Effects of Sex Hormone Treatment on the Metabolic Syndrome in Transgender Individuals: Focus on Metabolic Cytokines.

Effects of Sex Hormone Treatment on the Metabolic Syndrome in Transgender Individuals: Focus on Metabolic Cytokines.

J Clin Endocrinol Metab. 2017 Dec 05;:

Authors: Auer MK, Ebert T, Pietzner M, Defreyne J, Fuss J, Stalla GK, T'Sjoen G

Abstract
Context: Hormone treatment (HT) in transgender persons affects many components of the metabolic syndrome (MS).
Objective: To determine the role of direct hormonal effects, changes in metabolic cytokines and body composition on metabolic outcomes.
Design, Setting, and Participants: 24 transwomen and 45 transmen from the European Network for the Investigation of Gender Incongruence (ENIGI) investigated at baseline and following 12 months of HT.
Outcome Measures: Best predictors for changes in components of MS applying least absolute shrinkage and selection operator (LASSO) regression.
Results: In transwomen, a decrease in triglyceride levels was best explained by a decrease in fat mass and an increase in FGF-21, while a decrease in total and LDL-cholesterol levels was principally due to a decrease in resistin. A decrease in HDL-cholesterol depended on an inverse association with fat mass. In contrast, in transmen, an increase in LDL-cholesterol was predicted by a decrease in FGF-21 and an increase in the waist-to-hip-ratio, while a decrease in the HDL/total cholesterol-ratio depended on a decline in adiponectin levels. In transwomen, worsened insulin resistance and increased early insulin response seemed to be due to a direct treatment effect, while improvements in hepatic insulin sensitivity in transmen were best predicted by a positive association with chemerin, resistin and FGF-21, while they were inversely related to changes in waist-to-hip-ratio, leptin and AFABP levels.
Conclusions: The effects of HT on different components of the MS are sex-specific and involve a complex interplay of direct hormonal effects, changes in body composition and metabolic cytokine secretion.

PMID: 29216353 [PubMed - as supplied by publisher]

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