Evidence mapPaperPMID 39441016Full record

ArticleThe Journal of clinical endocrinology and metabolism2025

Cardiometabolic Risk Assessment in Transgender Individuals-Differential Effect of Sex Hormones and Sex Chromosomes.

Yu Lei, Anna Wiik, Margery A Connelly, Linnea Lindberg, Daniel P Andersson, Stefan Arver, Thomas Gustafsson, Uwe J F Tietge

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yu LeiDivision of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, S-141 83 Stockholm, Sweden.
Anna WiikDivision of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, S-141 83 Stockholm, Sweden.
Margery A ConnellyLabcorp, Morrisville, NC 27560, USA.
Linnea LindbergDivision of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, S-141 83 Stockholm, Sweden.
Daniel P AnderssonDepartment of Medicine-H7, Karolinska Institutet, S-141 83 Stockholm, Sweden.
Stefan ArverANOVA, Andrology, Sexual Medicine and Transgender Medicine, Karolinska University Hospital, S-141 86 Stockholm, Sweden.
Thomas GustafssonDivision of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, S-141 83 Stockholm, Sweden.
Uwe J F TietgeDivision of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, S-141 83 Stockholm, Sweden.ORCID 0000-0001-9469-7651

Funding

1.6 Million ClubCIMED FoUI-963234Stockholm County Council 20160337Stockholm County Council 954970Stockholm County Council 962029Stockholm County Council 963296Stockholm County Council K0138-2015the Thuring Foundation
6 · The paper itself

Abstract

contextWhile transgender individuals represent a substantial group seeking medical care, the differential effect of sex on cardiometabolic risk metrics is incompletely understood.

objectiveThe present study aimed to characterize the effect of sex hormones and chromosomes on a contemporary panel of cardiometabolic risk biomarkers and functional cardiovascular measurements.

methodsA total of 17 transgender men and 17 transgender women were studied at baseline (T0), 4 weeks (hormonal castration, T1), and 11 months following gender-affirming hormone treatment (T12). We analyzed carotid intima-media thickness and arterial stiffness, lipoproteins, and other metabolites comprehensively by nuclear magnetic resonance spectroscopy and high-density lipoprotein-mediated cholesterol efflux capacity (CEC) from macrophages. T0 to T12 comparisons informed the effect of sex hormones, comparisons of genetic XX and XY individuals at T1 the effect of sex chromosomes.

resultsVascular function was comparable at T12 and T0; systolic blood pressure increased in transgender men (P = .002). Transgender men developed a proatherogenic lipoprotein profile; estrogen treatment in transgender women tended to result in improvements. Several metabolites indicating increased diabetes risk including plasma glucose were changed in transgender men (P = .025), with opposite changes in transgender women (P = .002). Interestingly, at T1 apparent diabetes risk was lower in XX compared with XY individuals (P = .002). CEC decreased in transgender women (P < .01), while remaining unchanged in transgender men. However, in both groups the strong positive association of apolipoprotein A-1 with cholesterol efflux observed at T0 was lost at T12.

conclusionThe results are consistent with increased cardiometabolic risk in transgender men, while transgender women show beneficial changes early during gender-affirming hormone therapy. Sex chromosomes have fewer intrinsic effects. XY individuals and transgender men display an increased apparent diabetes risk. Further research on cardiometabolic risk is needed for transgender individuals.

Indexed as

Cardiometabolic Risk FactorsCardiovascular DiseasesGonadal Steroid HormonesSex ChromosomesTransgender PersonsAdultBiomarkersCarotid Intima-Media ThicknessFemaleHumansMaleMiddle AgedRisk AssessmentVascular StiffnessYoung AdultBiomarkersGonadal Steroid Hormonescardiovascularcholesterolcholesterol efflux capacitydiabetesHDLintima-media thicknesslipoprotein particle numberslipoproteinsmetabolitestriglycerides

Identifiers

PMID39441016
PMCPMC12187189

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.