Background

The organ-specific effects of gender-affirming sex hormone treatment (GAHT) in transgender women (TW) and transgender men (TM) are insufficiently explored. This study investigated the effects of GAHT on adipose tissue function.

Methods

In a single-center interventional prospective study, 32 adults undergoing GAHT, 15 TW and 17 TM, were examined with anthropometry and abdominal subcutaneous adipose tissue biopsies obtained before initiation of treatment, 1 month after endogenous sex hormone inhibition and three and 11 months after initiated GAHT. Fat cell size, basal/stimulated lipolysis and cytokine secretion in adipose tissue were analyzed.

Results

TW displayed an increase in complement component 3a and retinol-binding protein 4 (RBP4) secretion after sex hormone inhibition, which returned to baseline following estradiol treatment. No changes in lipolysis were seen in TW. TM showed downregulation of RBP4 after treatment, but no changes in basal lipolysis. In TM, the estrogen suppression led to higher noradrenaline stimulated (NA) lipolysis that was normalized following testosterone treatment. At 11 months, the ratio of NA/basal lipolysis was lower compared to baseline. There were no significant changes in fat cell size in either TW or TM.

Conclusion

In TW, gonadal hormone suppression results in transient changes in cytokines and in TM there are some changes in NA-stimulated lipolysis following testosterone treatment. However, despite the known metabolic effects of sex hormones, the overall effects of GAHT on adipose tissue function are small and likely have limited clinical relevance, but larger studies with longer follow-up are needed to confirm these findings.

Trial registration

ClinicalTrials.gov Identifier: NCT02518009, Retrospectively registered 7 August 2015.

中文翻译：

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跨性别者性别肯定治疗后的脂肪因子分泌和脂肪分解

背景

性别肯定性激素治疗（GAHT）对跨性别女性（TW）和跨性别男性（TM）的器官特异性影响尚未得到充分探索。本研究调查了 GAHT 对脂肪组织功能的影响。

方法

在一项单中心介入前瞻性研究中，对 32 名接受 GAHT、15 TW 和 17 TM 的成人进行了人体测量和在开始治疗前、内源性激素抑制后 1 个月以及开始后 3 个月和 11 个月获得的腹部皮下脂肪组织活检检查。 GAHT。分析脂肪组织中的脂肪细胞大小、基础/刺激脂肪分解和细胞因子分泌。

结果

TW 在性激素抑制后显示补体成分 3a 和视黄醇结合蛋白 4 (RBP4) 分泌增加，在雌二醇治疗后恢复到基线。TW 中没有观察到脂肪分解的变化。治疗后TM显示RBP4下调，但基础脂肪分解没有变化。在 TM 中，雌激素抑制导致去甲肾上腺素刺激 (NA) 脂肪分解升高，而睾酮治疗后该脂肪分解恢复正常。11 个月时，NA/基础脂肪分解的比率低于基线。TW 或 TM 中的脂肪细胞大小没有显着变化。

结论

在 TW 中，性腺激素抑制会导致细胞因子的短暂变化，而在 TM 中，睾酮治疗后 NA 刺激的脂肪分解会发生一些变化。然而，尽管已知性激素的代谢影响，但 GAHT 对脂肪组织功能的总体影响很小，并且可能具有有限的临床相关性，但需要更大规模的研究和更长的随访来证实这些发现。

试用注册

ClinicalTrials.gov 标识符：NCT02518009，2015 年 8 月 7 日回顾注册。