Young transgender people face a higher risk of cardiovascular diseases, according to a new study.
Anna Valentine, MD, of the University of Colorado Anschutz Medical Campus in Aurora, presented the findings of her team’s study at the Endocrine Society’s virtual ENDO 2021 meeting. Existing research shows increased cardiovascular risks in adult transgender people.
Researchers found that transgender youths assigned female at birth had a higher risk of obesity compared to cisgender female youths, as well as a nearly doubled chance of polycystic ovary syndrome. However, transgender youth did not have an increased risk of hypertension, dysglycaemia, or liver dysfunction.
These differences could be explained by any number of different mechanisms, Dr Valentine explained. “We know that some youth with gender dysphoria have higher rates of overweight and obesity, and that having overweight and obesity itself increases your risk of having other diagnoses.” It is also known that “youth with gender dysphoria have higher rates of mental health comorbidities … as well as getting less physical activity,” she said.
“And they also may be taking medication that could all influence their cardiometabolic health,” she added.
Adult transwomen taking estradiol are more likely to have higher levels of triglycerides and a higher rate of stroke, blood clots, and myocardial infarction (MI). Adult trans men are at greater risk of elevated triglycerides, low-density lipoprotein cholesterol, and body mass index (BMI), as well as lower high-density lipoprotein cholesterol, and an increased risk of MI.
The data of 4174 paediatric patients (average age of 16) diagnosed with gender dysphoria, were compared with 16 651 cisgender controls. This data came from six large paediatric centres. Participants were matched with four controls.
However, the data did not include information on which participants were receiving hormonal treatment, which is something that Dr Valentine is looking to address in her research.
“We do know that in the adult data, that there is some association with estradiol use and testosterone use with differences in cholesterol parameters, but this is still an emerging field in paediatrics,” Dr Valentine explained. “We have some small single-center studies that sometimes say ‘yes, with hormones we see an increase in BMI,’ but other studies say ‘this section looks very stable on this hormone’.”
“The fact that we have such a large cohort in this multicentre analysis for our next steps, I think it will be really interesting to look at that,” she added.
Source: MedPage Today
Presentation information: Valentine A, et al “Multicenter analysis of cardiometabolic-related diagnoses in transgender adolescents” ENDO 2021.
