scholarly journals Muscle Strength in Transgender Women After Long-Term Hormone Therapy: A Cross-Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A792-A793
Author(s):  
Leonardo A M Alvares ◽  
Marcelo R Santos ◽  
Francis Ribeiro Souza ◽  
Lívia Marcela Santos ◽  
Henrique A Ramos ◽  
...  
Keyword(s):  
Motor Control ◽  
Muscle Strength ◽  
Hormone Therapy ◽  
Oxidation Mechanism ◽  
Cross Sectional Study ◽  
Transgender Women ◽  
The Body ◽  
Sectional Study ◽  
Cross Sectional

Abstract Introduction: Cisgender women (CW) are usually weaker than cisgender men (CM), but when the strength is expressed in relation to the body weight (BW) or fat free mass (FFM) it is observed that the difference disappears what suggests that the innate qualities of the muscle and its motor control mechanisms are similar in CW and CM. The effects of prior exposure to testosterone during puberty on the performance of transgender women (TW) undergoing physical effort are not well known. Objective: To evaluate muscular strength of TW in long-term gender affirming hormone therapy (GAHT). Methods: A cross-sectional study was carried out with 8 TW (average age of 34.0 yo, SD ±4.8), 8 CM and 8 CW matched by age and body mass index (BMI). All TW were non-gonadectomized subjects and were in estrogen plus cyproterone acetate therapy (average time of 15.6 years (SD ±8.7) of treatment). Mean total testosterone (ng/dL) levels of TW, CW and CM were 83.5, 20.5 and 480.5 at the time of the study, respectively. Hemoglobin levels of TW, CW and CM were 14,2 (range 13,5-14,9), 14,35 (range 12,8-14,7) and 15,35 (range 14,0-18,2), respectively BC was assessed by InBody 720. Handgrip strength tests were carried out using the Stoelting hand-held hydraulic dynamometer. Results: The mean maximum strength was 31,9 kg (SD±2.4) in TW, 29.2 kg (SD±4.4) in CW, and 47.5 (SD±8.6) in CM (TWvs.CW p=0.0743; TWxCM p<0.0018; CWvsCM p<0.001). Free fat mass (FFM) of TW was 55.56±6.88 kg, CW 38.98±4,09 kg, CM 64,98±6,29 kg (TWvsCW p<0,0001; TWvsCM p=0,024; CWvsCM p<0,0001). In the evaluation Median Strength/FFM, a mean of 0.54 was observed in the TW group, and 0.76 in the CW and CM (TWvsCW p=0.0157 and TWvsCM p=0.036, CWvsCM p>0.9999). Discussion: The expression of muscle strength/FFM is the same in CM and CW, which suggests that the innate quality of the muscles as well as their motor control is similar in these groups, as showed in many data in the literature. However, the analysis of this ratio in TW showed a significant lower rate than the other groups. Conclusion: After GAHT muscle strength of TW is equal of CW. There is a decrease in the functionality of the muscular unit in producing strength in this group of TWs since strength decreased disproportionately to muscle mass which leads us to believe that there are important functional changes in intracellular oxidation mechanism.

scholarly journals Cardiovascular Risk Factors in Transgender Women Undergoing Long-Term Gender-Affirming Hormone Therapy: A Cross-Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A788-A789
Author(s):  
Leonardo A M Alvares ◽  
Lívia M Santos ◽  
Henrique A Ramos ◽  
Larissa G Rodeghel ◽  
Nathan B Cavenaghi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Hormone Therapy ◽  
Cross Sectional Study ◽  
Transgender Women ◽  
Activity Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Statistical Point

