Effects of gender-affirming hormone therapy on body fat: a retrospective case‒control study in Chinese transwomen.
Humans
Female
Adult
Retrospective Studies
Transgender Persons
Case-Control Studies
China
/ epidemiology
Male
Obesity
/ blood
Adipose Tissue
/ drug effects
Blood Glucose
/ metabolism
Middle Aged
Body Fat Distribution
Estrogens
/ blood
Transsexualism
/ drug therapy
Sex Reassignment Procedures
Intra-Abdominal Fat
/ drug effects
Body Mass Index
Asian People
East Asian People
Fat
Gender-affirming hormone therapy
Lipids
Transwomen
Journal
Lipids in health and disease
ISSN: 1476-511X
Titre abrégé: Lipids Health Dis
Pays: England
ID NLM: 101147696
Informations de publication
Date de publication:
17 May 2024
17 May 2024
Historique:
received:
26
02
2024
accepted:
06
05
2024
medline:
18
5
2024
pubmed:
18
5
2024
entrez:
17
5
2024
Statut:
epublish
Résumé
There is insufficient research on how gender-affirming hormone therapy (GAHT) affects body fat modifications in transwomen from China. It is unclear whether hormone therapy affects the prevalence of obesity and blood lipid levels within this population. The current research aimed to assess how GAHT and treatment duration had an impact on the change in and redistribution of body fat in Chinese transwomen. This study included 40 transwomen who had not received GAHT and 59 who had. Body fat, blood lipid, and blood glucose levels were measured. GAHT is mainly a pharmacologic (estrogen and anti-androgen) treatment. The study also stratified participants based on the duration of GAHT to assess its impact on body fat distribution. The duration of GAHT was within one year, one to two years, two to three years, or more than three years. After receiving GAHT, total body fat increased by 19.65%, and the percentage of body fat increased by 17.63%. The arm, corrected leg, and leg regions showed significant increases in fat content (+ 24.02%, + 50.69%, and + 41.47%, respectively) and percentage (+ 25.19%, + 34.90%, and + 30.39%, respectively). The total visceral fat content decreased (-37.49%). Based on the diagnostic standards for a body mass index ≥ 28 or total body fat percentage ≥ 25% or 30%, the chance of developing obesity did not change significantly. Blood glucose levels significantly increased (+ 12.31%). Total cholesterol levels (-10.45%) decreased significantly. Fat changes in those who received GAHT for one to two years were significantly different from those who did not receive GAHT. After receiving GAHT, total body fat and regional fat increased in Chinese transwomen, and the body fat distribution changed from masculine to feminine, especially during the first two years. However, neither the increase in total body fat percentage nor the decrease in visceral fat content didn't bring about significant changes in the incidence of obesity, nor did triglycerides or low-density lipoprotein-cholesterol.
Sections du résumé
BACKGROUND
BACKGROUND
There is insufficient research on how gender-affirming hormone therapy (GAHT) affects body fat modifications in transwomen from China. It is unclear whether hormone therapy affects the prevalence of obesity and blood lipid levels within this population. The current research aimed to assess how GAHT and treatment duration had an impact on the change in and redistribution of body fat in Chinese transwomen.
METHODS
METHODS
This study included 40 transwomen who had not received GAHT and 59 who had. Body fat, blood lipid, and blood glucose levels were measured. GAHT is mainly a pharmacologic (estrogen and anti-androgen) treatment. The study also stratified participants based on the duration of GAHT to assess its impact on body fat distribution. The duration of GAHT was within one year, one to two years, two to three years, or more than three years.
RESULTS
RESULTS
After receiving GAHT, total body fat increased by 19.65%, and the percentage of body fat increased by 17.63%. The arm, corrected leg, and leg regions showed significant increases in fat content (+ 24.02%, + 50.69%, and + 41.47%, respectively) and percentage (+ 25.19%, + 34.90%, and + 30.39%, respectively). The total visceral fat content decreased (-37.49%). Based on the diagnostic standards for a body mass index ≥ 28 or total body fat percentage ≥ 25% or 30%, the chance of developing obesity did not change significantly. Blood glucose levels significantly increased (+ 12.31%). Total cholesterol levels (-10.45%) decreased significantly. Fat changes in those who received GAHT for one to two years were significantly different from those who did not receive GAHT.
CONCLUSION
CONCLUSIONS
After receiving GAHT, total body fat and regional fat increased in Chinese transwomen, and the body fat distribution changed from masculine to feminine, especially during the first two years. However, neither the increase in total body fat percentage nor the decrease in visceral fat content didn't bring about significant changes in the incidence of obesity, nor did triglycerides or low-density lipoprotein-cholesterol.
Identifiants
pubmed: 38760846
doi: 10.1186/s12944-024-02131-y
pii: 10.1186/s12944-024-02131-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
146Subventions
Organisme : the Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University, China
ID : JNU1AF-CFTP-2022-a01227
Organisme : Science and Technology Program of Guangzhou, China
ID : 2023A03J0602
Informations de copyright
© 2024. The Author(s).
