Body composition and risk for sarcopenia in transgender women.

OBJECTIVES: Body composition and strength of cisgender (cis) individuals are well established. However, those for transgender women (trans women) undergoing gender-affirming hormone therapy remain unclear. This study aimed to detect possible body composition and strength variations related to sarcopenia. METHODS: This was a cross-sectional comparative study of 37 trans women, 34 cis men, and 34 cis women. Body composition was measured in all individuals by bioelectrical impedance analysis; prehensile strength by dynamometry was studied in trans women. RESULTS: In this study, trans women had higher body mass index values than cis individuals (P < 0.01). Fat mass was 41% higher for trans women than cis men. Muscle mass (MM) was lower in trans women than cis men (-10%), and higher than cis women (24%). Bone mass was lower in trans women than cis men and higher in cis women (P < 0.01). Trans women's prehensile strengths were 25.26 kg for the right hand and 24.8 kg for the left. Appendicular skeletal muscle mass was 23.63 kg, and appendicular skeletal muscle mass index was 8.14 kg. CONCLUSION: Trans women undergoing gender-affirming hormone therapy show a tendency to adapt body compartments to those of cis women with increased fat mass and reduced muscle mass. Prehensile strength in trans women was close to the cutoff points for sarcopenia risk. Nutrition, physical activity, strength, and body composition are important to avoid the possible risk for sarcopenia. More studies along these lines are necessary, especially in older adults.

Capacidad antioxidante total de la dieta de las mujeres gestantes de la Comunidad de Madrid / Total antioxidant capacity of the diet of pregnant women in the Community of Madrid

INTRODUCCIÓN Y OBJETIVO: el embarazo es una etapa de la vida con alta vulnerabilidad nutricional y aumento de los niveles de estrés oxidativo en la madre. La capacidad antioxidante total (CAT) identifica el efecto protector de la dieta equilibrada, rica en alimentos de origen vegetal con actividad antioxidante. El objetivo de este estudio fue relacionar la CAT con la ingesta dietética y el índice de masa corporal (IMC) en mujeres gestantes pertenecientes a la Comunidad de Madrid. MÉTODOS: se realizó un estudio transversal comparativo de 89 mujeres gestantes y 61 mujeres sanas en edad reproductiva. Se registraron la edad, el lugar de origen, el peso, la estatura, el IMC, la ingesta de macronutrientes y micronutrientes, y la CAT dietética por frecuencia alimentaria; la CAT se clasificó como deseable (≥ 19.301,0 μm/g) y no deseable (< 19.301,0 μm/g); el análisis estadístico, con la prueba del χ², la prueba de la t de Student o la prueba de la U de Mann Whitney, se realizó de acuerdo con la normalidad de las variables en la población estudiada. Se utilizó el programa SPSS, versión 23. RESULTADOS: se encontraron diferencias en el perfil calórico, la ingesta de micronutrientes antioxidantes y la CAT dietética (p < 0,05). La CAT promedio en las gestantes fue de 23.163,0 ± 10.829,0 μm/g, frente a 25.916,0 ± 9.703,0 μm/g en las no gestantes (p = 0,035). Las gestantes con CAT deseable (56,2 %) preferían consumir frutas y verduras, mientras que el 65,6 % de las mujeres no gestantes preferían el pan, la pasta y los cereales (p = 0,03). La fruta de mano, los frutos cítricos, las verduras de hoja verde y el tomate eran consumidos preferentemente por ambos grupos. En las mujeres gestantes, en cuanto al estado nutricional deficiente, la tasa de sobrepeso y obesidad fue del 36,0 %, frente al 28,0 % entre las no gestantes (p < 0,001)