Abstract Introduction: Few data of long-term outcomes of cardiovascular (CVRF) risk factors of transgender women (TW) undergoing gender-affirming hormone therapy (GAHT) are available. Objectives: Evaluate CV risk factors after long-term GAHT in TW. Methods: A cross-sectional study was carried out with 8 TW (average age of 34.0 ±4.8 yo), 8 matched CM and 8 CW on age, body mass index (BMI) and activity level. All TW were non-gonadectomized subjects and were in estrogen [(E); transdermal estradiol (n=2), oral estradiol (n=3) and conjugated estrogen (n=3)] plus cyproterone acetate (CA) (n=8) therapy in an average time of 15.6 ±8.7 years. Results: Total Testosterone (ng/dL) level of TW, CW and CM were 83,5 (range 12,0-637,0), 20,5 (range 12,0-41,0) and 480,5 (range 264,0-843,0), respectively. It was similar between TW and CW (p=0,7284) and different in the comparison TWvsCM (p=0,0325). In TW group, the median of blood glucose was 84 mg / dL, HBA1c 5.1%, total cholesterol 146 mg / dL, HDLc 43 mg / dL, LDLc 89 mg / dL and triglycerides 81.5 mg / dL. In the comparison with other groups, there was no difference from the statistical point of view. It is necessary to emphasize the HDLc of TW (43 mg/dL) which was exactly the same of CM (p>0,999) and lower than CW (60 mg/dL)(p=0,0720). Systolic Blood Pressure (SBP)(mmHg) of TW (126±13) was higher than that of CW (95±11;p<0.001) and equal to that of CM (115±9;p=0.1489). Regards Diastolic Blood Pressure (DBP) (mmHg), the medians of TW, CW and CM were 80, 60 and 80, respectively, and in the comparison TWxCW p = 0.0070 and TWxCM p> 0.9999. Discussion: Youth TW (16.3 ± 1.4 yo) taking an average estradiol dose of 1.5 ± 1.0 mg/day, with an average AGHT duration of 12.3 ± 9.9 months matched to controls on age and BMI did have higher HDL than CW and TW participants were more insulin resistant than CM. About SBP of that youth TW (107 ± 12), it was lower than CW 113 ± 7 (p>0,05) and CM 116 ± 8 (p<0,001). Other previous study showed that after 6 months of estradiol use, in doses ranging from 2 to 8 mg daily glucose enhanced 6 mg/dL (from 86 to 92) as well as TC from 170 to 178 mg/dL, HDLc from 50 to 54 mg/dL, TGL from 102 to 115 mg/dL, and LDL did not change (93), while a systematic review and meta-analysis showed increased only in TG levels. SBP and DBP increased on average of 7,2 mmHg and 5,7 mmHg, respectively. Conclusion: Metabolic findings observed after the first few months of TW GAHT appear to remain at long term, except for HDLc. SBP and DBP appear to increase in the long term, after a drop initially observed.

scholarly journals First Evidence of Cardiopulmonary Adaptation to Physical Effort in Transgender Women After Long-Term Hormone Therapy: A Cross-Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A790-A791
Author(s):  
Leonardo A M Alvares ◽  
Marcelo R Santos ◽  
Francis R Souza ◽  
Lívia M Santos ◽  
Berenice Bilharinho Mendonca ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hormone Therapy ◽  
Fat Mass ◽  
Short Form ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Total Testosterone ◽  
Sectional Study ◽  
Cross Sectional

