Abstract
Introduction: Previous findings suggest that transgender (TGD) populations have disproportionately higher cardiovascular (CV) risks. We aimed to evaluate the prevalence and odds of CV risk factors in the TGD population in rural Appalachia. Methods: Our case-control study enrolled 92 self-identified TGD people and 73 randomly selected cisgender people. The average age for the TGD and cisgender groups were 29.2 and 29.9, respectively. CV risks of interest examined in both groups were tobacco use, hypertension (HTN), prediabetes/diabetes mellitus (DM), obesity, and hyperlipidemia (HLD). Univariate analysis was used to generate the prevalence of risk factors. Multivariable logistic regressions, adjusted for age and family history of ASCVD, were used to estimate the odds ratio and 95% confidence Interval of having risks of interest. Results: This analysis included 89 and 69 TGD and cisgender individuals, respectively. There was a >6-fold increase in tobacco use (adjusted OR 6.64 [2.59-17.01]) and 4-fold increase in prediabetes/DM (adjusted OR 3.98 [1.05-15.15]) among the TGD population. Among the TGD population, there were increased odds of obesity (OR 13.39 [3.30-54.30] and HLD (OR 3.46 [1.03-11.59]) in the trans-male group compared to the trans-female group. Also, surgical and/or hormonal treatments were significantly associated with higher odds of tobacco use (OR 6.67 [2.80-15.98]), and statin need (OR 3.97 [1.14-13.81] in the TGD group. Conclusion The TGD population have disproportionately higher odds of CV risks in rural Appalachia, worse among trans-male and individuals who received hormonal and/or surgical treatment. This study is limited by sample size.
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