INTRODUCTION AND OBJECTIVE: pregnancy is a stage of life with high nutritional vulnerability and increased levels of maternal oxidative stress. Total antioxidant capacity (CAT) identifies the protective effect of a balanced diet rich in foods of plant origin with antioxidant activity. The aim of this study was to relate CAT with dietary intake and body mass index (BMI) in pregnant women in the Community of Madrid. METHODS: a cross-sectional, comparative study was conducted in 89 pregnant women and 61 healthy women of reproductive age. Age, place of origin, weight, height, BMI, macronutrient and micronutrient intake, and dietary CAT by food frequency were recorded; CAT was classified as desirable (≥ 19,301.0 μm/g) or undesirable (< 19,301.0 μm/g); the statistical analysis, including χ², Student's t-test or Mann Whitney U-test, was made using the SPSS program V.23. RESULTS: differences were found in caloric profile, intake of antioxidant micronutrients, and dietary CAT (p < 0.05). Mean CAT in pregnant women was 23,163.0 ± 10,829.0 μm/g, whereas in non-pregnant women it was 25,916.0 ± 9,703.0 μm/g (p = 0.035). Pregnant women with a desirable CAT (56.2 %) preferred to consume fruits and vegetables, and 65.6 % of non-pregnant women preferred bread, pasta and cereals (p = 0.02). Hand fruit, citrus fruits, green leafy vegetables, and tomato were preferentially consumed by both groups. In pregnant women, poor nutritional status, overweight, and obesity rates of 36.0 % were found versus 28.0 % in non-pregnant women (p < 0.001). CONCLUSION: the BMI of pregnant women is not related to dietary CAT or the relatively low consumption of antioxidant components

[Total antioxidant capacity of the diet of pregnant women in the Community of Madrid]. / Capacidad antioxidante total de la dieta de las mujeres gestantes de la Comunidad de Madrid.

INTRODUCTION: Introduction and objective: pregnancy is a stage of life with high nutritional vulnerability and increased levels of maternal oxidative stress. Total antioxidant capacity (CAT) identifies the protective effect of a balanced diet rich in foods of plant origin with antioxidant activity. The aim of this study was to relate CAT with dietary intake and body mass index (BMI) in pregnant women in the Community of Madrid. Methods: a cross-sectional, comparative study was conducted in 89 pregnant women and 61 healthy women of reproductive age. Age, place of origin, weight, height, BMI, macronutrient and micronutrient intake, and dietary CAT by food frequency were recorded; CAT was classified as desirable (≥ 19,301.0 µm/g) or undesirable (< 19,301.0 µm/g); the statistical analysis, including χ², Student's t-test or Mann Whitney U-test, was made using the SPSS program v.23. Results: differences were found in caloric profile, intake of antioxidant micronutrients, and dietary CAT (p < 0.05). Mean CAT in pregnant women was 23,163.0 ± 10,829.0 µm/g, whereas in non-pregnant women it was 25,916.0 ± 9,703.0 µm/g (p = 0.035). Pregnant women with a desirable CAT (56.2 %) preferred to consume fruits and vegetables, and 65.6 % of non-pregnant women preferred bread, pasta and cereals (p = 0.02). Hand fruit, citrus fruits, green leafy vegetables, and tomato were preferentially consumed by both groups. In pregnant women, poor nutritional status, overweight, and obesity rates of 36.0 % were found versus 28.0 % in non-pregnant women (p < 0.001). Conclusion: the BMI of pregnant women is not related to dietary CAT or the relatively low consumption of antioxidant components.

