Altered arterial stiffness in male‐to‐female transsexuals undergoing hormonal treatment

Sharula,; Chekir, Chebib; Emi, Yayoi; Arai, Fujimi; Kikuchi, Yukako; Sasaki, Akira; Matsuda, Miwa; Shimizu, Keiko; Tabuchi, Kazuhiro; Kamada, Y.; Hiramatsu, Yuji; Nakatsuka, Mikiya

doi:10.1111/j.1447-0756.2011.01815.x

Cited by 16 publications

(6 citation statements)

References 27 publications

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“…Female to male transsexuals treated with androgen therapy have increased arterial stiffness, as measured by brachial‐ankle PWV (Emi, Adachi, Sasaki, Nakamura, & Nakatsuka, ). In contrast, male to female transsexuals treated with oestrogen, but not oestrogen plus progestin, exhibit decreased wave reflection and brachial‐ankle PWV (Sharula et al, ). It is clear that sex hormones substantially impact arterial stiffness, and these effects may differ with age, CVD risk factor presence, and the interaction with the status of other sex hormones in an individual.…”

Section: The Effect Of Sex Hormones On Arterial Stiffnessmentioning

confidence: 99%

Sex differences in mechanisms of arterial stiffness

DuPont

Kenney

Patel

et al. 2019

British J Pharmacology

197

150

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Arterial stiffness progressively increases with aging and is an independent predictor of cardiovascular disease (CVD) risk. Evidence supports that there are sex differences in the time course of aging-related arterial stiffness and the associated CVD risk, which increases disproportionately in postmenopausal women. The association between arterial stiffness and mortality is almost twofold higher in women versus men. The differential clinical characteristics of the development of arterial stiffness between men and women indicate the involvement of sex-specific mechanisms. This review summarizes the current literature on sex differences in vascular stiffness induced by aging, obesity, hypertension, and sex-specific risk factors as well as the impact of hormonal status, diet, and exercise on vascular stiffness in males andfemales. An understanding of the mechanisms driving sex differences in vascular stiffness has the potential to identify novel sex-specific therapies to lessen CVD risk, the leading cause of death in males and females.Large conduit arteries are composed of three layers: (a) the outer tunica adventitia, (b) the middle tunica media, and (c) the inner tunica intima, each of which contributes to the overall stiffness of the vessel wall (Figure 1). The tunica adventitia consists primarily of fibroblasts,

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Section: The Effect Of Sex Hormones On Arterial Stiffnessmentioning

confidence: 99%

Sex differences in mechanisms of arterial stiffness

DuPont

Kenney

Patel

et al. 2019

British J Pharmacology

197

150

View full text Add to dashboard Cite

show abstract

“…Generally, women have significantly lower SUA levels than age-matched men, which then tend to increase after menopause [3]. In addition, many studies in postmenopausal women or male-to-female transgenders have shown SUA reduction after estrogen treatment [4,5]. Moreover, masculinizing hormone therapy in female-to-male transgender patients suppresses estradiol levels and could elevate the SUA levels [6].…”

Section: Introductionmentioning

confidence: 99%

Influence of androgen deprivation therapy on serum urate levels in patients with prostate cancer: A retrospective observational study

Lee

Cho

et al. 2018

PLoS ONE

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ObjectivesAlthough estrogenic modulation of serum urate levels is well-known, the androgenic effect on urate homeostasis remains controversial. We investigated the effect of androgen deprivation therapy (ADT) on serum urate levels.MethodsWe retrospectively enrolled a total of 489 prostate cancer patients with available serum urate levels at baseline and 3 and 6 months after ADT (n = 150) or prostate surgery (n = 339). We extracted the demographic, clinical, and laboratory data from a data warehouse and compared the changes in urate levels between the two treatment groups and between the different ADT regimens (with versus without luteinizing hormone-releasing hormone (LHRH) agonists) using generalized estimating equation (GEE).ResultsThe baseline urate levels and the proportion of hyperuricemic subjects were comparable between the two groups. After 6 months, the urate levels were significantly decreased (by −0.66 mg/dL, 95% confidence interval (CI) [-0.81 to -0.51]) in the ADT group, whereas they did not significantly change in the surgery group in the univariate GEE analysis. The ADT group (4.7% from 18.0% at baseline) had a significantly lower proportion of hyperuricemic patients than surgery group (16.5% from 15.9% at baseline) at 6-month (p < 0.001). Regardless of whether LHRH agonists were used, the serial urate levels were lowered by the ADT. Temporal changes in the urate levels were significantly associated with the treatment group, baseline hyperuricemia, and poor functional or advanced cancer status. The ADT-related serum urate level reduction also remained significant in the multivariate GEE analysis (regression coefficient = −0.43 [−0.67 to −0.19] after 3 months and −0.37 [−0.64 to −0.10] after 6 months). Moreover, propensity-score-matched analyses yielded the same results.ConclusionsOur results showed that longitudinal serum urate levels were significantly reduced in men receiving ADT. This finding suggests that androgen could have an independent role in urate homeostasis.

