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Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people

(2020) DIABETES CARE. 43(2). p.411-417
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Organization
Abstract
OBJECTIVE: The long-term influences of sex hormone administration on insulin sensitivity and incretin hormones are controversial. We investigated these effects in 35 transgender men (TM) and 55 transgender women (TW) from the European Network for the Investigation of Gender Incongruence (ENIGI) study. RESEARCH DESIGN AND METHODS: Before and after 1 year of gender-affirming hormone therapy, body composition and oral glucose tolerance tests (OGTTs) were evaluated. RESULTS: In TM, body weight (2.8 +/- 1.0 kg; P < 0.01), fat-free mass (FFM) (3.1 +/- 0.9 kg; P < 0.01), and waist-to-hip ratio (-0.03 +/- 0.01; P < 0.01) increased. Fasting insulin (-1.4 +/- 0.8 mU/L; P = 0.08) and HOMA of insulin resistance (HOMA-IR) (2.2 +/- 0.3 vs. 1.8 +/- 0.2; P = 0.06) tended to decrease, whereas fasting glucose (-1.6 +/- 1.6 mg/dL), glucose-dependent insulinotropic polypeptide (GIP) (-1.8 +/- 1.0 pmol/L), and glucagon-like peptide 1 (GLP-1) (-0.2 +/- 1.1 pmol/L) were statistically unchanged. Post-OGTT areas under the curve (AUCs) for GIP (2,068 +/- 1,134 vs. 2,645 +/- 1,248 [pmol/L] x min; P < 0.01) and GLP-1 (2,352 +/- 796 vs. 2,712 +/- 1,015 [pmol/L] x min; P < 0.01) increased. In TW, body weight tended to increase (1.4 +/- 0.8 kg; P = 0.07) with decreasing FFM (-2.3 +/- 0.4 kg; P < 0.01) and waist-to-hip ratio (-0.03 +/- 0.01; P < 0.01). Insulin (3.4 +/- 0.8 mU/L; P < 0.01) and HOMA-IR (1.7 +/- 0.1 vs. 2.4 +/- 0.2; P < 0.01) rose, fasting GIP (-1.4 +/- 0.8 pmol/L; P < 0.01) and AUC GIP dropped (2,524 +/- 178 vs. 1,911 +/- 162 [pmol/L] x min; P < 0.01), but fasting glucose (-0.3 +/- 1.4 mg/dL), GLP-1 (1.3 +/- 0.8 pmol/L), and AUC GLP-1 (2,956 +/- 180 vs. 2,864 +/- 93 [pmol/L] x min) remained unchanged. CONCLUSIONS: In this cohort of transgender persons, insulin sensitivity but also post-OGTT incretin responses tend to increase with masculinization and to decrease with feminization.
Keywords
REPLACEMENT THERAPY, BODY-COMPOSITION, EUROPEAN NETWORK, SEX STEROIDS, RESISTANCE, TESTOSTERONE, MEN, SECRETION

