Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects

Elbers, Jolanda; Giltay, Erik J.; Teerlink, Tom; Scheffer, P; Asscheman, H.; Seidell, Jacob C.; Gooren, Louis

doi:10.1046/j.1365-2265.2003.01753.x

Cited by 279 publications

(264 citation statements)

References 67 publications

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“…[83][84][85] In obese postmenopausal women, a similar increase in visceral fat and decrease in subcutaneous fat have been reported after administration of a weak androgen (nandrolone decanoate). 86 Similarly, high doses of exogenous testosterone increase BMI and visceral fat mass in female cynomolgus monkeys.…”

Section: Cardiovascular Risk Factors and Diseasesupporting

confidence: 58%

“…In FM transsexuals, testosterone therapy has been reported to increase HL activity. 83 The sensitivity of lipolytic enzymes for androgens is further supported by findings from the HERITAGE study showing a strong inverse association between SHBG and HL activity and a positive association between SHBG and LPL activity. 106 Apart from direct regulatory effects, testosterone and SHBG may also influence lipid metabolism indirectly through their associations with obesity.…”

Section: Lipid Profilementioning

confidence: 79%

“…104,105 In FM transsexuals, testosterone administration has been associated with a reduction in HDL-C and an increase of triglyceride levels. 83 In obese, postmenopausal women administration of nandrolone decanoate 86 causes a decrease in HDL-C and an increase in LDL-C levels. These clinical and experimental data suggest that greater androgenicity is required to induce an atherogenic lipid profile.…”

Section: Lipid Profilementioning

confidence: 99%

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Testosterone, SHBG and cardiovascular health in postmenopausal women

Brand

Schouw

2010

Int J Impot Res

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Cardiovascular disease (CVD) affects men and women differently with women having a lower incidence and later onset of disease. Research has recently refocused interest on the cardiovascular role of androgens. The purpose of this review is to summarize the evidence available on the association between testosterone and cardiovascular health in postmenopausal women. Published studies relating testosterone and sex hormone-binding globulin (SHBG) to CVD and its risk factors were reviewed. Studies included in this review suggest that increased androgenicity, characterized by high testosterone and low SHBG levels, is associated with an adverse CVD risk factor profile in postmenopausal women. However, evidence for an association with cardiovascular events is lacking and it is uncertain whether the observed associations with endogenous testosterone have clinical implications regarding the use of postmenopausal testosterone therapy. Large-scale, longitudinal studies relating testosterone and SHBG levels to cardiovascular risk factors and endpoints are needed to determine the temporal relationship between androgenicity and cardiovascular risk and to ascertain the long-term efficacy and safety of testosterone therapy in postmenopausal women.

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Section: Cardiovascular Risk Factors and Diseasesupporting

confidence: 58%

Section: Lipid Profilementioning

confidence: 79%

Section: Lipid Profilementioning

confidence: 99%

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Testosterone, SHBG and cardiovascular health in postmenopausal women

Brand

Schouw

2010

Int J Impot Res

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“…Preadipocytes are known to have androgen receptors and high androgen levels have been shown to induce selective IR in cultured adipocytes (Belosi et al, 2006). Also, long term androgen administration in female-to-male transsexuals has been shown to induce the development of abdominal obesity and IR (Elbers et al, 2003). This is further supported by the effects of anti-androgens like spironolactone, which appear to reduce IR in some (Diamanti-Kandarakis and Panidis, 2007) but not all studies (Cenk Sayin et al, 2003).…”

Section: Pcos and Obesitymentioning

confidence: 99%

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Rachoń

Teede

2010

Molecular and Cellular Endocrinology

137

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Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution.Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.

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“…As ethinyl estradiol stood out as a risk factor in MtoF in the study on mortality (14), we have reviewed our earlier studies of the effects of cross-sex hormone administration on surrogate cardiovascular risks (28,39,40,41,42,43,44,45) included in Tables 2 and 3. The estrogen used in our own studies was ethinyl estradiol.…”

Section: Relevance Of Chemical Structure and Route Of Estrogen Adminimentioning

confidence: 99%

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

114

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Objective: The incidence of heart disease increases with age, but is lower in women than in men up to 75 years. A protective effect of female sex hormones or, alternatively, acceleration in male heart disease by testosterone at younger ages, could explain this sex difference. In contrast with the above, male-to-female transsexual subjects (MtoF) treated with estrogens (Canti-androgens) show more cardiovascular pathology than female-to-male transsexual subjects (FtoM) receiving testosterone. Why MtoF suffer more frequently from cardiovascular disease than females is as yet unclear. The mode of cross-sex hormone treatment may be a factor, and, if so, it may need adaptations. Subjects and methods: Studies in transsexual people on the effects of cross-sex hormone treatment on surrogate cardiovascular risks and on clinical endpoints were reviewed. With regard to MtoF, a parallel was sought with men with prostate cancer, undergoing androgen deprivation and estrogen administration. Results: Exposure of FtoM to testosterone was not associated with a strong increase in cardiovascular events. Aging and pre-existing cardiovascular pathology contributed to the risk of cardiovascular disease in MtoF. Use of the synthetic biopotent compound ethinyl estradiol in a dose two to four times of oral contraceptives increased cardiovascular risk substantially. The route of administration of estrogens (oral vs transdermal) may have impacted on the risks. Conclusion: MtoF should not be treated with oral ethinyl estradiol. Transdermal estrogens are probably safer than oral estrogens. Pre-existing cardiovascular risks should be taken into consideration when prescribing and choosing the type of estrogens in crosssex hormone administration (oral vs transdermal). In addition, risk factors, as they emerge with aging, should be addressed.

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Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects

Cited by 279 publications

References 67 publications

Testosterone, SHBG and cardiovascular health in postmenopausal women

Testosterone, SHBG and cardiovascular health in postmenopausal women

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

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