Effects of sex steroids on cardiovascular risk profile in transgender men under gender affirming hormone therapy

Endocrinol Diabetes Nutr (Engl Ed). 2019 Jun-Jul;66(6):385-392. doi: 10.1016/j.endinu.2018.11.004. Epub 2019 Jan 28.
[Article in English, Spanish]

Abstract

Purpose: Gender affirming hormone therapy (HT) in transgender men both improves and impairs several surrogate cardiovascular risk markers. However, few prospective works with long follow-up and control group are available. In this context, this work aimed to assess the changes in the metabolic and cardiovascular risk pattern after 12 months of HT in transgender men. Furthermore, we aimed to investigate early effects on target tissues that may reflect an initial vascular damage.

Methods: Prospective observational study, including 20 transgender men, attended in the Gender Identity Unit (UIG) of the Hospital Clinic from July 2013 to November 2015. Anthropometric and body composition by dual-energy X-ray absorptiometry (DXA), hormonal, metabolic and coagulation parameters, endothelial dysfunction by flow-mediated dilation (FMD) and intima-media thickness (IMT) by carotid ultrasound, were assessed at baseline, at 6 and 12 months of HT.

Results: We observed an impairment of lipid profile, and increase of homocysteine and leucocytes count, as well as changes in body composition with increased total lean mass together with decreased total fat mass. In addition, higher mean-maximum common IMT was observed after 12 months of HT.

Conclusion: Our work shows changes in metabolic and inflammatory parameters after HT after short-medium follow-up, which could increase cardiovascular risk in this setting, together with initial evidence of vascular changes.

Keywords: Cardiovascular risk; Esteroides sexuales; Gender affirming hormone therapy; Personas transgénero; Riesgo cardiovascular; Sex steroids; Terapia hormonal que afirma el género; Transgender people.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology*
  • Gonadal Steroid Hormones / adverse effects*
  • Gonadal Steroid Hormones / therapeutic use
  • Humans
  • Male
  • Metabolic Diseases / chemically induced*
  • Metabolic Diseases / epidemiology*
  • Prospective Studies
  • Risk Assessment
  • Sex Reassignment Procedures / methods*
  • Time Factors
  • Young Adult

Substances

  • Gonadal Steroid Hormones