Sluková Dorota, Deischinger Carola, Just Ivica, Kaufmann Ulrike, Trattnig Siegfried, Krššák Martin, Kosi-Trebotic Lana, Harreiter Juergen, Kautzky-Willer Alexandra
Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, General Hospital Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
High Field MR Centre of Excellence, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria.
J Clin Transl Endocrinol. 2024 Dec 6;39:100379. doi: 10.1016/j.jcte.2024.100379. eCollection 2025 Mar.
We aimed to assess the changes in body fat distribution, intraorgan lipid accumulation, and cardiometabolic risk factors after 6 months of gender-affirming hormone therapy (GAHT) in transgender men (TM) and transgender women (TW).
Conducted at the Medical University of Vienna between 2019 and 2022, the study included 15 TW and 20 TM. We conducted magnetic resonance imaging and spectroscopy to determine the visceral (VAT) and subcutaneous adipose tissue (SAT) amounts, the VAT/SAT ratio, and the intraorgan lipid content (liver, pancreas, myocardium), bloodwork, and an oral glucose tolerance test at baseline and after 6 months of GAHT.
Pancreatic, hepatic, and intramyocardial lipid contents did not significantly change in either group after 6 months of GAHT. In TW, VAT/SAT ratio decreased significantly from baseline 0,930 (IQR 0,649-1,287) to 0,758 (IQR 0,424-0,900; p = 0,011) after 6 months of GAHT. The updated homeostatic model assessment for insulin sensitivity (HOMA2-%S) significantly decreased from 83,03 % (±31,11) to 64,27 % (±18,01; p = 0,047), indicating decreased insulin sensitivity, while the updated homeostatic model assessment for β-cell function (HOMA2-%β) increased (from 128,11 % (±35,80) to 156,80 % (±39,49); p = 0,020) in TW after 6 months of GAHT. In TM, there were no changes in glucose metabolism parameters except for an increase in HbA (5,1% (±0,3) vs 5,3% (±0,4), p = 0,001).
6 months of GAHT were not associated with statistically significant changes in myocardial, hepatic, or pancreatic lipid content. Short-term GAHT led to a marked body fat redistribution with a significant decrease in the VAT/SAT ratio in TW.
我们旨在评估跨性别男性（TM）和跨性别女性（TW）接受6个月性别确认激素治疗（GAHT）后身体脂肪分布、器官内脂质蓄积和心脏代谢危险因素的变化。
该研究于2019年至2022年在维也纳医科大学进行，纳入了15名TW和20名TM。我们在基线时以及GAHT治疗6个月后进行了磁共振成像和波谱分析，以确定内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的量、VAT/SAT比值以及器官内脂质含量（肝脏、胰腺、心肌），还进行了血液检查和口服葡萄糖耐量试验。
GAHT治疗6个月后，两组的胰腺、肝脏和心肌内脂质含量均无显著变化。在TW中，GAHT治疗6个月后，VAT/SAT比值从基线时的0.930（四分位间距0.649 - 1.287）显著降至0.758（四分位间距0.424 - 0.900；p = 0.011）。更新后的胰岛素敏感性稳态模型评估（HOMA2-%S）从83.03%（±31.11）显著降至64.27%（±18.01；p = 0.047），表明胰岛素敏感性降低，而更新后的β细胞功能稳态模型评估（HOMA2-%β）在TW接受GAHT治疗6个月后升高（从128.11%（±35.80）升至至156.80%（±39.49）；p = 0.020）。在TM中，除糖化血红蛋白升高外（5.1%（±0.3）对5.3%（±0.4），p = 0.001），糖代谢参数无变化。
6个月的GAHT与心肌、肝脏或胰腺脂质含量的统计学显著变化无关。短期GAHT导致TW体内明显的体脂重新分布，VAT/SAT比值显著降低。
