CONTEXT

Increase in body fat and dyslipidemia have been reported in persons receiving gender-affirming hormone therapy (GAHT). However, little is known whether these changes are associated with a pro-inflammatory state.

OBJECTIVE

To study the relationship between changes in body composition, cardiometabolic parameters and systemic inflammatory indices in transgender persons at baseline and one year after starting GAHT.

METHOD

A single center retrospective study including 50 assigned female at birth (AFAB) (median age 21.5 years) and 37 assigned male at birth (AMAB) persons (median age 29 years) with data separated by a 1-year period.

RESULTS

Testosterone therapy in AFAB persons led to a significant increase in VAT (P = 0.0006), trunk/limb ratio (P < 0.001), uric acid (P < 0.001), LDL-cholesterol (P < 0.05) and a significant decrease in HDL-cholesterol (P < 0.05). There were no changes in systemic inflammatory indices. Results of the final regression models indicated that increase in uric acid explained 33.2% of the variation in VAT [F(1,15) = 7.458; adjusted R square 0.332; P = 0.015]. In AMAB persons receiving GAHT, we observed an increase in total body fat (P = 0.002), fat mass index (P = 0.001) and HDL cholesterol (P < 0.05). The aspartate transaminase to lymphocyte ratio index decreased (P < 0.05) one year after the start of treatment.

CONCLUSION

GAHT in the AFAB persons led to a significant increase in VAT and altered metabolic profile. There were no changes in systemic inflammatory indices. The AMAB people presented a non-deleterious cardiometabolic phenotype.

CLINICAL TRIAL REGISTRATION

The study is registered at ClinicalTrials.gov (NCT04508231).