Abstract Introduction: Cisgender men (CM) and women (CM) present different acute cardiopulmonary (CP) adaptation to effort. The smallest arteriovenous difference in oxygen (O2) and cardiac output (CO) in CW determine a lower maximum VO2 (VO2max) than CM. CP capacity adaptation to effort of TW undergoing gender-affirming hormone therapy (GAHT) was not yet reported. Objective: To evaluate CP capacity of TW in long-term GAHT. Methods: A cross-sectional study was carried out with 8 TW (average age of 34.0 ±4.8 yo), 8 CM and 8 CW matched on age, body mass index and activity level. All TW were non-gonadectomized subjects and were in estrogen [transdermal estradiol (n=2), oral estradiol (n=3) and conjugated estrogen (n=3)], plus cyproterone acetate (n=8) therapy in an average time of 15.6 ±8.7 years. Body composition was assessed by InBody 720, and participants’ level of physical activity by IPAQ (International Physical Activity Questionnaire) short form. Total testosterone (ng/dL) levels of TW, CW and CM were 83,5 (12,0;637,0), 20,5 (12,0;41,0) and 480,5 (264,0;843,0), respectively. Hemoglobin levels of TW, CW and CM were 14,2 (13,5;14,9), 14,35 (12,8;14,7) and 15,35 (14,0;18,2), respectively. Everyone performed a CP exercise testing on a treadmill with an incremental effort. Results: Mean VO2max (L/min) in the group of TW was 2648±575.5, of CW 2128±394.0 and of CM 3235±554.0 (TWvsCW p=0.1311; TWvsCM p=0.0806; CWvsCM p=0.009). Free fat mass (FFM) of TW was 55.56±6.88 kg, CW 38.98±4,09 kg, and CM 64,98±6,29 kg (TWvsCW p<0,0001; TWvsCM p=0,024; CWvsCM p<0,0001). Analysis of VO2max/FFM (L/min/kg), TW′s rate was 46.6±6.2, CW′s was 54.6±8.4 and CM′s was 49.4±6.1 (TWvsCW p=0.0770;TWvsCM p=0.6942; CWvsCM p=0.3185). O2 pulse, VE/VO2 (ventilatory equivalents for O2) and VE/VCO2 (ventilatory equivalents for carbon dioxide) were similar in all groups. There was high correlation of O2pulse and free fat mass/height2 (FFM/Hgt2) of TW (r 0,925;p 0,008), not observed in CW (r 0.614;p0.105) or CM (r 0.737; p 0.037).% predicted Heart Rate (%HR) at effort was higher in TW (104) than in CW (95.8)(p=0.0221) and CM (100.3)(p=0.3334). Discussion: Aerobic capacity of TW was intermediate between CM and CW. Regards VO2 / FFM ratio, TW had a lower index than other groups. Since changes in pulmonary O2 diffusion, CO and blood circulation were ruled out as causing such data, it could be related to O2 uptake drops by the muscle. Increased sympathetic activity and %HR in TW and high correlation of O2pulse and FFM/Hgt2 make up compatible framework with exacerbation of ergoreflex. Conclusion: Our results support the finding of a VO2max similar between TW undergoing long-term GAHT and CW groups, despite the previous expose of TWs to testosterone during puberty. We hypothesized the presence of an increased ergoreflex sensitivity in TW individuals. These preliminary results should be confirmed by increasing the number of individuals studied.

scholarly journals Body Composition of Transgender Women After Long-Term Hormone Therapy - a Cross-Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A788-A788
Author(s):  
Leonardo A M Alvares ◽  
Lívia M Santos ◽  
Marcelo R Santos ◽  
Francis R Souza ◽  
Victor P Almeida ◽  
...  
Keyword(s):  
Body Composition ◽  
Hormone Therapy ◽  
Fat Mass ◽  
Lean Mass ◽  
Cyproterone Acetate ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Short Term ◽  
Cross Sectional

Abstract Introduction: Few studies of transgender women (TW) body composition (BC) in long-term gender-affirming hormone therapy (GAHT) have been reported. Objective: To evaluate BC parameters of TW in long-term GAHT. Methods: A cross-sectional study was carried out with 8 TW (average age of 34.0 yo ±4.8), 8 cisgender men (CM) and 8 cisgender women (CW) matched to age and body mass index (BMI). All TW were non-gonadectomized subjects and were in estrogen [(E); transdermal estradiol (n=2), oral estradiol (n=3) and conjugated estrogen (n=3)], plus cyproterone acetate (CA) (n=8) therapy in an average time of 15.6 ±8.7 years of treatment. Total testosterone (ng/dL) levels of TW, CW and CM were 83,5 (range 12,0-637,0), 20,5 (range 12,0-41,0) and 480,5 (range 264,0-843,0) at the time of the study, respectively. BC was assessed by InBody 720. Percentage of fat mass (%FM), skeletal muscle mass (SMM) were evaluated. Baumgartner Index was calculated. Results: Regards %FM, that of TW was lower than CW (29,59 ±7,56 vs 32,9 ±3,99; p=0,5394) and higher than CM (23,58 ± 6,44; p=0.1512). SMM of TW was 33.6% higher than that of CW (p<0.001) and 14,7% lower than that of CM (p=0,014). Baumgartner Index of CM group was 17.7% higher than TW group (p=0,001), which presented rates 20.3% higher than the CW (0,002). Discussion: BC changes in the first two years of GAHT in TW were consistent with loss of lean mass and gained fat mass associated with an increase of body weight. This profile was identified in adults and youth transgender after short-term hormone therapy. Conclusion: Our data shown a similar profile of short-term treatment, with a body composition intermediate between BMI-matched cisgender males and females. However, unlike young TW undergoing short-term GAHT, the parameters of BC in the TW using estrogens plus cyproterone acetate in the long term did not present %FM statistically different from CW and CM, in contrast to the lean mass that maintained significant differences in the long term.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals Association between Short Hours of Sleep and Overweight/Obesity in Mexican Adolescent Population: A School-Based Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 939
Author(s):  
Ana Fresan ◽  
Alma Delia Genis-Mendoza ◽  
María Lilia López-Narváez ◽  
Tania Guadalupe Gómez-Peralta ◽  
Daniela Georgina Aguilar-Velázquez ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
The Body ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obese Adolescent ◽  
School Based ◽  
Prevalence Of Obesity ◽  
Mexican Adolescents

