Laboratory tests in the adult gender-expansive population
Description
Supplementary file 1: Data for serum/plasma laboratory tests with sex-specific reference intervals performed on patients with sexual orientation/gender identity (SOGI) field differences for legal sex/sex assigned at birth (SAAB)/gender identity (GI) in the electronic medical record (EMR) at the University of Iowa Hospitals and Clinics from January 1, 2021 to December 31, 2021. The data elements include: deidentified patient number, age (years) at time of laboratory testing, location type (outpatient, inpatient, or emergency department) at time of specimen collection, legal sex in EMR, SAAB in EMR, GI in EMR, presence of SOGI mismatch (yes/no), change of legal sex in EMR, gender-affirming gonadectomy (yes/no), GI from chart review, gender-affirming hormone and route of administration, values for tests for 17 laboratory tests, and how the values of these 17 laboratory tests were relative to age-matched reference intervals for cisgender men and women. Assays details and reference intervals are summarized in Supplemental file 3. Chart review for SOGI fields previously reported [1]. There are a total of 1,166 unique patients (all 18.0 years or older) and 7,530 laboratory tests. Supplementary file 2: Data for plasma creatinine performed for patients 18.0 years or older taking gender-affirming estradiol or testosterone at the University of Iowa Hospitals and Clinics from January 1, 2021 to December 31, 2021. The data elements include: deidentified patient number, age (years) at time of laboratory testing, location type at time of specimen collection, legal sex in EMR, SAAB in EMR, GI in EMR, GI from chart review, gender-affirming hormone and route of administration, self-declared race in EMR (African-American or not), plasma creatinine (mg/dL), estimated glomerular filtration rate (eGFR) calculation using female sex and the 2021 CKD-EPI equation without race refit, eGFR using male as sex, and chronic kidney disease (CKD) stage using either female or male as sex. eGFR equation and CKD stages are from references 2 and 3, respectively. There are a total of 620 unique patients and 1,469 plasma creatinine values. Supplementary file 3: Includes Supplemental Table 1 with details on laboratory assay and Supplemental Table 2 with reference intervals for the laboratory tests analyzed. Data tabs for Supplemental Files 1 and 2 include one for primary data and another defining abbreviations. [1] N.G. Hines et al, Patterns of gender identity data within electronic health record databases can be used as a tool for identifying and estimating the prevalence of gender-expansive people, JAMIA Open 6 (2) (2023) ooad042. DOI: 10.1093/jamiaopen/ooad042. [2] C. Delgado et al., A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease, Am J Kidney Dis 79 (2) (2022) 268-288 e261. DOI: 10.1053/j.ajkd.2021.08.003. [3] Kidney Int Suppl (2011) 3 (1) (2013) 5-14.
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This study was conducted with ethical approval from the University of Iowa Institutional Review Board as a retrospective study with waiver of informed consent (protocols # 202202388). Demographics and sex/gender information retrieval has been described in our previous study [1]. The present study did not influence test ordering, analysis, or clinical management for any patient. The study focused on a subset of patients that had frequently ordered, non-hormonal laboratory tests with sex-specific reference intervals. These encompassed the following 17 tests: creatinine, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, lactate dehydrogenase, creatine kinase, hemoglobin, ferritin, iron, iron percent saturation, N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity (generation 5) troponin T (hs-TnT), total calcium, phosphorus, erythrocyte sedimentation rate, and uric acid. Supplementary file 3 includes details on laboratory assays and reference intervals for the laboratory tests analyzed. [1] N.G. Hines et al, Patterns of gender identity data within electronic health record databases can be used as a tool for identifying and estimating the prevalence of gender-expansive people, JAMIA Open 6 (2) (2023) ooad042. DOI: 10.1093/jamiaopen/ooad042.