1. Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy
- Author
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Guy T'Sjoen, Martin den Heijer, Alessandra D. Fisher, Christel J. M. de Blok, Jaap Seidell, Maartje Klaver, Thomas Schreiner, Jos W. R. Twisk, Justine Defreyne, Renée de Mutsert, Daan M. van Velzen, Nota Nienke, Chantal M. Wiepjes, Internal medicine, Epidemiology and Data Science, APH - Health Behaviors & Chronic Diseases, APH - Methodology, APH - Aging & Later Life, Amsterdam Gastroenterology Endocrinology Metabolism, APH - Quality of Care, Youth and Lifestyle, and Network Institute
- Subjects
Male ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,Blood lipids ,Obesity/physiopathology ,Type 2 diabetes ,Biochemistry ,Body Mass Index ,Endocrinology ,Risk Factors ,insulin resistance ,Medicine and Health Sciences ,Prospective Studies ,skin and connective tissue diseases ,Adiposity ,Cardiometabolic risk ,Total body ,Prognosis ,transgender ,adipose tissue ,Cardiovascular Diseases ,Female ,AcademicSubjects/MED00250 ,cardiovascular risk ,Adult ,medicine.medical_specialty ,Hormone Replacement Therapy ,visceral fat ,body fat distribution ,Hormone Replacement Therapy/adverse effects ,Intra-Abdominal Fat ,Transgender Persons ,lipids ,Young Adult ,Insulin resistance ,Transgender Persons/statistics & numerical data ,SDG 3 - Good Health and Well-being ,Internal medicine ,Commentaries ,medicine ,Humans ,Obesity ,Cardiovascular Diseases/etiology ,Online Only Articles ,Visceral fat ,hormone therapy ,business.industry ,Biochemistry (medical) ,Cardiometabolic Risk Factors ,medicine.disease ,Hormone therapy ,sense organs ,Insulin Resistance ,Intra-Abdominal Fat/physiopathology ,business ,metabolism ,Hormone ,trans persons ,Follow-Up Studies - Abstract
Introduction Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. Methods In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. Results In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (−2 grams; 95% CI −15, 11), albeit with a large range from −318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI −10, 16; range −372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. Conclusions Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.
- Published
- 2022