Cardiometabolic Effects of Testosterone in Transmen and Estrogen Plus Cyproterone Acetate in Transwomen

Abstract Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid...

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Published inThe journal of clinical endocrinology and metabolism Vol. 104; no. 6; pp. 1937 - 1947
Main Authors van Velzen, Daan M, Paldino, Alessia, Klaver, Maartje, Nota, Nienke M, Defreyne, Justine, Hovingh, G Kees, Thijs, Abel, Simsek, Suat, T’Sjoen, Guy, den Heijer, Martin
Format Journal Article
LanguageEnglish
Published Washington, DC Endocrine Society 01.06.2019
Copyright Oxford University Press
Oxford University Press
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Abstract Abstract Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein–cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein–cholesterol levels decreased (HDL-C; 10.8%; 95% CI, −14.0 to −7.6). In transwomen, HT slightly decreased BP (systolic BP, −2.6%, 95% CI, −4.2 to −1.0; diastolic BP, −2.2%, 95% CI, −4.0 to −0.4) and decreased levels of TC (−9.7%; 95% CI, −11.3 to −8.1), LDL-C (−6.0%; 95% CI, −8.6 to 3.6), HDL-C (−9.3%; 95% CI, −11.4 to −7.3), and triglycerides (−10.2%; 95% CI, −14.5 to −5.9). Conclusion Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes. In this prospective observational study, favorable lipid changes were found in transwomen and unfavorable lipid changes found in transmen after 12 months of gender-affirming hormone therapy.
AbstractList The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein-cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein-cholesterol levels decreased (HDL-C; 10.8%; 95% CI, -14.0 to -7.6). In transwomen, HT slightly decreased BP (systolic BP, -2.6%, 95% CI, -4.2 to -1.0; diastolic BP, -2.2%, 95% CI, -4.0 to -0.4) and decreased levels of TC (-9.7%; 95% CI, -11.3 to -8.1), LDL-C (-6.0%; 95% CI, -8.6 to 3.6), HDL-C (-9.3%; 95% CI, -11.4 to -7.3), and triglycerides (-10.2%; 95% CI, -14.5 to -5.9). Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.
Context: The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective: The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods: In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results: Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein-cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein-cholesterol levels decreased (HDL-C; 10.8%; 95% CI, -14.0 to -7.6). In transwomen, HT slightly decreased BP (systolic BP, -2.6%, 95% CI, -4.2 to -1.0; diastolic BP, -2.2%, 95% CI, -4.0 to -0.4) and decreased levels of TC (-9.7%; 95% CI, -11.3 to -8.1), LDL-C (-6.0%; 95% CI, -8.6 to 3.6), HDL-C (-9.3%; 95% CI, -11.4 to -7.3), and triglycerides (-10.2%; 95% CI, -14.5 to -5.9). Conclusion: Unfavorable changes in lipid profile were observed in transmen; a favorable effectwas noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes. (J Clin Endocrinol Metab 104: 1937-1947, 2019)
CONTEXTThe impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. OBJECTIVEThe effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. DESIGN AND METHODSIn this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. RESULTSMean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein-cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein-cholesterol levels decreased (HDL-C; 10.8%; 95% CI, -14.0 to -7.6). In transwomen, HT slightly decreased BP (systolic BP, -2.6%, 95% CI, -4.2 to -1.0; diastolic BP, -2.2%, 95% CI, -4.0 to -0.4) and decreased levels of TC (-9.7%; 95% CI, -11.3 to -8.1), LDL-C (-6.0%; 95% CI, -8.6 to 3.6), HDL-C (-9.3%; 95% CI, -11.4 to -7.3), and triglycerides (-10.2%; 95% CI, -14.5 to -5.9). CONCLUSIONUnfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.
Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein–cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein–cholesterol levels decreased (HDL-C; 10.8%; 95% CI, −14.0 to −7.6). In transwomen, HT slightly decreased BP (systolic BP, −2.6%, 95% CI, −4.2 to −1.0; diastolic BP, −2.2%, 95% CI, −4.0 to −0.4) and decreased levels of TC (−9.7%; 95% CI, −11.3 to −8.1), LDL-C (−6.0%; 95% CI, −8.6 to 3.6), HDL-C (−9.3%; 95% CI, −11.4 to −7.3), and triglycerides (−10.2%; 95% CI, −14.5 to −5.9). Conclusion Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.