INTRODUCCIÓN: Introducción y objetivo: el embarazo es una etapa de la vida con alta vulnerabilidad nutricional y aumento de los niveles de estrés oxidativo en la madre. La capacidad antioxidante total (CAT) identifica el efecto protector de la dieta equilibrada, rica en alimentos de origen vegetal con actividad antioxidante. El objetivo de este estudio fue relacionar la CAT con la ingesta dietética y el índice de masa corporal (IMC) en mujeres gestantes pertenecientes a la Comunidad de Madrid. Métodos: se realizó un estudio transversal comparativo de 89 mujeres gestantes y 61 mujeres sanas en edad reproductiva. Se registraron la edad, el lugar de origen, el peso, la estatura, el IMC, la ingesta de macronutrientes y micronutrientes, y la CAT dietética por frecuencia alimentaria; la CAT se clasificó como deseable (≥ 19.301,0 µm/g) y no deseable (< 19.301,0 µm/g); el análisis estadístico, con la prueba del χ², la prueba de la t de Student o la prueba de la U de Mann Whitney, se realizó de acuerdo con la normalidad de las variables en la población estudiada. Se utilizó el programa SPSS, versión 23. Resultados: se encontraron diferencias en el perfil calórico, la ingesta de micronutrientes antioxidantes y la CAT dietética (p < 0,05). La CAT promedio en las gestantes fue de 23.163,0 ± 10.829,0 µm/g, frente a 25.916,0 ± 9.703,0 µm/g en las no gestantes (p = 0,035). Las gestantes con CAT deseable (56,2 %) preferían consumir frutas y verduras, mientras que el 65,6 % de las mujeres no gestantes preferían el pan, la pasta y los cereales (p = 0,03). La fruta de mano, los frutos cítricos, las verduras de hoja verde y el tomate eran consumidos preferentemente por ambos grupos. En las mujeres gestantes, en cuanto al estado nutricional deficiente, la tasa de sobrepeso y obesidad fue del 36,0 %, frente al 28,0 % entre las no gestantes (p < 0,001). Conclusión: el IMC de las mujeres gestantes no está relacionado con la CAT dietética ni con el relativo bajo consumo de componentes antioxidantes.

Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

Prevalencia de hiperandrogenismo y síndrome de ovario poliquístico en transexuales de mujer a hombre / Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals

INTRODUCCIÓN: La prevalencia de hiperandrogenismo (HA), que incluye el síndrome de ovario poliquístico (SOP), es alta en los pacientes transexuales de mujer a hombre (TMH). Este hecho se ha relacionado con el síndrome metabólico (SM), lo que parece aumentar la morbimortalidad cardiovascular a lo largo del tratamiento hormonal cruzado (THC). OBJETIVOS: Determinar la prevalencia de HA y SOP en pacientes TMH antes del inicio del THC, y su asociación con el SM y sus componentes, la insulinorresistencia (IR) y otros factores de riesgo cardiovascular (RCV). MATERIALES Y MÉTODOS: Setenta y siete TMH fueron valorados clínica y analíticamente para HA antes de iniciar el THC. También se determinaron los factores de RCV, la IR y otros parámetros del SM. RESULTADOS: La prevalencia de HA fue del 49,4% (el 73,7% de ellos con SOP [criterios de Rotterdam]), y del total de la muestra el 36,4% presentaron SOP. La prevalencia global de SM fue del 38,4 y 51,7% (criterios ATP-III e IDF, respectivamente). Los pacientes con HA frente a aquellos sin HA presentaban SM (criterios ATP-III e IDF, respectivamente) en el 36,8 y 57,9% frente al 25,6 y 41% (p < 0,0001 y p < 0,01, respectivamente). El 54,5% de los pacientes tenía normopeso (índice de masa corporal [IMC] 18,5-24,9 kg/m2), el 26% sobrepeso (IMC 25-29,9 kg/m2) y el 19,5% eran obesos (IMC ≥ 30 kg/m2). Al ajustar por el IMC la comparación de parámetros hormonales, metabólicos y antropométricos mostró diferencias estadísticamente significativas en los valores de glucemia, HOMA-IR y perímetro abdominal (p < 0,001), así como en los de colesterol-HDL (HDL) (p = 0,033), pero no en las concentraciones de testosterona total o de testosterona libre calculada. Del total de la muestra el 27,3% presentaron niveles de HDL por debajo de 50mg/dl. CONCLUSIONES: El HA y el SOP son muy prevalentes en la población TMH. HA y SOP se relacionan con el desarrollo temprano de SM, IR y otros factores de RCV, de consecuencias desconocidas en la edad adulta

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p < 0.0001 and P < 0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m-2), 26% were overweight (BMI 25-29.9 kg.m-2), and 19.5% were obese (BMI ≥ 30 kg.m-2). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P < 0.001 for all), as well as HDL cholesterol (HDL) (P = 0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood

Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals.

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p<0.0001 and P<0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m(-2)), 26% were overweight (BMI 25-29.9 kg.m(-2)), and 19.5% were obese (BMI ≥ 30 kg.m(-2)). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P<0.001 for all), as well as HDL cholesterol (HDL) (P=0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood.