Endocrine Abstracts

JOINT1588

Introduction: Gender affirming hormone treatment (GAHT) may associate with higher risk of cardiovascular-metabolic disease and screening is recommended as part of clinical care. Long term prospective data are requested to tailor individual follow-up.

Objectives: To evaluate prospective changes in metabolic syndrome during 24 months of masculinizing or feminizing GAHT.

Methods: Prospective audit with patient’s informed consent conducted at a public center of gender identity with annual clinical and biochemical evaluation. GAHT regimen followed international guidelines, and feminizing estradiol treatment was combined with cyproterone acetate. Study outcomes were BMI, waist, hip, blood pressure, lipid status, and HbA1c at baseline, 12 and 24 months. Metabolic syndrome was defined by obesity (BMI >30 kg/m², waist ≥80 cm, or waist–hip-ratio (WHR) >0.9), elevated triglycerides (TG) ≥1.7 mmol/l, HDL <1.0 mmol/l, blood pressure (BP) ≥140/90 mmHg, and HbA1c ≥ 5.6%.

Results: The cohort included 438 persons, 220 were undergoing masculinizing GAHT (TransM_TN, treatment naïve n=113, TransM_TO, treatment ongoing n=107) or feminizing GAHT (TransF_TN, treatment naïve n=137, TransF_TO, treatment ongoing n=81. At baseline, the median age was 22 years (19–28) and 26 years (24–37) in TransM_TN and TransF_TN, respectively. In transM_TN, waist, WHR, systolic BP, TG, and HbA1c increased from baseline to 12 months, whereas HDL decreased. Total cholesterol increased from 12 to 24 months. ≥2 metabolic syndrome criteria were present in 40/110=36% at baseline and in 16/34=47% at 24 months. In TransF_TN, weight, BMI, waist, hip, and WHR increased from baseline to 12 months whereas HbA1c, cholesterol, and TG decreased. From 12 to 24 months, BMI, waist, and hip increased. ≥2 metabolic syndrome criteria were present in 71/134=53% at baseline and in 17/42=41% at 24 months.

Conclusion: Metabolic and cardiovascular risk factors increased after GAHT, especially within the first year of GAHT initiation.