Change in lipid profile and glucose levels after 12 months of testosterone therapy in transgender men

Fernandez Laura Montanez; Cebada Ane Bayona

doi:10.1530/endoabs.90.P473

Introduction: Approximately 0.5% of the world population experiences gender dysphoria, a discrepancy between one’s biological sex and gender identity. Transgender men (TM), individuals who were assigned female at birth but who identify as men, can benefit from therapy with testosterone (T) to address gender dysphoria. Although unfavourable changes in lipid profiles have been previously reported, most studies did not show an adverse impact of testosterone treatment on fasting glucose levels.

Methodology: We performed a retrospective analysis to compare lipid profile - total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TG) levels-, fasting plasma glucose (FPG) levels and weight, from baseline to 12 months after the initiation T therapy. We included a cohort of 60 TM who attended our clinic from January to December 2021. After assuring normal distribution of the variables using Kolmogórov-Smirnov test, we performed a Paired samples t-test to compare pre- and post-treatment parameters. Results were presented as total number (percentage) for qualitative variables and as mean ± standard deviation for quantitative variables. Statistical analysis was conducted using SPSS software v.23.

Results: The mean age of our cohort was 20.6 ± 5.3 years and 16 of them (26.7%) were smokers. Regarding T therapy, 15 of TM (25%) were using transdermal testosterone, 32 (53.3%) testosterone undecanoate and 13 (21.7%) testosterone cypionate. Lipid profile, FPG and weight, baseline and 12 months after the initiation of testosterone therapy were compared (Table 1). A significant increase in LDL levels (mean difference +6.050, P = 0.008) and a significant decrease in HDL levels (mean difference -8.050, P< 0.001) were observed. These changes did not correlate with testosterone levels or treatment modality.

Table 1 Clinical characteristics of participants and the control group.
Measurements	Baseline	After 12 months of T	P values
TC(mg/dl)	169.7 ± 25.0	167.4 ± 28.8	P =0.342
LDL(mg/dl)	96.9 ± 22.9	102.9 ± 27.0	P = 0.008
HDL(mg/dl)	56.3 ± 11.6	48.3 ± 9.3	P<0.001
TG(mg/dl)	73.7 ± 30.5	78.5 ± 31.2	P = 0.261
FPG (mg/dl)	87.2 ±8.0	84.4 ± 10.5	P =0.060
Weight (Kg)	66.2 ± 14.6	66.8 ± 12.6	P =0.525

Conclusion: As observed in other publications, this study shows a significant impairment in LDL and HDL levels 12 months after the initiation of testosterone treatment. Unlike, no worsening in FPG levels or weight gain were observed. We should take these results into consideration to address cardiovascular risk and promote positive changes in lifestyle to TM who start testosterone therapy.

Endocrine Abstracts

P473