Références
Battle DE. Diagnostic and statistical Manual of Mental disorders (DSM). Codas. 2013;25:191–2.
pubmed: 24413388
Libby V, Lee M, Liu JH. Transgender health: hormonal management at 50 years and beyond. Maturitas. 2019;126:34–7.
doi: 10.1016/j.maturitas.2019.04.220
pubmed: 31239115
T’Sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of Transgender Medicine. Endocr Rev. 2019;40:97–117.
doi: 10.1210/er.2018-00011
pubmed: 30307546
Lvfen G, Linzhi G, Xingmei X, Lishan X, Yuwei S, Shunkai L, Yanbin J, Xiaoyu W. Strategies for gender-affirming hormone therapy for transgender women. Obstetrics-Gynecology Genet (Electronic Edition). 2022;12:37–45.
Klaver M, de Blok CJM, Wiepjes CM, Nota NM, Dekker M, de Mutsert R, Schreiner T, Fisher AD. T’Sjoen G, den Heijer M. Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study. Eur J Endocrinol. 2018;178:163–71.
doi: 10.1530/EJE-17-0496
pubmed: 29183889
Tack LJW, Craen M, Lapauw B, Goemaere S, Toye K, Kaufman JM, Vandewalle S, T’Sjoen G, Zmierczak HG, Cools M. Proandrogenic and antiandrogenic progestins in transgender youth: Differential effects on body composition and bone metabolism. J Clin Endocrinol Metab. 2018;103:2147–56.
doi: 10.1210/jc.2017-02316
pubmed: 29672753
Fighera TM, Da SE, Lindenau JD, Spritzer PM. Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen. Clin Endocrinol (Oxf). 2018;88:856–62.
doi: 10.1111/cen.13607
pubmed: 29630732
Haraldsen IR, Haug E, Falch J, Egeland T, Opjordsmoen S. Cross-sex pattern of bone mineral density in early onset gender identity disorder. Horm Behav. 2007;52:334–43.
doi: 10.1016/j.yhbeh.2007.05.012
pubmed: 17604029
Van Caenegem E, Wierckx K, Taes Y, Schreiner T, Vandewalle S, Toye K, Kaufman JM, T’Sjoen G. Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study. Osteoporos Int. 2015;26:35–47.
doi: 10.1007/s00198-014-2805-3
pubmed: 25377496
Wierckx K, Mueller S, Weyers S, Van Caenegem E, Roef G, Heylens G, T’Sjoen G. Long-term evaluation of cross-sex hormone treatment in transsexual persons. J Sex Med. 2012;9:2641–51.
doi: 10.1111/j.1743-6109.2012.02876.x
pubmed: 22906135
Yun Y, Kim D, Lee ES. Effect of Cross-sex hormones on Body Composition, Bone Mineral density, and muscle strength in Trans Women. J Bone Metab. 2021;28:59–66.
doi: 10.11005/jbm.2021.28.1.59
pubmed: 33730784
pmcid: 7973405
Yanrong L, Yifan S, Piao Y, Lili Y. Regulation mechanism of adipocyte differentiation and its effect on metabolism. Int J Clin Res. 2023;7:1–8.
van Velzen DM, Paldino A, Klaver M, Nota NM, Defreyne J, Hovingh GK, Thijs A, Simsek S. T Sjoen G, den Heijer M. Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen. J Clin Endocrinol Metabolism. 2019;104:1937–47.
doi: 10.1210/jc.2018-02138
Maraka S, Singh ON, Rodriguez-Gutierrez R, Davidge-Pitts CJ, Nippoldt TB, Prokop LJ, Murad MH. Sex steroids and cardiovascular outcomes in transgender individuals: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2017;102:3914–23.
doi: 10.1210/jc.2017-01643
pubmed: 28945852
Stults-Kolehmainen MA, Stanforth PR, Bartholomew JB, Lu T, Abolt CJ, Sinha R. DXA estimates of fat in abdominal, trunk and hip regions varies by ethnicity in men. Nutr Diabetes. 2013;3:e64.
doi: 10.1038/nutd.2013.5
pubmed: 23507968
pmcid: 3608895
Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J Clin Nutr. 1990;51:1106–12.
doi: 10.1093/ajcn/51.6.1106
pubmed: 2349926
Imboden MT, Welch WA, Swartz AM, Montoye AH, Finch HW, Harber MP, Kaminsky LA. Reference standards for body fat measures using GE dual energy x-ray absorptiometry in caucasian adults. PLoS ONE. 2017;12:e0175110.
doi: 10.1371/journal.pone.0175110
pubmed: 28388669
pmcid: 5384668
Seyed-Sadjadi N, Berg J, Bilgin AA, Grant R. Visceral fat mass: is it the link between uric acid and diabetes risk? Lipids Health Dis. 2017;16:142.
doi: 10.1186/s12944-017-0532-4
pubmed: 28738905
pmcid: 5525310
Group COWG. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Chin J Epidemiol 2002:10–5.
