Effect of cross-sex hormone treatment on cardiovascular risk factors in transsexual individuals. Experience in a specialized unit in Catalonia

Endocrinol Nutr. 2015 May;62(5):210-6. doi: 10.1016/j.endonu.2015.02.001. Epub 2015 Mar 16.

Abstract

Background and aims: Since the onset of cross hormone therapy (CHT) in transsexual individuals, there has been concern about possible chronic side effects. Our objective was to assess baseline differences in lipid profile in individuals with gender identity disorder in relation to prior CHT, and changes in the lipid profile and other cardiovascular (CV) risk factors after 24 months of treatment.

Methods: Retrospective longitudinal study including all individuals assisted for the first time in the Gender Identity Unit of Catalonia from 2006 to 2010. Socio-demographical, anthropometric and laboratory data were collected.

Results: We evaluated 247 transsexuals, 150 male to female (MtF: 60.7%) and 97 female to male (FtM; 39.3%). At baseline, FtM transsexuals were younger and had started prior CHT less often than MtF (13.4% vs. 64.7%; p<0.001). During follow up, in MtF weight and BMI increased significantly, as well as systolic and diastolic blood pressure, though these latter remained within normal range. No significant differences in lipid profile were observed. FtM transsexuals also presented an increase in weight and BMI, without differences in blood pressure. A general worsening in lipid profile was observed in this group, with increased total cholesterol (166.0 ± 35.1 vs. 175.6 ± 38.2mg/dL; p=0.001), triglycerides (70.6 ± 30.7 vs. 102.3 ± 68.5 mg/dL; p<0.001) and LDL cholesterol (103.8 ± 28.7 vs. 112.8 ± 30.3 mg/dL; p=.013) and decreased HDL cholesterol (52.2 ± 12.2 vs. 45.4 ± 13.8 mg/dL; p=0.001), even though final levels were all within normal range.

Conclusion: There is no detectable increase in CV risk factors in MtF transsexuals who were treated with currently prescribed estrogenic compounds, while a slight worsening in lipid profile takes place in the FtM group, though within normal limits.

Keywords: Cardiovascular risk; Lipids; Lípidos; Riesgo cardiovascular; Transexualidad; Transsexualism.

MeSH terms

  • Adult
  • Androgens / adverse effects
  • Androgens / pharmacology
  • Blood Pressure / drug effects
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Dyslipidemias / chemically induced*
  • Dyslipidemias / epidemiology
  • Emigrants and Immigrants
  • Estrogens / pharmacology
  • Female
  • Gonadal Steroid Hormones / adverse effects
  • Gonadal Steroid Hormones / pharmacology*
  • Health Services for Transgender Persons / statistics & numerical data
  • Humans
  • Lipid Metabolism / drug effects*
  • Lipids / blood
  • Male
  • Retrospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Spain / epidemiology
  • Transgender Persons*
  • Transsexualism / blood*
  • Young Adult

Substances

  • Androgens
  • Estrogens
  • Gonadal Steroid Hormones
  • Lipids