Cardiovascular Risk Factors in Transgender Women Undergoing Long-Term Gender-Affirming Hormone Therapy: A Cross-Sectional Study

• Published in: Journal of the Endocrine Society 2021-05, Vol.5 (Supplement_1), p.A788-A789
• Main Authors: Alvares, Leonardo A M, Santos, Lívia M, Ramos, Henrique A, Rodeghel, Larissa G, Cavenaghi, Nathan B, Araújo, Clara M, Santana, Thiago R, Mendonca, Berenice Bilharinho, Costa, Elaine Maria Frade, Domenice, Sorahia
• Format: Article
• Language: English
• Subjects: Reproductive Endocrinology
• ISSN: 2472-1972; 2472-1972
• DOI: 10.1210/jendso/bvab048.1604

Introduction: Few data of long-term outcomes of cardiovascular (CVRF) risk factors of transgender women (TW) undergoing gender-affirming hormone therapy (GAHT) are available. Objectives: Evaluate CV risk factors after long-term GAHT in TW. Methods: A cross-sectional study was carried out with 8 TW (average age of 34.0 ±4.8 yo), 8 matched CM and 8 CW on age, body mass index (BMI) and activity level. All TW were non-gonadectomized subjects and were in estrogen [(E); transdermal estradiol (n=2), oral estradiol (n=3) and conjugated estrogen (n=3)] plus cyproterone acetate (CA) (n=8) therapy in an average time of 15.6 ±8.7 years. Results: Total Testosterone (ng/dL) level of TW, CW and CM were 83,5 (range 12,0-637,0), 20,5 (range 12,0-41,0) and 480,5 (range 264,0-843,0), respectively. It was similar between TW and CW (p=0,7284) and different in the comparison TWvsCM (p=0,0325). In TW group, the median of blood glucose was 84 mg / dL, HBA1c 5.1%, total cholesterol 146 mg / dL, HDLc 43 mg / dL, LDLc 89 mg / dL and triglycerides 81.5 mg / dL. In the comparison with other groups, there was no difference from the statistical point of view. It is necessary to emphasize the HDLc of TW (43 mg/dL) which was exactly the same of CM (p>0,999) and lower than CW (60 mg/dL)(p=0,0720). Systolic Blood Pressure (SBP)(mmHg) of TW (126±13) was higher than that of CW (95±11;p 0.9999. Discussion: Youth TW (16.3 ± 1.4 yo) taking an average estradiol dose of 1.5 ± 1.0 mg/day, with an average AGHT duration of 12.3 ± 9.9 months matched to controls on age and BMI did have higher HDL than CW and TW participants were more insulin resistant than CM. About SBP of that youth TW (107 ± 12), it was lower than CW 113 ± 7 (p>0,05) and CM 116 ± 8 (p