scholarly journals Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy

2021 ◽  
Author(s):  
Maartje Klaver ◽  
Daan van Velzen ◽  
Christel de Blok ◽  
Nienke Nota ◽  
Chantal Wiepjes ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Hormone Therapy ◽  
Body Fat ◽  
Visceral Fat ◽  
Cardiometabolic Risk ◽  
Trans Men ◽  
Total Body Fat ◽  
In Trans ◽  
Trans Women ◽  
Total Body

Abstract Introduction Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. Methods In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. Results In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (−2 grams; 95% CI −15, 11), albeit with a large range from −318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI −10, 16; range −372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. Conclusions Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.

scholarly journals Incident diabetes risk is not increased in transgender individuals using hormone therapy

2021 ◽  
Author(s):  
Daan van Velzen ◽  
Chantal Wiepjes ◽  
Nienke Nota ◽  
Daniel van Raalte ◽  
Renée de Mutsert ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
General Population ◽  
Hormone Therapy ◽  
Trans Men ◽  
Data Registry ◽  
Central Registry ◽  
In Trans ◽  
Trans Women

Abstract Background In trans women receiving hormone therapy, body fat and insulin resistance increases, with opposite effects in trans men. These metabolic alterations may alter the risk of developing type 2 diabetes in trans women and trans men. We aimed to compare the incidence of type 2 diabetes of adult trans women and trans men during hormone therapy with rates from their birth sex in the general population. Methods Retrospective data from the Amsterdam Cohort of Gender Dysphoria with transgender individuals on hormone therapy between 1972 and 2018 were linked to a nationwide health data registry. Because no central registry of diabetes is available, the occurrence of diabetes was inferred from the first dispense of a glucose-lowering agent. Standardized incidence ratios (SIR) were computed for trans women and trans men in comparison with the same birth sex from the general population. Results Compared to their birth sex in the general population, no difference in the incidence of type 2 diabetes mellitus was observed in trans women (N=2585, 90 cases, SIR 0.94 95%CI 0.76–1.14) or trans men (N=1514, 32 cases, SIR 1.40 95%CI 0.96–1.92). Conclusion Despite studies reporting an increase in insulin resistance in feminizing hormone therapy and a decrease in insulin resistance in masculinizing hormone therapy, the incidence of diabetes in transgender individuals after initiation of hormone therapy was not different compared to the general population.

scholarly journals The DGAT2 gene is a candidate for the dissociation between fatty liver and insulin resistance in humans

2009 ◽  
Vol 116 (6) ◽  
pp. 531-537 ◽  
Author(s):  
Konstantinos Kantartzis ◽  
Fausto Machicao ◽  
Jürgen Machann ◽  
Fritz Schick ◽  
Andreas Fritsche ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Fatty Liver ◽  
Body Fat ◽  
Visceral Fat ◽  
Magnetic Resonance Tomography ◽  
Liver Fat ◽  
Oral Glucose ◽  
Total Body Fat ◽  
Total Body

The enzyme DGAT (acyl-CoA:diacylglycerol acyltransferase) catalyses the final step of triacylglycerol (triglyceride) synthesis. Mice overexpressing hepatic DGAT2 fed a high-fat diet develop fatty liver, but not insulin resistance, suggesting that DGAT2 induces a dissociation between fatty liver and insulin resistance. In the present study, we investigated whether such a phenotype also exists in humans. For this purpose, we determined the relationships between genetic variability in the DGAT2 gene with changes in liver fat and insulin sensitivity in 187 extensively phenotyped subjects during a lifestyle intervention programme with diet modification and an increase in physical activity. Changes in body fat composition [MR (magnetic resonance) tomography], liver fat and intramyocellular fat (1H-MR spectroscopy) and insulin sensitivity [OGTT (oral glucose tolerance test) and euglycaemic–hyperinsulinaemic clamp] were determined after 9 months of intervention. A change in insulin sensitivity correlated inversely with changes in total body fat, visceral fat, intramyocellular fat and liver fat (OGTT, all P<0.05; clamp, all P≤0.03). Changes in total body fat, visceral fat and intramyocellular fat were not different between the genotypes of the SNPs (single nucleotide polymorphisms) rs10899116 C>T and rs1944438 C>T (all P≥0.39) of the DGAT2 gene. However, individuals carrying two or one copies of the minor T allele of SNP rs1944438 had a smaller decrease in liver fat (−17±10 and −24±5%; values are means±S.E.M.) compared with subjects homozygous for the C allele (−39±7%; P=0.008). In contrast, changes in insulin sensitivity were not different among the genotypes (OGTT, P=0.76; clamp, P=0.53). In conclusion, our findings suggest that DGAT2 mediates the dissociation between fatty liver and insulin resistance in humans. This finding may be important in the prevention and treatment of insulin resistance and Type 2 diabetes in subjects with fatty liver.