Background/Aim: Obesity in adolescents is increasing; as such, the aim of this study was to determine the prevalence of obesity in Mexican adolescents and examine its possible association with hours of sleep. Methods: A school-based cross-sectional study was carried out. This study included 863 adolescents aged between 11 and 16 years. The prevalence of obesity was estimated using the body mass index (BMI). The duration of sleep (and other information) was assessed by a self-reported questionnaire. The Cochran–Mantel–Hansel test for categorical variables and a general linear model for continuous variables were used to evaluate the interaction effect of BMI and sex with respect to sleeping and assessed activity conditions. Results: It was found that 47.6% of the adolescents were overweight/obese. Men were more frequently overweight/obese than women (52.6% vs. 41.8%, p = 0.002). Moreover, overweight/obese adolescents were younger and spent fewer daily hours watching television (p < 0.05). Men practiced sports more hours per week than women (p = 0.04). However, women spent more daily time on the internet (p = 0.05), and overweight/obese adolescent women slept fewer hours than overweight/obese men and adolescents with normal weight (p = 0.008). Conclusions: The development of strategies for the prevention of overweight/obesity and the improvement of sleep duration should include a gender perspective to improve health habits in Mexican adolescents.

Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study

2021 ◽  
Author(s):  
Larissa Cristina Lins Berber ◽  
Mariana Silva Melendez-Araújo ◽  
Eduardo Yoshio Nakano ◽  
Kênia Mara Baiocchi de Carvalho ◽  
Eliane Said Dutra
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grazing Behavior ◽  
Post Bariatric Surgery

scholarly journals Current understanding and implementation of ‘care navigation’ across England: a cross-sectional study of NHS clinical commissioning groups

2019 ◽  
Vol 69 (687) ◽  
pp. e675-e681 ◽  
Author(s):  
Stephanie Tierney ◽  
Geoff Wong ◽  
Kamal R Mahtani
Keyword(s):  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Health And Wellbeing ◽  
Medical Needs ◽  
Social Prescribing ◽  
Evaluation Of Care

BackgroundCare navigation is an avenue to link patients to activities or organisations that can help address non-medical needs affecting health and wellbeing. An understanding of how care navigation is being implemented across primary care is lacking.AimTo determine how ‘care navigation’ is interpreted and currently implemented by clinical commissioning groups (CCGs).Design and settingA cross-sectional study involving CCGs in England.MethodA questionnaire was sent to all CCGs inviting them to comment on who provided care navigation, the type of patients for whom care navigation was provided, how individuals were referred, and whether services were being evaluated. Responses were summarised using descriptive statistics.ResultsThe authors received usable responses from 83% of CCGs (n = 162), and of these >90% (n = 147) had some form of care navigation running in their area. A total of 75 different titles were used to describe the role. Most services were open to all adult patients, though particular groups may have been targeted; for example, people who are older and those with long-term conditions. Referrals tended to be made by a professional, or people were identified by a receptionist when they presented to a surgery. Evaluation of care navigation services was limited.ConclusionThere is a policy steer to engaging patients in social prescribing, using some form of care navigator to help with this. Results from this study highlight that, although this type of role is being provided, its implementation is heterogeneous. This could make comparison and the pooling of data on care navigation difficult. It may also leave patients unsure about what care navigation is about and how it could help them.

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