ArticleThe Journal of clinical endocrinology and metabolism2025
Cardiometabolic Risk Assessment in Transgender Individuals-Differential Effect of Sex Hormones and Sex Chromosomes.
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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Who cites it
1 citing paper in PubMed.
- Sex differences in the association of the CRP-TyG index with coronary artery disease and long-term mortality in MASLD.Frontiers in endocrinology · 2026Article
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Authors and funding
8 authors.
Funding
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.
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