Cross-sex hormone therapy alters the serum lipid profile: a retrospective cohort study in 169 transsexuals.

ABSTRACT

INTRODUCTION: Cross-sex hormone therapy (CSHT) is known to lead to alterations in the serum lipid profile. However, the available reports in the literature are problematic, because of methodological limitations. AIMS: To assess changes in the fasting serum lipid profile during CSHT, including long-term follow-up. METHODS: Retrospective chart analysis of all 89 male-to-female (MtF) and 80 female-to-male (FtM) transsexuals who underwent standard CSHT at the Department of Gynecologic Endocrinology of the Medical University of Vienna (university hospital, tertiary care center), from 1995 to 2009. MAIN OUTCOME MEASURES: The results of the lipid profile were analyzed, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and the TC-to-HDL ratio, at the time of treatment initiation (time point "0") and at 3, 12, 24, and 60 months after the start of CSHT. RESULTS: The mean age of patients about to commence CSHT was 35.7 ± 11.4 years (MtF) and 26.0 ± 6.3 years (FtM). For MtF transsexuals, consistent follow-up for 24 and 60 months was available in 83 (93.3%) and 58 (65.2%) patients, respectively; for FtM transsexuals, follow-up was available in 57 (71.3%) and 39 (48.8%) patients, respectively. When testing for an association between the lipid parameters and the time after treatment initiation, significant increases for TG (P < 0.001), TC (P = 0.021), and HDL (P = 0.001) were found for MtF transsexuals, whereas TG, TC, and LDL (P < 0.001) increased and HDL (P < 0.001) decreased in FtM patients. CONCLUSION: Both MtF and FtM transsexuals experience alterations in the serum lipid profile because of CSHT, with the changes in FtM patients possibly more relevant in terms of atherogenesis.