Insulin resistance in transgender individuals correlates with android fat mass

Bretherton, Ingrid; Spanos, Cassandra; Leemaqz, Shalem; Premaratne, Gehan; Grossmann, Mathis; Zajac, Jeffrey D

doi:10.1177/2042018820985681

Cited by 28 publications

(28 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results align with previous reports of increased insulin sensitivity and altered metabolism in transgender men (Fig. 6A, S12D, E) 13, 76, 79 .…”

Section: Resultssupporting

confidence: 93%

The molecular consequences of androgen activity in the human breast

Karimzadeh

Ing

et al. 2022

Preprint

View full text Add to dashboard Cite

SummaryThe mammary gland has been extensively studied for estrogen and progesterone reactivity, but the molecular effects of androgen in the breast remain largely unexplored. Transgender men are recorded female at birth but identify as male and may undergo gender-affirming androgen therapy to align their physical characteristics and gender identity. Here we perform single cell resolution transcriptome, chromatin, and spatial profiling of androgen treated breasts from transgender men. We find male-biased androgen receptor gene targets are upregulated in cells expressing androgen receptor, and that paracrine signaling drives sex-relevant changes in other cell types. We observe an altered epithelium, shifts in immune populations, and a reduction of capillary vasculature. Finally, we find evidence of the metabolic impact of androgen and identify a gene regulatory network driving androgen-directed fat loss. This work elucidates the molecular consequences of androgen in the human breast at single cell resolution.

show abstract

“…These results align with previous reports of increased insulin sensitivity and altered metabolism in transgender men (Fig. 6A, S12D, E) 13, 76, 79 .…”

Section: Resultssupporting

confidence: 93%

The molecular consequences of androgen activity in the human breast

Karimzadeh

Ing

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…GAHT reduces mental health problems in trans people and helps obtain the desired physical features [37,40,41,46,51,52,[55][56][57][58][59][60], but the role of the mental health professional in the gender team is clear from the relatively high prevalence of mental health problems. The main somatic concerns are bone health, cardiovascular events, and cancer risk.…”

Section: Discussionmentioning

confidence: 99%

“…They found an increase of 7.8 kg (95% CI 4.0; 11.5) in lean mass and higher android/gynoid fat ratio in trans men compared to cis women. Trans women experienced a decrease of lean mass of 6.9 kg (95% CI −10.6; −3.1) and a lower android/gynoid fat ratio compared to cis men [59]. Another ENIGI study [60] evaluated selfreported symptoms during the first year of GAHT in trans men (n = 193, median age = 23) and in trans women (n= 205, median age = 29).…”

Section: Body Composition and Contoursmentioning

confidence: 99%

Gender‐affirming hormone therapy: An updated literature review with an eye on the future

D'hoore

T’Sjoen

2022

J Intern Med

View full text Add to dashboard Cite

show abstract

“…A number of changes in surrogate cardiovascular risk markers occur after commencing feminizing hormone therapy, including increased weight, visceral fat, total body fat, reduced insulin sensitivity, and potentially increased systolic and diastolic blood pressure ( 7 , 23 ). Endocrine Society guidelines suggest cardiovascular risk factors be treated as they emerge, in accordance with established guidelines ( 10 ), and other groups advocate managing hypertension, hypercholesterolaemia, diabetes and smoking before initiating feminizing therapy as a risk mitigation strategy ( 9 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

Feminizing Hormone Therapy Prescription Patterns and Cardiovascular Risk Factors in Aging Transgender Individuals in Australia

Balcerek

Nolan

Brownhill³

et al. 2021

Front. Endocrinol.

Self Cite

View full text Add to dashboard Cite

ContextThe safety and efficacy of feminizing hormone therapy in aging transgender (trans) individuals is unclear. Current recommendations suggest transdermal estradiol beyond the age of 45 years, especially if cardiometabolic risk factors are present.ObjectiveTo evaluate feminizing hormone therapy regimens and cardiovascular risk factors in aging trans individuals.DesignRetrospective cross-sectional analysis.SettingPrimary care and endocrine specialist clinic in Melbourne, Australia.ParticipantsTrans individuals on feminizing therapy for ≥6 months.Main Outcomes MeasuresFeminizing hormone regimens and serum estradiol concentrations by age group: (a) ≥45 years, (b) <45 years, and prevalence of cardiometabolic risk factors in individuals ≥45 years.Results296 individuals were stratified by age group: ≥45 years (n=55) and <45 years (n=241). There was no difference in median estradiol concentration between groups (328 nmol/L vs. 300 nmol/L, p=0.22). However, there was a higher proportion of individuals ≥45 years treated with transdermal estradiol (31% vs. 8%, p<0.00001). Of those treated with oral estradiol, the median dose was lower in the ≥45 years group (4mg vs. 6mg, p=0.01). The most prevalent cardiometabolic risk factor in the ≥45 years group was hypertension (29%), followed by current smoking (24%), obesity (20%), dyslipidaemia (16%) and diabetes (9%).ConclusionsA greater proportion of trans individuals ≥45 years of age were treated with transdermal estradiol. Of those who received oral estradiol, the median dose was lower. This is important given the high prevalence of cardiometabolic risk factors in this age group, however cardiovascular risk management guidelines in this demographic are lacking.

show abstract

Insulin resistance in transgender individuals correlates with android fat mass

Cited by 28 publications

References 60 publications

The molecular consequences of androgen activity in the human breast

The molecular consequences of androgen activity in the human breast

Gender‐affirming hormone therapy: An updated literature review with an eye on the future

Feminizing Hormone Therapy Prescription Patterns and Cardiovascular Risk Factors in Aging Transgender Individuals in Australia

Contact Info

Product

Resources

About