Leptin: a significant indicator of total body fat but not of visceral fat and insulin insensitivity in African-American women

Diabetes ◽  
1996 ◽  
Vol 45 (11) ◽  
pp. 1635-1637 ◽  
Author(s):  
A. Dua ◽  
M. I. Hennes ◽  
R. G. Hoffmann ◽  
D. L. Maas ◽  
G. R. Krakower ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
Body Fat ◽  
Visceral Fat ◽  
American Women ◽  
Total Body Fat ◽  
Total Body ◽  
Insulin Insensitivity

scholarly journals Body mass index and waist circumference are better predictors of insulin resistance than total body fat percentage in middle-aged and elderly Taiwanese

Medicine ◽  
2017 ◽  
Vol 96 (39) ◽  
pp. e8126 ◽  
Author(s):  
Yiu-Hua Cheng ◽  
Yu-Chung Tsao ◽  
I-Shiang Tzeng ◽  
Hai-Hua Chuang ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Body Mass ◽  
Body Fat ◽  
Body Fat Percentage ◽  
Middle Aged ◽  
Fat Percentage ◽  
Total Body Fat ◽  
Total Body

scholarly journals Ethnic Variation in Fat and Lean Body Mass and the Association with Insulin Resistance

2009 ◽  
Vol 94 (12) ◽  
pp. 4696-4702 ◽  
Author(s):  
Scott A. Lear ◽  
Simi Kohli ◽  
Gregory P. Bondy ◽  
André Tchernof ◽  
Allan D. Sniderman
Keyword(s):  
Insulin Resistance ◽  
Ethnic Groups ◽  
Body Mass ◽  
Body Fat ◽  
South Asian ◽  
Lean Mass ◽  
South Asians ◽  
Model Assessment ◽  
Total Body Fat ◽  
Total Body

Context: Body fat distribution varies among different ethnic groups, yet less is known regarding differences in lean mass and how this may affect insulin resistance. Objective: Our objective was to compare total body fat to lean mass ratio (F:LM) in Aboriginal, Chinese, European, and South Asian individuals with differences in insulin resistance. Participants, Design, and Setting: Aboriginal (196), Chinese (222), European (202), and South Asian (208) individuals were recruited across a range of body mass index to participate in this cross-sectional community study. Main Outcome Measures: Total body fat, lean mass, and insulin resistance were assessed using homeostasis model assessment (HOMA). Results: After adjustment for confounders and at a given body fat, South Asian men had less lean mass than Aboriginal [3.42 kg less; 95% confidence interval (CI) = 1.55–5.29], Chinese (3.01 kg less; 95% CI = 1.33–4.70), and European (3.57 kg less; 95% CI = 1.82–5.33) men, whereas South Asian women had less lean mass than Aboriginal (1.98 kg less; 95% CI = 0.45–3.50), Chinese (2.24 kg less; 95% CI = 0.81–3.68), and European (2.97 kg less; 95% CI = 1.67–4.27) women. In adjusted models, F:LM was higher in South Asian compared with Chinese and European men and higher in South Asian compared with Aboriginal, Chinese, and European women (P &lt; 0.01 for all). Insulin and HOMA were greatest in South Asians after adjustment; however, these differences were no longer apparent when F:LM was considered. Conclusions: South Asians have a phenotype of high fat mass and low lean mass, which may account for greater levels of insulin and HOMA compared with other ethnic groups.

scholarly journals Serum lipocalin-2 levels are positively associated with not only total body fat but also visceral fat area in Chinese men

Medicine ◽  
2016 ◽  
Vol 95 (30) ◽  
pp. e4039 ◽  
Author(s):  
Yuqi Luo ◽  
Xiaojing Ma ◽  
Xiaoping Pan ◽  
Yiting Xu ◽  
Qin Xiong ◽  
...  
Keyword(s):  
Body Fat ◽  
Visceral Fat ◽  
Lipocalin 2 ◽  
Visceral Fat Area ◽  
Chinese Men ◽  
Total Body Fat ◽  
Total Body

scholarly journals Gender dysphoria and sexual euphoria - A Bayesian perspective on the influence of gender-affirming hormone therapy on sexual arousal

