Endocrinology, Diabetology and Internal Medicine, Max Planck Institute of Psychiatry, Munich, Germany.
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
J Clin Endocrinol Metab. 2018 Feb 1;103(2):790-802. doi: 10.1210/jc.2017-01559.
Hormonal treatment in transgender persons affects many components of the metabolic syndrome (MS).
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 were investigated at baseline and after 12 months of hormonal therapy.
Best predictors for changes in components of MS, applying least absolute shrinkage and selection operator regression.
In transwomen, a decrease in triglyceride levels was best explained by a decrease in fat mass and an increase in fibroblast growth factor 21 (FGF-21); the decrease in total and low-density lipoprotein cholesterol levels was principally due to a decrease in resistin. A decrease in high-density lipoprotein cholesterol depended on an inverse association with fat mass. In contrast, in transmen, an increase in low-density lipoprotein cholesterol was predicted by a decrease in FGF-21 and an increase in the waist/hip ratio; a decrease in the high-density lipoprotein/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; however, improvements in hepatic insulin sensitivity in transmen were best predicted by a positive association with chemerin, resistin, and FGF-21 and were inversely related to changes in the waist/hip ratio and leptin and adipocyte fatty acid-binding protein levels.
The effects of hormonal therapy 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.
激素治疗会影响跨性别者代谢综合征（MS）的许多方面。
确定直接激素作用、代谢细胞因子变化和身体成分对代谢结果的作用。
设计、设置和参与者：来自欧洲性别不一致调查网络的 24 名跨性别女性和 45 名跨性别男性，在基线和 12 个月激素治疗后进行了研究。
采用最小绝对收缩和选择算子回归，确定代谢综合征各成分变化的最佳预测指标。
在跨性别女性中，甘油三酯水平的降低主要由脂肪量的减少和成纤维细胞生长因子 21（FGF-21）的增加来解释；总胆固醇和低密度脂蛋白胆固醇水平的降低主要归因于抵抗素的减少。高密度脂蛋白胆固醇的降低取决于与脂肪量的反比关系。相反，在跨性别男性中，低密度脂蛋白胆固醇的增加与 FGF-21 的减少和腰臀比的增加有关；高密度脂蛋白/总胆固醇比值的降低取决于脂联素水平的下降。在跨性别女性中，胰岛素抵抗的恶化和早期胰岛素反应的增加似乎是由于直接的治疗作用；然而，在跨性别男性中，肝胰岛素敏感性的改善与 chemerin、抵抗素和 FGF-21 呈正相关，与腰臀比和瘦素及脂肪细胞脂肪酸结合蛋白水平的变化呈负相关。
激素治疗对代谢综合征不同成分的影响具有性别特异性，涉及直接激素作用、身体成分变化和代谢细胞因子分泌的复杂相互作用。
