TY - JOUR
T1 - Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy
AU - Klaver, Maartje
AU - van Velzen, Daan
AU - de Blok, Christel
AU - Nota, Nienke
AU - Wiepjes, Chantal
AU - Defreyne, Justine
AU - Schreiner, Thomas
AU - Fisher, Alessandra
AU - Twisk, Jos
AU - Seidell, Jaap
AU - t'Sjoen, Guy
AU - den Heijer, Martin
AU - de Mutsert, Renée
N1 - Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - INTRODUCTION: Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. METHODS: In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. RESULTS: In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (-2 grams; 95% CI -15, 11), albeit with a large range from -318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI -10, 16; range -372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. CONCLUSIONS: Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.
AB - INTRODUCTION: Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. METHODS: In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. RESULTS: In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (-2 grams; 95% CI -15, 11), albeit with a large range from -318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI -10, 16; range -372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. CONCLUSIONS: Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.
KW - Adiposity
KW - Adult
KW - Body Mass Index
KW - Cardiometabolic Risk Factors
KW - Cardiovascular Diseases/etiology
KW - Female
KW - Follow-Up Studies
KW - Hormone Replacement Therapy/adverse effects
KW - Humans
KW - Intra-Abdominal Fat/physiopathology
KW - Male
KW - Obesity/physiopathology
KW - Prognosis
KW - Prospective Studies
KW - Risk Factors
KW - Transgender Persons/statistics & numerical data
KW - Young Adult
KW - hormone therapy
KW - insulin resistance
KW - lipids
KW - transgender
KW - visceral fat
UR - http://www.scopus.com/inward/record.url?scp=85122840119&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85122840119&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34415999
U2 - https://doi.org/10.1210/clinem/dgab616
DO - https://doi.org/10.1210/clinem/dgab616
M3 - Article
C2 - 34415999
SN - 0021-972X
VL - 107
SP - e153-e164
JO - Journal of clinical endocrinology and metabolism
JF - Journal of clinical endocrinology and metabolism
IS - 1
ER -