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MLA
Shadid, Samiah, et al. “Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People.” DIABETES CARE, vol. 43, no. 2, 2020, pp. 411–17, doi:10.2337/dc19-1061.
APA
Shadid, S., Abosi-Appeadu, K., De Maertelaere, A.-S., Defreyne, J., Veldeman, L., Holst, J. J., … T’Sjoen, G. (2020). Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people. DIABETES CARE, 43(2), 411–417. https://doi.org/10.2337/dc19-1061
Chicago author-date
Shadid, Samiah, Kessewa Abosi-Appeadu, Anne-Sophie De Maertelaere, Justine Defreyne, Laurens Veldeman, Jens J Holst, Bruno Lapauw, Tina Vilsbøll, and Guy T’Sjoen. 2020. “Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People.” DIABETES CARE 43 (2): 411–17. https://doi.org/10.2337/dc19-1061.
Chicago author-date (all authors)
Shadid, Samiah, Kessewa Abosi-Appeadu, Anne-Sophie De Maertelaere, Justine Defreyne, Laurens Veldeman, Jens J Holst, Bruno Lapauw, Tina Vilsbøll, and Guy T’Sjoen. 2020. “Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People.” DIABETES CARE 43 (2): 411–417. doi:10.2337/dc19-1061.
Vancouver
1.
Shadid S, Abosi-Appeadu K, De Maertelaere A-S, Defreyne J, Veldeman L, Holst JJ, et al. Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people. DIABETES CARE. 2020;43(2):411–7.
IEEE
[1]
S. Shadid et al., “Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people,” DIABETES CARE, vol. 43, no. 2, pp. 411–417, 2020.
@article{8648326,
  abstract     = {{OBJECTIVE: The long-term influences of sex hormone administration on insulin sensitivity and incretin hormones are controversial. We investigated these effects in 35 transgender men (TM) and 55 transgender women (TW) from the European Network for the Investigation of Gender Incongruence (ENIGI) study.
RESEARCH DESIGN AND METHODS: Before and after 1 year of gender-affirming hormone therapy, body composition and oral glucose tolerance tests (OGTTs) were evaluated.
RESULTS: In TM, body weight (2.8 +/- 1.0 kg; P < 0.01), fat-free mass (FFM) (3.1 +/- 0.9 kg; P < 0.01), and waist-to-hip ratio (-0.03 +/- 0.01; P < 0.01) increased. Fasting insulin (-1.4 +/- 0.8 mU/L; P = 0.08) and HOMA of insulin resistance (HOMA-IR) (2.2 +/- 0.3 vs. 1.8 +/- 0.2; P = 0.06) tended to decrease, whereas fasting glucose (-1.6 +/- 1.6 mg/dL), glucose-dependent insulinotropic polypeptide (GIP) (-1.8 +/- 1.0 pmol/L), and glucagon-like peptide 1 (GLP-1) (-0.2 +/- 1.1 pmol/L) were statistically unchanged. Post-OGTT areas under the curve (AUCs) for GIP (2,068 +/- 1,134 vs. 2,645 +/- 1,248 [pmol/L] x min; P < 0.01) and GLP-1 (2,352 +/- 796 vs. 2,712 +/- 1,015 [pmol/L] x min; P < 0.01) increased. In TW, body weight tended to increase (1.4 +/- 0.8 kg; P = 0.07) with decreasing FFM (-2.3 +/- 0.4 kg; P < 0.01) and waist-to-hip ratio (-0.03 +/- 0.01; P < 0.01). Insulin (3.4 +/- 0.8 mU/L; P < 0.01) and HOMA-IR (1.7 +/- 0.1 vs. 2.4 +/- 0.2; P < 0.01) rose, fasting GIP (-1.4 +/- 0.8 pmol/L; P < 0.01) and AUC GIP dropped (2,524 +/- 178 vs. 1,911 +/- 162 [pmol/L] x min; P < 0.01), but fasting glucose (-0.3 +/- 1.4 mg/dL), GLP-1 (1.3 +/- 0.8 pmol/L), and AUC GLP-1 (2,956 +/- 180 vs. 2,864 +/- 93 [pmol/L] x min) remained unchanged.
CONCLUSIONS: In this cohort of transgender persons, insulin sensitivity but also post-OGTT incretin responses tend to increase with masculinization and to decrease with feminization.}},
  author       = {{Shadid, Samiah and Abosi-Appeadu, Kessewa and De Maertelaere, Anne-Sophie and Defreyne, Justine and Veldeman, Laurens and Holst, Jens J and Lapauw, Bruno and Vilsbøll, Tina and T'Sjoen, Guy}},
  issn         = {{0149-5992}},
  journal      = {{DIABETES CARE}},
  keywords     = {{REPLACEMENT THERAPY,BODY-COMPOSITION,EUROPEAN NETWORK,SEX STEROIDS,RESISTANCE,TESTOSTERONE,MEN,SECRETION}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{411--417}},
  title        = {{Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people}},
  url          = {{http://dx.doi.org/10.2337/dc19-1061}},
  volume       = {{43}},
  year         = {{2020}},
}

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