New analysis from Karolinska Institutet exhibits that long-term intercourse hormone remedy in transgender people can result in important adjustments in physique composition and threat components for heart problems, notably in transgender males. The research is revealed within the Journal of Inner Medication.
We noticed that transgender males handled with testosterone elevated their muscle quantity by a median of 21 % over six years, but additionally that the quantity of belly fats elevated by 70 %. As well as, they’d extra liver fats and better ranges of ‘unhealthy’ LDL ldl cholesterol, which can improve the danger of heart problems.”
Tommy Lundberg, docent on the Division of Laboratory Medication, Karolinska Institutet
The researchers adopted 17 grownup transgender males and 16 transgender girls who had been prescribed remedy with testosterone and estrogen, respectively. They used magnetic resonance imaging (MRI) to map physique composition and measured metabolic threat components by way of blood assessments, blood strain and vascular stiffness. The scans had been carried out earlier than the beginning of hormone remedy, after one yr and after 5 to 6 years.
The outcomes present that long-term hormone remedy results in a number of main adjustments in each physique composition and metabolic threat components, notably in transgender males. The adjustments in fats volumes continued over time, whereas the best adjustments in muscle mass and energy occurred after only one yr of remedy.
“Earlier research on this space have been comparatively short-term, as much as two years,” explains Tommy Lundberg. “Our outcomes present that you will need to proceed monitoring the long-term well being results of hormone remedy in transgender people to stop heart problems and different well being points.”
In transgender girls receiving estrogen remedy, the adjustments weren’t as pronounced. Their muscle quantity decreased by a median of seven % after 5 years of remedy, whereas muscle energy remained unchanged. The transgender girls elevated their whole fats quantity however gained much less belly fats.
Tissue samples from muscle, fats and pores and skin had been additionally taken as a part of the research. The subsequent step is to analyse these tissue samples to grasp the interplay between genetic intercourse and intercourse hormones. The researchers are investigating, amongst different issues, how hormone remedy impacts skeletal muscle gene expression and the mechanisms behind adjustments in adipose tissue.
“Along with the well being elements, our analysis contributes to elevated data about cheap expectations of the masculinising and feminising results of intercourse hormone remedy,” says Tommy Lundberg. “Nonetheless, a few of the adjustments had been comparatively modest and may elevate warning relating to expectations of long-term and huge adjustments on this affected person group.”
The analysis was funded by Area Stockholm, the Thuring Basis, the 1.6 Million Membership, the Centre for Progressive Medication at Karolinska Institutet, the Swedish Analysis Council, the Swedish Medical Affiliation, the Novo Nordisk Basis and the European Basis for Research of Diabetes.
Two of the co-authors are employed by AMRA Medical AB. Tommy Lundberg has been compensated for professional opinions on elements associated to skeletal muscle adjustments in transgender people and reimbursed for travelling to present lectures on the identical subject.
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Journal reference:
Lundberg, T. R., et al. (2024) Longitudinal adjustments in regional fats and muscle composition and cardiometabolic biomarkers over 5 years of hormone remedy in transgender people. Journal of Inner Medication. doi.org/10.1111/joim.20039.
