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Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen

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Abstract
Context: The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective: The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods: In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results: Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein-cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein-cholesterol levels decreased (HDL-C; 10.8%; 95% CI, -14.0 to -7.6). In transwomen, HT slightly decreased BP (systolic BP, -2.6%, 95% CI, -4.2 to -1.0; diastolic BP, -2.2%, 95% CI, -4.0 to -0.4) and decreased levels of TC (-9.7%; 95% CI, -11.3 to -8.1), LDL-C (-6.0%; 95% CI, -8.6 to 3.6), HDL-C (-9.3%; 95% CI, -11.4 to -7.3), and triglycerides (-10.2%; 95% CI, -14.5 to -5.9). Conclusion: Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.
Keywords
SEEKING TRANSGENDER POPULATION, HIGH-DENSITY-LIPOPROTEIN, CORONARY-HEART-DISEASE, A-I KINETICS, INSULIN-RESISTANCE, POSTMENOPAUSAL WOMEN, REPLACEMENT THERAPY, FOLLOW-UP, HORMONAL TREATMENT, HYPOGONADAL MEN

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MLA
van Velzen, Daan M., et al. “Cardiometabolic Effects of Testosterone in Transmen and Estrogen plus Cyproterone Acetate in Transwomen.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, vol. 104, no. 6, 2019, pp. 1937–47, doi:10.1210/jc.2018-02138.
APA
van Velzen, D. M., Paldino, A., Klaver, M., Nota, N. M., Defreyne, J., Hovingh, G. K., … den Heijer, M. (2019). Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 104(6), 1937–1947. https://doi.org/10.1210/jc.2018-02138
Chicago author-date
Velzen, Daan M. van, Alessia Paldino, Maartje Klaver, Nienke M. Nota, Justine Defreyne, G. Kees Hovingh, Abel Thijs, Suat Simsek, Guy T’Sjoen, and Martin den Heijer. 2019. “Cardiometabolic Effects of Testosterone in Transmen and Estrogen plus Cyproterone Acetate in Transwomen.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 104 (6): 1937–47. https://doi.org/10.1210/jc.2018-02138.
Chicago author-date (all authors)
van Velzen, Daan M., Alessia Paldino, Maartje Klaver, Nienke M. Nota, Justine Defreyne, G. Kees Hovingh, Abel Thijs, Suat Simsek, Guy T’Sjoen, and Martin den Heijer. 2019. “Cardiometabolic Effects of Testosterone in Transmen and Estrogen plus Cyproterone Acetate in Transwomen.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 104 (6): 1937–1947. doi:10.1210/jc.2018-02138.
Vancouver
1.
van Velzen DM, Paldino A, Klaver M, Nota NM, Defreyne J, Hovingh GK, et al. Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM. 2019;104(6):1937–47.
IEEE
[1]
D. M. van Velzen et al., “Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen,” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, vol. 104, no. 6, pp. 1937–1947, 2019.
@article{8653704,
  abstract     = {{Context: The impact of gender-affirming hormone therapy (HT) on cardiometabolic parameters is largely unknown. Objective: The effects of 1 year of treatment with oral or transdermal administration of estrogen (plus cyproterone) and transdermal or IM application of testosterone on serum lipid levels and blood pressure (BP) were assessed in transgender persons. Design and Methods: In this prospective, observational substudy of the European Network for the Investigation of Gender Incongruence, measurements were performed before and after 12 months of HT in 242 transwomen and 188 transmen from 2010 to 2017. Results: Mean values are reported. In transmen, HT increased diastolic BP (2.5%; 95% CI, 0.6 to 4.4) and levels of total cholesterol (TC; 4.1%; 95% CI, 1.5 to 6.6), low-density lipoprotein-cholesterol (LDL-C; 13.0%; 95% CI, 9.2 to 16.8), and triglycerides (36.9%; 95% CI, 29.8 to 44.1); high-density lipoprotein-cholesterol levels decreased (HDL-C; 10.8%; 95% CI, -14.0 to -7.6). In transwomen, HT slightly decreased BP (systolic BP, -2.6%, 95% CI, -4.2 to -1.0; diastolic BP, -2.2%, 95% CI, -4.0 to -0.4) and decreased levels of TC (-9.7%; 95% CI, -11.3 to -8.1), LDL-C (-6.0%; 95% CI, -8.6 to 3.6), HDL-C (-9.3%; 95% CI, -11.4 to -7.3), and triglycerides (-10.2%; 95% CI, -14.5 to -5.9). Conclusion: Unfavorable changes in lipid profile were observed in transmen; a favorable effect was noted in transwomen. HT effects on BP were negligible. Long-term studies are warranted to assess whether and to what extent HT in trans individuals results in a differential effect on cardiovascular disease outcomes.}},
  author       = {{van Velzen, Daan M. and Paldino, Alessia and Klaver, Maartje and Nota, Nienke M. and Defreyne, Justine and Hovingh, G. Kees and Thijs, Abel and Simsek, Suat and T'Sjoen, Guy and den Heijer, Martin}},
  issn         = {{0021-972X}},
  journal      = {{JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM}},
  keywords     = {{SEEKING TRANSGENDER POPULATION,HIGH-DENSITY-LIPOPROTEIN,CORONARY-HEART-DISEASE,A-I KINETICS,INSULIN-RESISTANCE,POSTMENOPAUSAL WOMEN,REPLACEMENT THERAPY,FOLLOW-UP,HORMONAL TREATMENT,HYPOGONADAL MEN}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1937--1947}},
  title        = {{Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen}},
  url          = {{http://doi.org/10.1210/jc.2018-02138}},
  volume       = {{104}},
  year         = {{2019}},
}

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