Alterations in Lipids and Adipocyte Hormones in Female-to-Male Transsexuals

Prakash Chandra,Vin Tangpricha,Tai C Chen,Sukhdeep S Basra

doi:10.1155/2010/945053

Abstract

Testosterone therapy in men and women results in decreased high-density lipoprotein cholesterol (HDL) and increased low-density lipoprotein cholesterol (LDL). We sought to determine whether testosterone therapy has this same effect on lipid parameters and adipocyte hormones in female-to-male (FTM) transsexuals. Twelve FTM transsexuals provided a fasting lipid profile including serum total cholesterol, HDL, LDL, and triglycerides prior to and after 1 year of testosterone therapy (testosterone enanthate or cypionate 50–125 mg IM every two weeks). Subjects experienced a significant decrease in mean serum HDL (52 ± 11 to 40 ± 7 mg/dL) (P < .001). The mean LDL (P = .316), triglyceride (P = .910), and total cholesterol (P = .769) levels remained unchanged. In a subset of subjects, we measured serum leptin levels which were reduced by 25% but did not reach statistical significance (P = .181) while resistin levels remained unchanged. We conclude that testosterone therapy in FTM transsexuals can promote an increased atherogenic lipid profile by lowering HDL and possibly reduce serum leptin levels. However, long-term studies are needed to determine whether decreases in HDL result in adverse cardiovascular outcomes.

Highlights

Transsexualism is a medical condition characterized by gender dysphoria which is managed with cross-sex hormones and surgery to align an individual’s physical appearance with their gender orientation [1, 2]
Other studies not examined in the metaanalysis by Elamin et al have demonstrated increased total cholesterol (TC) [4] and low-density lipoprotein (LDL) levels [4, 5] in FTM transsexuals receiving testosterone therapy
17 FTM transsexuals treated with intramuscular injections of long acting testosterone undecanonate for 36 months demonstrated a decrease in TC and LDL without effecting triglyceride and high-density lipoprotein (HDL) levels [6]

Summary

Introduction

Transsexualism is a medical condition characterized by gender dysphoria which is managed with cross-sex hormones and surgery to align an individual’s physical appearance with their gender orientation [1, 2]. Gooren et al [7] suggested that an increased atherogenic lipid profile can be a result increased weight and visceral fat after testosterone therapy in FTM transsexuals [8]. This changed adiposity pattern can lead to differential adipocyte hormone secretion [9, 10]. We hypothesized that supraphysiologic (male replacement) doses of testosterone in FTM transsexuals (genetic females) would lead to a more atherogenic lipid profile and increase markers of insulin resistance. Our prospective clinical trial evaluated changes in the lipid profile and the adipokines, resistin and leptin, in FTM transsexuals before and after treatment with male-replacement doses of testosterone

Results

Discussion

Conclusion