New analysis from Karolinska Institutet reveals that long-term intercourse hormone remedy in transgender people can result in important modifications in physique composition and danger elements for heart problems, notably in transgender males. The examine is printed within the Journal of Inner Drugs.
We noticed that transgender males handled with testosterone elevated their muscle quantity by a median of 21 % over six years, but in addition that the quantity of stomach fats elevated by 70 %. As well as, they’d extra liver fats and better ranges of ‘unhealthy’ LDL ldl cholesterol, which can improve the chance of heart problems.”
Tommy Lundberg, docent on the Division of Laboratory Drugs, 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 danger elements by way of blood exams, blood stress 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 modifications in each physique composition and metabolic danger elements, notably in transgender males. The modifications in fats volumes continued over time, whereas the best modifications in muscle mass and power 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 it is very important 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 modifications weren’t as pronounced. Their muscle quantity decreased by a median of seven % after 5 years of remedy, whereas muscle power remained unchanged. The transgender girls elevated their complete fats quantity however gained much less stomach fats.
Tissue samples from muscle, fats and pores and skin had been additionally taken as a part of the examine. The following 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 modifications in adipose tissue.
“Along with the well being elements, our analysis contributes to elevated data about affordable expectations of the masculinising and feminising results of intercourse hormone remedy,” says Tommy Lundberg. “Nevertheless, a number of the modifications had been comparatively modest and will increase warning concerning expectations of long-term and enormous modifications on this affected person group.”
The analysis was funded by Area Stockholm, the Thuring Basis, the 1.6 Million Membership, the Centre for Revolutionary Drugs 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 knowledgeable opinions on elements associated to skeletal muscle modifications 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 modifications in regional fats and muscle composition and cardiometabolic biomarkers over 5 years of hormone remedy in transgender people. Journal of Inner Drugs. doi.org/10.1111/joim.20039.