2021 ◽  
Author(s):  
Manfred Klöbl ◽  
Murray Bruce Reed ◽  
Patricia Handschuh ◽  
Ulrike Kaufmann ◽  
Melisande Elisabeth Konadu ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Hormone Therapy ◽  
Sexual Arousal ◽  
Response Patterns ◽  
Erotic Stimuli ◽  
Trans Men ◽  
Subjective Sexual Arousal ◽  
In Trans ◽  
Trans Women ◽  
In Cis

While the concept of sexual orientation is more clearly defined in cisgender, this is less so in transgender individuals. Both experienced gender and sex hormones have a relation to sexual preferences, arousal in response to erotic stimuli, and thus sexual orientation. In transgender individuals sexual orientation occasionally changes before or during transition, which may involve gender-affirming hormone therapy. Using functional magnetic resonance imaging, we investigated whether the neuronal and behavioral patterns of sexual arousal in transgender individuals moved from the given (before) to their chosen gender after 4.5 months of hormone therapy. To this aim, trans women and men as well as age-matched cisgender controls rated visual stimuli showing heterosexual, lesbian or gay intercourse for subjective sexual arousal. Utilizing a Bayesian framework allowed us to incorporate behavioral findings in cisgender individuals of different sexual orientations. The hypothesized changes in response patterns could indeed be observed in the behavioral responses to the single but not the differentiation between stimulus categories with the strongest results for trans men and lesbian scenes. Activation of the ventral striatum supported our hypothesis only for lesbian scenes in trans women. This prominent role of lesbian stimuli might be explained by their differential responses in cis women and men. We show that correlates of sexual arousal in transgender individuals might change in direction of the chosen gender. Future investigations longer into transition might resolve the discrepancy on behavioral and neuronal levels.

scholarly journals Physical and Sociodemographic Features Associated With Quality of Life Among Transgender Women and Men Using Gender-Affirming Hormone Therapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Eliane D. Silva ◽  
Tayane M. Fighera ◽  
Roberta M. Allgayer ◽  
Maria Inês R. Lobato ◽  
Poli Mara Spritzer
Keyword(s):  
Quality Of Life ◽  
Hormone Therapy ◽  
Gender Dysphoria ◽  
Transgender Women ◽  
Breast Development ◽  
Body Hair ◽  
Trans Men ◽  
In Trans ◽  
Trans Women

Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the sex assigned at birth and the gender identity, lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy (GAHT) may improve quality of life (QoL).Objectives: We aimed to assess perceived QoL, to compare QoL scores between trans women and men and to identify possible contributing factors related to GAHT in a sample of transgender women and transgender men.Methods: In this cross-sectional study, transgender women and men were recruited by availability sampling from a national transgender health service. Individuals over 18 years old with a confirmed diagnosis of gender dysphoria receiving medically prescribed GAHT for at least 6 months were consecutively included. Also included were trans men who had undergone mastectomy and trans women who had received breast augmentation surgery. Individuals who had undergone gender affirmation surgery (specifically genital surgery) or with uncontrolled clinical/psychiatric conditions at the time of the initial assessment were excluded. Sociodemographic, physical, and hormone data were collected from all participants. The WHOQOL-BREF questionnaire was used to evaluate QoL. A total of 135 transgender individuals were invited. Seventeen individuals with previous genital surgery (12.6%) and five who refused to participate (3.7%) were excluded. Therefore, 113 patients were enrolled and completed the study (60 trans women and 53 trans men).Results: QoL scores did not differ between trans women and trans men. In trans women, greater breast development and stable relationships, and higher body mass index were associated with higher QoL domain scores. In trans men, higher domain scores were found in individuals in a stable relationship, with increased body hair, engaging in physical activity, and being employed.Conclusion: Data from this study suggest that GAHT-related physical characteristics, such as breast development in trans women and increased body hair in trans men, are similar between groups, are associated with higher QoL scores, and that sociodemographic parameters may impact these associations. Healthcare providers might consider these factors when planning interventions to improve QoL in transgender individuals.

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