使用可注射的睾酮十一烷酸酯（TU）的跨性别男性的Hct增加了高达5％，使用中间可注射睾酮酯（TE）的跨性别男性高达6.9％。与接受TU的人相比，使用TE的跨性别者的血清Hct水平增加更大。红细胞增多症的患病率根据所使用的截止值而有所不同(50%，52%,和54%）。红细胞增多症也与烟草使用有关，开始激素治疗的年龄，体重指数（BMI），和肺部疾病。评估睾酮制剂对红细胞增多症诊断的影响的研究呈现矛盾的结果。与顺式男性相比，跨性别男性发生红细胞增多的危险比为7.4（95％CI：4.1，13.4），使用52％的血细胞比容截止值。
结论：所有睾酮制剂均导致Hct升高，无论剂量如何，配方，和管理方法。吸烟,开始睾酮治疗的年龄较高，BMI较高,易感病史与Hct的增加有关。TE和TU对Hct的影响差异是矛盾的，尽管重要的是要指出这些数据来自观察研究，回顾性,样本量小。
