Cross-sex hormone use does not increase cardiovascular risk in young male-to-female transsexuals: a study of self-medication by healthy Thai cabaret dancers
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 511 - 518
DOI: https://doi.org/10.5372/1905-7415.0904.421
Keywords
© 2015 Prawit Onpanna, Paiboon Daosodsai, Kawin Leelawat, Supatra Porasuphatana
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Serum sex hormone levels
| Sex hormone | Cross-sex hormone Mean ± SD, (median) | Control Mean ± SD, (median) |
|---|---|---|
| 17β-estradiol (pg/mL) | 145.3 ± 417.2 (21) Significantly different from control group ( | 28.2 ± 16.1 (29) |
| Progesterone (unit) | 0.4 ± 0.2 (0.4) Significantly different from control group ( | 0.6 ± 0.5 (0.5) |
| Testosterone (unit) | 2.1 ± 3.3 (0.2) Significantly different from control group ( | 5.6 ± 3.2 (6) |
Correlation of serum sex hormones with cardiovascular risk markers
| Serum 17β estradiol | Serum progesterone | Serum testosterone | ||||
|---|---|---|---|---|---|---|
| CSHgrou | Control group | CSHgroup | Control group | CSHgroup | Control group | |
| Age | –0.44 Significantly different from the control group ( | –0.47 Significantly different from the control group ( | ||||
| Body Mass Index | 0.4 Significantly different from the control group ( | |||||
| Total cholesterol | –0.47 Significantly different from the control group ( | |||||
| Low density lipoprotein | –0.41 Significantly different from the control group ( | |||||
| C-reactive protein | 0.5 Significantly different from the control group ( | |||||
Odds ratio (95% CI) of effects of CSH use on various outcomes
| Outcomes | Effect of CSH (odds ratio (95% CI)) | |
|---|---|---|
| Crude model | Adjusted model (age, smoking) | |
| Fibrinogen | 2.73 (0.27-27.29) | 2.14 (0.66–6.92) |
| C-reactive protein | ||
| Body Mass Index | 0.27 (0.69-1.12) | 0.55 (0.11-2.67) |
| Systolic blood pressure | 0.50 (0.21-1.24) | 0.63 (0.23–1.72) |
| Diastolic blood pressure | ||
| Pulse | 0.42 (0.17–1.06) | 0.60 (0.21–1.74) |
| Total cholesterol | 0.97 (0.42-2.24) | 0.91 (0.35–2.40) |
| Triglyceride | 0.37 (0.10-1.31) | 0.47 (0.12–1.86) |
| Low density lipoprotein | 0.90 (0.39-2.10) | 3.10 (1.17–8.19) |
| High density lipoprotein | 0.32 (0.76-1.32) | 0.50 (0.11–2.30) |
Prevalence comparison of cardiovascular risk factors between cross-sex hormone (CSH) using group and control group
| Clinical outcomes | Value cut point of risk for clinical outcomes | CSH group | Control group | ||||
|---|---|---|---|---|---|---|---|
| No of CSH | MtF transsexuals in CSH group who had risk (% of risk for CSH users) | No of control | MtF transsexuals in control group who had risk (% of risk for nonusers) | Pearson chi-square | |||
| Age (years) | >30 | 56 | 19 (34%) | 46 | 19 (41%) | 0.44 | |
| C-reactive protein | >1.8 | 52 | 9 (17%) | 43 | 19 (44%) | 0.004 Significantly different from control group ( | |
| Out of range of | |||||||
| Fibrinogen | 200-400 | 45 | 12 (27%) | 40 | 7 (18%) | 0.31 | |
| Systolic blood pressure | >120 mmHg | 47 | 12 (26%) | 41 | 17 (41%) | 0.13 | |
| Diastolic blood pressure | >80 mmHg | 36 | 0 (0%) | 30 | 0 (0%) | – | |
| Pulse (/min) | >80 | 44 | 12 (27%) | 36 | 17 (47%) | 0.67 | |
| Body Mass Index | >25 kg/mm | 40 | 3 (8%) | 40 | 9 (23%) | 0.06 | |
| Total cholesterol | >200 mg/dL | 52 | 19 (37%) | 43 | 16 (37%) | 0.95 | |
| Triglyceride | >150 mg/dL | 52 | 4 (8%) | 43 | 8 (19%) | 0.11 | |
| Low density lipoprotein | >100 mg/dL | 51 | 32 (63%) | 43 | 28 (65%) | 0.81 | |
| High density lipoprotein | <40, >60 mg/dL | 52 | 3 (6%) | 43 | 7 (16%) | 0.10 | |
Baseline characteristics
| Characteristic | Cross sex hormone use (n = 66) | Control (n = 36) |
|---|---|---|
| Age (years old) | 28.0 (± 6.3) | 29.1 (± 8.4) |
| Years of exogenous hormone exposure | 12.5 (± 6.2) | – |
| Cigarette smoking, (% Yes) | 20% Significantly different from control group (Pearson chi-square) ( | 54% |
| Body Mass Index (kg/m2) | 20.4 (± 2.1) Significantly different from control group ( | 21.6 (± 2.6) |
| Systolic Blood Pressure, SBP (mmHg) | 114.8 (± 15.4) | 117.8 ( ± 11.8) |
| Diastolic Blood Pressure, DBP (mmHg) | 72.9 (± 11.3) | 75.6 (± 9.8) |
| Pulse (/minute) | 76.3 (± 11.8) | 79.1 (± 10.6) |
| Total cholesterol (mg/dL) | 189.7 (± 34.8) | 189.2 ( ± 52.1) |
| Triglyceride (mg/dL) | 95.5 (± 40.0) | 107.8 ( ± 56.0) |
| Low density cholesterol (mg/dL) | 108.7 (± 28.4) | 114.3 ( ± 38.9) |
| High density lipoprotein (mg/dL) | 59.8 (± 22.5) Significantly different from control group ( | 51.5 (± 16.0) |
| C-reactive protein, (CRP) (mg/L) | 1.4 (±1.7) Significantly different from control group ( | 2.1 (±1.8) |
| Fibrinogen (mg/dL) | 246.7 (± 66.9) | 264.9 ( ± 63.0) |