Long-Term Sex Hormone Treatment in Transgender Care Tied to Changes in Body Composition

TUESDAY, Dec. 3, 2024 (HealthDay News) — Long-term sex hormone treatment in transgender individuals can lead to significant changes in body composition and risk factors for cardiovascular disease, according to a study published online Nov. 27 in the Journal of Internal Medicine.

Tommy R. Lundberg, Ph.D., from the Karolinska Institute in Stockholm, and colleagues examined changes in body composition, muscle volumes, and fat distribution as well as muscle strength, arterial stiffness, and cardiometabolic biomarkers in 17 transgender men (TM) and 16 transgender women (TW) at baseline and after one and five to six years of hormone therapy.

The researchers found that skeletal muscle size increased in TM (21 percent after six years) and decreased in TW (7 percent after five years). Muscle strength was unchanged in TW but increased 18 percent after six years in TM. There was almost complete muscle fat infiltration toward the affirmed sex phenotype after one year of therapy in both TM and TW. For fat volume distribution, TW showed increased total adiposity but decreased visceral fat volume, while TM showed increased visceral fat (70 percent) and liver fat, but relatively stable total adipose tissue levels. There were no changes in arterial stiffness and blood pressure, but there was a significant increase in triglyceride and low-density lipoprotein cholesterol levels and a decrease in high-density lipoprotein levels in TM after six years.

“These unique longitudinal data underscore the importance of continued clinical monitoring of the long-term health effects of gender-affirming hormone therapy in both TW and, perhaps especially, TM,” the authors write.

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