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Arterial Stiffness in Transgender Men Receiving Long-term Testosterone Therapy
Flávia Siqueira Cunha1, Tania Aparecida Sartori Sanchez Bachega1, Elaine Maria Frade Costa1
1Disciplina de Endocrinologia e Metabologia, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, 05403-900 São Paulo, SP, Brazil.
Journal of the Endocrine Society
|April 17, 2023
Summary
Long-term androgen therapy in transgender men (TM) was associated with increased aortic stiffness compared to cisgender controls. This suggests testosterone may accelerate arterial aging, highlighting the need for cardiovascular risk monitoring in TM undergoing hormone treatment.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Transgender Health
Background:
- Androgen therapy is a key component of gender-affirming care for transgender men (TM).
- The long-term effects of testosterone on arterial function in TM remain incompletely understood.
- Evaluating cardiovascular risk markers is crucial for this population.
Purpose of the Study:
- To assess arterial stiffness in transgender men (TM) undergoing long-term gender-affirming hormone therapy.
- To compare aortic stiffness, measured by carotid-femoral pulse wave velocity (cf-PWV), between TM and cisgender controls.
Main Methods:
- A cross-sectional case-control study included 33 TM on testosterone therapy for an average of 14 years.
- cf-PWV was measured to evaluate aortic stiffness.
- TM were compared to 111 age- and BMI-matched cisgender men and women controls.
Main Results:
- Transgender men (TM) exhibited significantly higher cf-PWV (7.4 m/s) compared to cisgender men (6.6 m/s) and women (6.9 m/s).
- cf-PWV showed a positive correlation with age in TM.
- Systolic blood pressure and hypertension diagnosis were independently associated with cf-PWV in TM.
Conclusions:
- Long-term testosterone treatment in TM was linked to accelerated aging-related aortic stiffening.
- These findings suggest a potential detrimental effect of testosterone on arterial function.
- Preventive cardiovascular strategies are recommended for TM on testosterone therapy due to elevated risk.
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