背景:目前的证据表明性别烦躁不安(GD)的病因是多因素的:然而,尚不清楚。内分泌干扰化学物质(EDC)是病因假说之一。
目的:在本研究中,我们的目的是评估尿中双酚A(BPA)的水平,噻虫嗪,与病例匹配的顺式女性相比,激素幼稚变性人中的氟虫腈以及性激素水平与EDC之间的关系。
方法:被诊断为患有GD并从精神科门诊转诊到内分泌科门诊的未用药的变性人,马尔马拉大学医院,包括在研究中。对这些个体进行了资格评估;招募了38名未吸毒的变性人和22名顺式女性作为对照组。经过FSH的人体测量评估实验室测试,LH,总睾酮,和雌二醇进行,收集斑点尿液样本以评估BPA的尿液代谢排泄,噻虫嗪,和氟虫腈.
结果:我们发现雄激素,总睾酮,雄烯二酮,变性人和DHEAS水平明显高于顺式女性。噻虫嗪在顺式女性中比在变性人中高得多,而两组中氟虫腈和BPA水平相似。噻虫嗪和睾酮之间以及噻虫嗪和BPA水平之间呈负相关。
结论:现有数据表明,我们生活中接触最多的EDCs并不是GD发展的唯一因素。即使没有服用激素替代的变性人也有很高的睾丸激素水平;然而,机制尚未阐明。挑战在于确定这是导致GD的因素还是与GD共同发展的状况。
BACKGROUND: Current evidence suggests that the etiology of gender dysphoria (GD) is multifactorial: this, however, remains unclear. Endocrine-disrupting chemicals (EDCs) are one of the etiological hypotheses.
OBJECTIVE: In this study, we aimed to evaluate the urinary levels of bisphenol A (BPA), thiamethoxam, and
fipronil in hormone-naïve transmen compared with case-matched cis-women as well as the relation between sex hormone levels and EDCs.
METHODS: Drug-naïve transmen diagnosed with GD and who were referred from the psychiatry outpatient clinic to the outpatient clinic of the Department of Endocrinology, Marmara University Hospital, were included in the study. These individuals were assessed for eligibility; 38 drug-naïve transmen and 22 cis-women were recruited as the control group. After anthropometric evaluation laboratory tests for FSH, LH, total testosterone, and estradiol were carried out, spot urine samples were collected to evaluate the urine metabolic excretion of BPA, thiamethoxam, and
fipronil.
RESULTS: We found that androgens, total testosterone, androstenedione, and DHEAS levels were significantly higher in transmen than in cis-women. Thiamethoxam was considerably higher in cis-women than in transmen, whereas
fipronil and BPA levels were similar in both groups. A negative correlation was found between thiamethoxam and testosterone and between thiamethoxam and BPA levels.
CONCLUSIONS: The available data suggest that the EDCs that we are most exposed to in our lives are not the only factor in GD development. Even transmen who have not taken hormone replacement have high testosterone levels; however, the mechanism has not as yet been elucidated. The challenge is to determine whether this is a factor leading to GD or a condition that develops in common with GD.