Abstract Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein–cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein–cholesterol levels decreased (HDL-C; 10.8%; 95% CI, −14.0 to −7.6). In transwomen, HT slightly decreased BP (systolic BP, −2.6%, 95% CI, −4.2 to −1.0; diastolic BP, −2.2%, 95% CI, −4.0 to −0.4) and decreased levels of TC (−9.7%; 95% CI, −11.3 to −8.1), LDL-C (−6.0%; 95% CI, −8.6 to 3.6), HDL-C (−9.3%; 95% CI, −11.4 to −7.3), and triglycerides (−10.2%; 95% CI, −14.5 to −5.9). Conclusion Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes. In this prospective observational study, favorable lipid changes were found in transwomen and unfavorable lipid changes found in transmen after 12 months of gender-affirming hormone therapy.
Audience Academic
Author Hovingh, G Kees
Simsek, Suat
den Heijer, Martin
Defreyne, Justine
Nota, Nienke M
Thijs, Abel
Klaver, Maartje
van Velzen, Daan M
Paldino, Alessia
T’Sjoen, Guy
AuthorAffiliation Division of Endocrinology, Department of Internal Medicine, Amsterdam University Medical Center, De Boelelaan, HV Amsterdam, Netherlands Department of Endocrinology, Northwest Clinics, Wilhelminalaan, JD Alkmaar, Netherlands Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, Via Giovanni Sai, Trieste, Italy University of Trieste, Trieste, Italy Department of Endocrinology, Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium Center for Sexology and Gender, Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium Department of Vascular Medicine, Amsterdam University Medical Center, Meibergdreef DD, Amsterdam, Netherlands
AuthorAffiliation_xml – name: Division of Endocrinology, Department of Internal Medicine, Amsterdam University Medical Center, De Boelelaan, HV Amsterdam, Netherlands Department of Endocrinology, Northwest Clinics, Wilhelminalaan, JD Alkmaar, Netherlands Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, Via Giovanni Sai, Trieste, Italy University of Trieste, Trieste, Italy Department of Endocrinology, Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium Center for Sexology and Gender, Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium Department of Vascular Medicine, Amsterdam University Medical Center, Meibergdreef DD, Amsterdam, Netherlands
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30602016$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright Copyright © 2019 Endocrine Society 2019
Copyright © Oxford University Press 2015
Copyright © 2019 Endocrine Society.
COPYRIGHT 2019 Oxford University Press
Copyright © 2019 Endocrine Society
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Snippet Abstract Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of...
The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. The effects of 1 year of treatment with oral or...
Context: The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective: The effects of 1 year of treatment...
Context The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective The effects of 1 year of treatment with...
CONTEXTThe impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. OBJECTIVEThe effects of 1 year of treatment with...
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StartPage 1937
SubjectTerms Acetates
Acetic acid
Administration, Oral
Adolescent
Adult
Blood pressure
Blood Pressure - drug effects
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - chemically induced
Cardiovascular Diseases - prevention & control
Cholesterol
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Cyproterone acetate
Cyproterone Acetate - administration & dosage
Cyproterone Acetate - adverse effects
Estrogen
Estrogens
Estrogens - administration & dosage
Estrogens - adverse effects
Female
High density lipoprotein
Hormone Replacement Therapy - adverse effects
Hormone Replacement Therapy - methods
Hormones
Humans
Low density lipoprotein
Low density lipoproteins
Male
Phenols
Prospective Studies
Sex Factors
Sex Reassignment Procedures - adverse effects
Sex Reassignment Procedures - methods
Testosterone
Testosterone - administration & dosage
Testosterone - adverse effects
Transdermal medication
Transdermal Patch
Transgender people
Transgender Persons
Triglycerides
Triglycerides - blood
Young Adult
Title Cardiometabolic Effects of Testosterone in Transmen and Estrogen Plus Cyproterone Acetate in Transwomen
URI https://www.ncbi.nlm.nih.gov/pubmed/30602016
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https://search.proquest.com/docview/2163010026
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