Mai S, Yanbo Z. Research Progress on the diagnostic criteria of obesity and lts clinical application. Food Nutr China. 2014;20:76–80.
Wells JC. Sexual dimorphism of body composition. Best Pract Res Clin Endocrinol Metab. 2007;21:415–30.
doi: 10.1016/j.beem.2007.04.007
pubmed: 17875489
Cocchetti C, Castellini G, Iacuaniello D, Romani A, Maggi M, Vignozzi L, Schreiner T, den Heijer M, T’Sjoen G, Fisher AD. Does gender-affirming hormonal treatment affect 30-Year cardiovascular risk in transgender persons? A two-year prospective European study (ENIGI). J Sex Med. 2021;18:821–9.
doi: 10.1016/j.jsxm.2021.01.185
pubmed: 33745831
Milionis C, Ilias I, Venaki E, Koukkou E. Glucose homeostasis, diabetes mellitus, and gender-affirming treatment. Biomedicines 2023; 11.
Root-Bernstein R, Podufaly A, Dillon PF. Estradiol binds to insulin and insulin receptor decreasing insulin binding in vitro. Front Endocrinol (Lausanne). 2014;5:118.
doi: 10.3389/fendo.2014.00118
pubmed: 25101056
Kivimäki M, Strandberg T, Pentti J, Nyberg ST, Frank P, Jokela M, Ervasti J, Suominen SB, Vahtera J, Sipilä PN, et al. Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study. Lancet Diabetes Endocrinol. 2022;10:253–63.
doi: 10.1016/S2213-8587(22)00033-X
pubmed: 35248171
pmcid: 8938400
Hsu HY, Tsai MC, Yeh TL, Hsu LY, Hwang LC, Chien KL. Association of baseline as well as change in lipid levels with the risk of cardiovascular diseases and all-cause deaths. Sci Rep. 2021;11:7381.
doi: 10.1038/s41598-021-86336-6
pubmed: 33795701
pmcid: 8016969
Santangelo G, Moscardelli S, Simeoli PS, Guazzi M, Faggiano P. Management of dyslipidemia in secondary prevention of cardiovascular disease: the gap between theory and practice. 2022;11:pp. null.
Klaver M, van Velzen D, de Blok C, Nota N, Wiepjes C, Defreyne J, Schreiner T, Fisher A, Twisk J, Seidell J, et al. Change in visceral fat and total body Fat and the effect on cardiometabolic risk factors during transgender hormone therapy. J Clin Endocrinol Metab. 2022;107:e153–64.
doi: 10.1210/clinem/dgab616
pubmed: 34415999
Hunter GR, Gower BA, Kane BL. Age related shift in visceral fat. Int J Body Compos Res. 2010;8:103–8.
pubmed: 24834015
pmcid: 4018766
Coin A, Giannini S, Minicuci N, Rinaldi G, Pedrazzoni M, Minisola S, Rossini M, Del PA, Inelmen EM, Manzato E, Sergi G. Limb fat-free mass and fat mass reference values by dual-energy X-ray absorptiometry (DEXA) in a 20–80 year-old Italian population. Clin Nutr. 2012;31:506–11.
doi: 10.1016/j.clnu.2012.01.012
pubmed: 22342050
Bracco D, Thiébaud D, Chioléro RL, Landry M, Burckhardt P, Schutz Y. Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans. J Appl Physiol (1985). 1996;81:2580–7.
doi: 10.1152/jappl.1996.81.6.2580
pubmed: 9018509
Stults-Kolehmainen MA, Stanforth PR, Bartholomew JB. Fat in android, trunk, and peripheral regions varies by ethnicity and race in college aged women. Obes (Silver Spring). 2012;20:660–5.
doi: 10.1038/oby.2011.300
Fuller NJ, Laskey MA, Elia M. Assessment of the composition of major body regions by dual-energy X-ray absorptiometry (DEXA), with special reference to limb muscle mass. Clin Physiol. 1992;12:253–66.
doi: 10.1111/j.1475-097X.1992.tb00831.x
pubmed: 1606809
The fifth National Physical Fitness Monitoring Bulletin. National Physical Fitness Monitoring Center; 2022.
Ford K, Huggins E, Sheean P. Characterising body composition and bone health in transgender individuals receiving gender-affirming hormone therapy. J Hum Nutr Diet. 2022;35:1105–14.
doi: 10.1111/jhn.13027
pubmed: 35509260
pmcid: 9790536
Piché ME, Tchernof A, Després JP. Obesity phenotypes, diabetes, and Cardiovascular diseases. Circ Res. 2020;126:1477–500.
doi: 10.1161/CIRCRESAHA.120.316101
pubmed: 32437302