Change in visceral fat and its relation with change in lipids in trans persons during hormonal therapy: results from a multicenter prospective study

Maartje Klaver; Chantal Wiepjes; Blok Christel de; Nienke Nota; Justine Defreyne; Thomas Schneider; Alessandra Fisher; Guy T; Heijer Martin den; Mutsert Renee de

doi:10.1530/endoabs.56.GP222

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Endocrine Abstracts (2018) 56 GP222 | DOI: 10.1530/endoabs.56.GP222

ECE2018 Guided Posters Reproduction (10 abstracts)

Change in visceral fat and its relation with change in lipids in trans persons during hormonal therapy: results from a multicenter prospective study

Maartje Klaver ¹ , Chantal Wiepjes ¹ , Christel de Blok ¹ , Nienke Nota ¹ , Justine Defreyne ² , Thomas Schneider ³ , Alessandra Fisher ⁴ , Guy T’Sjoen ² , Martin den Heijer ¹ & Renée de Mutsert ⁵

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¹VU Medical Center, Amsterdam, Netherlands; ²Ghent University Hospital, Ghent, Belgium; ³Oslo University, Oslo, Norway; ⁴University of Florence, Florence, Italy; ⁵Leiden University and Medical Center, Leiden, Netherlands.

Introduction: Excess visceral adipose tissue (VAT) is strongly related to multiple cardiovascular risk factors such as dyslipidemia. Hormonal therapy (HT) in trans persons affects total body fat and body fat distribution, but the effect on VAT and its relation to changes in lipids is unknown. The aim of our study was to investigate the effect of one year HT on changes in VAT and its relation with changes in total cholesterol, HDL, LDL, and triglycerides after one year of HT.

Methods: In a multicenter prospective study at two university hospitals, 179 male-to-female trans persons (transwomen) and 162 female-to-male trans persons (transmen) underwent whole body dual-energy X-ray absorptiometry (Hologic Discovery A, Hologic Inc., USA) and laboratory measurements before and after one year of HT. Linear mixed models were performed to estimate changes over time and linear regression was used to examine the relation between changes in VAT with changes in lipids. Analyses were adjusted for age, body mass index (BMI), and smoking.

Results: In transwomen (median age: 29 years, IQR 23–43), VAT increased with 10 grams (range −289–251 grams, S.D.: 87) or 3% (95% CI 0;7), while abdominal fat increased with 13% (95% CI 9;18) and total body fat with 25% (95% CI 21;29). Changes in lipids per S.D. change in VAT were 0.2 mmol/l (95% CI 0.1;0.3) in total cholesterol, 0.1 mmol/l (95% CI 0.1;0.2) in LDL, 0.0 mmol/l (95% CI −0.1;0.0) in HDL, and 0.1 mmol/l (95% CI 0.0;0.2) in triglycerides. In transmen (median age: 24 years, IQR 21-33), VAT increased with 6 grams (range −331–179 grams, S.D.: 83) or 3% (95% CI −3;9), while total body fat decreased (−11%, 95% CI −13;−8) and abdominal fat did not change (−2%, 95% CI −6;2). Changes in lipids per S.D. change in VAT were 0.0 mmol/l (95% CI −0.1;0.1) in total cholesterol, 0.0 mmol/l (95% CI −0.1;0.1) in LDL, 0.0 mmol/l (95% CI −0.1;0.1) in HDL, and 0.1 mmol/l (95% CI 0.0;0.2) in triglycerides.

Conclusions: One year of HT resulted in large changes in total body fat, but in small mean changes in VAT, with a large inter-individual range in both transwomen and transmen. An increase in VAT was associated with small increases in total cholesterol and LDL in transwomen, but not in transmen.