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“… 23 In that study, systolic blood pressure in estrogen-treated transgender women was only significantly lower than that in untreated transgender women, but brachial-ankle pulse wave velocity was significantly decreased in estrogen-treated transgender women compared with both untreated transgender women and transgender women treated with estrogen plus progestin. 23 The carotid augmentation index was significantly lower in transgender women treated with oral estrogen than that in transgender women treated with parenteral estrogen or oral estrogen plus progestin. 23 These data indicate that estrogen treatment is likely to have some beneficial effects on vascular function in transgender women; however, progestin administered with estrogen may have adverse effects on arterial stiffness.…”

Section: Transgender Womenmentioning

confidence: 74%

“…7 Arterial stiffness in Japanese transgender women (22 untreated and 129 treated with estrogen alone or plus progestin) was evaluated using a volume-plethysmographic apparatus equipped with a multi-element applanation tonometry sensor. 23 In that study, systolic blood pressure in estrogen-treated transgender women was only significantly lower than that in untreated transgender women, but brachial-ankle pulse wave velocity was significantly decreased in estrogen-treated transgender women compared with both untreated transgender women and transgender women treated with estrogen plus progestin. 23 The carotid augmentation index was significantly lower in transgender women treated with oral estrogen than that in transgender women treated with parenteral estrogen or oral estrogen plus progestin.…”

Section: Changes In Risk Factors For Cardiovascular Diseases (Cvd) By...mentioning

confidence: 74%

“… 23 The carotid augmentation index was significantly lower in transgender women treated with oral estrogen than that in transgender women treated with parenteral estrogen or oral estrogen plus progestin. 23 These data indicate that estrogen treatment is likely to have some beneficial effects on vascular function in transgender women; however, progestin administered with estrogen may have adverse effects on arterial stiffness.…”

Section: Transgender Womenmentioning

confidence: 88%

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Cardiovascular Risk in Transgender People With Gender-Affirming Hormone Treatment

Masumori

Nakatsuka

2023

Circ Rep

Self Cite

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Gender-affirming hormone treatment generally by cross-sex hormones is an important strategy for transgender people to achieve the physical features affirming their experienced gender. Estrogens and androgens are administrated, usually for a long time, to transgender women and transgender men who would like to physically achieve feminization and masculinization, respectively. Several harmful adverse events have been reported in the literature following the administration of gender-affirming hormones, including worsening of lipid profiles and cardiovascular events (CVE) such as venous thromboembolism, stroke, and myocardial infarction, but it remains unknown whether the administration of cross-sex hormones to transgender people increases the subsequent risk of CVE and death. Based on the findings of the present narrative review of the recent literature, including meta-analyses and relatively large-scale cohort studies, it is likely that estrogen administration increases the risk of CVE in transgender women, but it remains inconclusive as to whether androgen administration increases the risk of CVE in transgender men. Thus, definitive evidence guaranteeing the long-term safety of cross-sex hormone treatment on the cardiovascular system is insufficient because of lack of evidence from well-organized, high-quality, and large-scale studies. In this situation, as well as considering the proper use of cross-sex hormones, pretreatment screening, regular medical monitoring, and appropriate intervention for risk factors of CVE are necessary to maintain and improve the health of transgender people.

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Altered arterial stiffness in male‐to‐female transsexuals undergoing hormonal treatment

Abstract: Estrogen treatment is likely to have some beneficial effects on lipid metabolism and vascular function in MTF transsexuals; however, progestin administered with estrogen may have adverse effects on arterial stiffness.

Cited by 16 publications

References 27 publications

Sex differences in mechanisms of arterial stiffness

Sex differences in mechanisms of arterial stiffness

Influence of androgen deprivation therapy on serum urate levels in patients with prostate cancer: A retrospective observational study

Cardiovascular Risk in Transgender People With Gender-Affirming Hormone Treatment

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