Marco Colizzi1, Rosalia Costa2, Francesca Scaramuzzi3, Claudia Palumbo4, Margarita Tyropani4, Valeria Pace4, Luca Quagliarella4, Francesco Brescia5, Lilia Carmen Natilla4, Giuseppe Loverro5, Orlando Todarello4. 1. Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Electronic address: marco.colizzi@hotmail.it. 2. Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy; Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, Tavistock Centre, London, United Kingdom. 3. Second Department of Obstetrics and Gynecology, University of Bari "A. Moro", Bari, Italy. 4. Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy. 5. Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Bari, Italy.
Abstract
OBJECTIVE: Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. METHODS: From a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems. RESULTS: When treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. CONCLUSION: This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals.
OBJECTIVE: Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. METHODS: From a sample of 146 GDpatients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GDpatients with and without concomitant psychiatric problems. RESULTS: When treated with hormone therapy, GDpatients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. CONCLUSION: This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals.
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