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Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy

Introduction: In the last decade, healthcare for the transgender population has increased considerably in many countries thanks to depathologization movements and the easier accessibility of medical assistance. The age at which they request to start gender-affirming hormones (GAHs) is increasingly y...

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Autores principales: Sánchez-Toscano, Esteban, Domínguez-Riscart, Jesús, Larrán-Escandón, Laura, Mateo-Gavira, Isabel, Aguilar-Diosdado, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573211/
https://www.ncbi.nlm.nih.gov/pubmed/37834785
http://dx.doi.org/10.3390/jcm12196141
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author Sánchez-Toscano, Esteban
Domínguez-Riscart, Jesús
Larrán-Escandón, Laura
Mateo-Gavira, Isabel
Aguilar-Diosdado, Manuel
author_facet Sánchez-Toscano, Esteban
Domínguez-Riscart, Jesús
Larrán-Escandón, Laura
Mateo-Gavira, Isabel
Aguilar-Diosdado, Manuel
author_sort Sánchez-Toscano, Esteban
collection PubMed
description Introduction: In the last decade, healthcare for the transgender population has increased considerably in many countries thanks to depathologization movements and the easier accessibility of medical assistance. The age at which they request to start gender-affirming hormones (GAHs) is increasingly younger. The cardiovascular risk associated with hormonal treatment is a novel research field, and the published studies are heterogeneous and inconclusive. Our objective is to determine the metabolic impact of GAHs in the transgender people treated in our Gender Identity Treatment Unit. Methods: We designed a pre–post study to analyze changes in anthropometric parameters (weight and body mass index), analytical determinations (fasting blood glucose, glycated hemoglobin, and lipoproteins), and blood pressure control in the transgender population treated with GAHs in Puerta del Mar University Hospital. These variables were collected before and one year after hormonal therapy. Results: A total of 227 transgender people were recruited between 2017 and 2020, 97 (40.09%) transwomen and 136 (59.91%) transmen. The average age at which GAHs began was 18 years. Weight, body mass index, and blood pressure increased significantly in both genders. Transmen showed a more atherogenic lipid profile, with a decrease in cholesterol LDL (p < 0.001) and an increase in triglycerides (p < 0.001). The risk of developing prediabetes or diabetes did not increase one year after treatment, although non-specific alterations in carbohydrate metabolism were detected, such as an increase in glycated hemoglobin in transmen (p = 0.040) and fasting blood glucose in transwomen (p = 0.008). No thromboembolic processes or cardiovascular events were reported during the first year of treatment. Conclusion: In our setting, transgender people developed changes in their metabolic profiles in the first year after hormonal treatment. Both transmen and transwomen showed early alterations in lipid and carbohydrate metabolism, slight elevations in blood pressure, and a tendency to gain weight. This makes lifestyle interventions necessary from the beginning of GAHs.
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spelling pubmed-105732112023-10-14 Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy Sánchez-Toscano, Esteban Domínguez-Riscart, Jesús Larrán-Escandón, Laura Mateo-Gavira, Isabel Aguilar-Diosdado, Manuel J Clin Med Article Introduction: In the last decade, healthcare for the transgender population has increased considerably in many countries thanks to depathologization movements and the easier accessibility of medical assistance. The age at which they request to start gender-affirming hormones (GAHs) is increasingly younger. The cardiovascular risk associated with hormonal treatment is a novel research field, and the published studies are heterogeneous and inconclusive. Our objective is to determine the metabolic impact of GAHs in the transgender people treated in our Gender Identity Treatment Unit. Methods: We designed a pre–post study to analyze changes in anthropometric parameters (weight and body mass index), analytical determinations (fasting blood glucose, glycated hemoglobin, and lipoproteins), and blood pressure control in the transgender population treated with GAHs in Puerta del Mar University Hospital. These variables were collected before and one year after hormonal therapy. Results: A total of 227 transgender people were recruited between 2017 and 2020, 97 (40.09%) transwomen and 136 (59.91%) transmen. The average age at which GAHs began was 18 years. Weight, body mass index, and blood pressure increased significantly in both genders. Transmen showed a more atherogenic lipid profile, with a decrease in cholesterol LDL (p < 0.001) and an increase in triglycerides (p < 0.001). The risk of developing prediabetes or diabetes did not increase one year after treatment, although non-specific alterations in carbohydrate metabolism were detected, such as an increase in glycated hemoglobin in transmen (p = 0.040) and fasting blood glucose in transwomen (p = 0.008). No thromboembolic processes or cardiovascular events were reported during the first year of treatment. Conclusion: In our setting, transgender people developed changes in their metabolic profiles in the first year after hormonal treatment. Both transmen and transwomen showed early alterations in lipid and carbohydrate metabolism, slight elevations in blood pressure, and a tendency to gain weight. This makes lifestyle interventions necessary from the beginning of GAHs. MDPI 2023-09-23 /pmc/articles/PMC10573211/ /pubmed/37834785 http://dx.doi.org/10.3390/jcm12196141 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sánchez-Toscano, Esteban
Domínguez-Riscart, Jesús
Larrán-Escandón, Laura
Mateo-Gavira, Isabel
Aguilar-Diosdado, Manuel
Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title_full Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title_fullStr Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title_full_unstemmed Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title_short Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
title_sort cardiovascular risk factors in transgender people after gender-affirming hormone therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573211/
https://www.ncbi.nlm.nih.gov/pubmed/37834785
http://dx.doi.org/10.3390/jcm12196141
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