Effect of long-term androgenic treatment on the structural and functional properties of the great arteries of female transsexuals

Abstract

BackgroundAndrogens act directly on the vasculature through your connection to the androgen receptor in the vascular wall, and can promote changes in structural and functional vascular properties.ObjectiveTo evaluate the structural and functional properties of large arteries in TF in prolonged use of testosterone esters and compare them with those of a control group men and women.Patients and methods42 patients with diagnosis of TF (42 ± 10 years) in treatment with testosterone esters for at least 1 year (1–38 years) and 147 healthy controls matched for age and BMI were submitted to evaluation of carotid parameters by radiofrequency ultrasound (WTS®): intima media thickness (IMT), diameter and relative distension. The carotid-femoral pulse wave velocity (PWVcf) was measured by Complior® device.ResultsThe TF showed higher (p < 0.01) PWVcf (7.2 ± 0.8 m/s) than the male controls (6.6 ± 0.9 m/s), but not than female controls (7 ± 1 m/s). When categorized by age, considering median values of age, TF ≥ 42 years showed higher PWVcf than male and female controls, independently of BP values. There is no diferences in carotid parameters between TF and control groups, but obese TF presented higher carotid diameter (6944 ± 527 vs. 6438 ± 555 µm and IMT (691 ± 72 vs. 601 ± 126 µm), and lower carotid distension (4,8 ± 1,5 vs. 6,5 ± 2,1%) than lean TF. The PWVcf was significantly correlated to age (r = 0.63), time of androgenic treatment (r = 0.37) and waist-hip ratio (0.39) in TF.ConclusionOlder TF subjects and TF with prolonged treatment had higher aortic stiffness. Obese TF presented worst carotid structural and functional markers