Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study
Background: Although the divergent male and female differentiation depends on key genes, many biological differences seen in men and women are driven by relative differences in estrogen and testosterone levels. Gender dysphoria denotes the distress that gender incongruence with the assigned sex at b...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-06-01
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| Series: | Contemporary Clinical Trials Communications |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865417301606 |
| _version_ | 1818859698916425728 |
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| author | Anna Wiik Daniel P. Andersson Torkel B. Brismar Setareh Chanpen Cecilia Dhejne Tomas J. Ekström John N. Flanagan Mats Holmberg Juha Kere Mats Lilja Malene E. Lindholm Tommy R. Lundberg Eva Maret Michael Melin Sofie M. Olsson Eric Rullman Kerstin Wåhlén Stefan Arver Thomas Gustafsson |
| author_facet | Anna Wiik Daniel P. Andersson Torkel B. Brismar Setareh Chanpen Cecilia Dhejne Tomas J. Ekström John N. Flanagan Mats Holmberg Juha Kere Mats Lilja Malene E. Lindholm Tommy R. Lundberg Eva Maret Michael Melin Sofie M. Olsson Eric Rullman Kerstin Wåhlén Stefan Arver Thomas Gustafsson |
| author_sort | Anna Wiik |
| collection | DOAJ |
| description | Background: Although the divergent male and female differentiation depends on key genes, many biological differences seen in men and women are driven by relative differences in estrogen and testosterone levels. Gender dysphoria denotes the distress that gender incongruence with the assigned sex at birth may cause. Gender-affirming treatment includes medical intervention such as inhibition of endogenous sex hormones and subsequent replacement with cross-sex hormones. The aim of this study is to investigate consequences of an altered sex hormone profile on different tissues and metabolic risk factors. By studying subjects undergoing gender-affirming medical intervention with sex hormones, we have the unique opportunity to distinguish between genetic and hormonal effects. Methods: The study is a single center observational cohort study conducted in Stockholm, Sweden. The subjects are examined at four time points; before initiation of treatment, after endogenous sex hormone inhibition, and three and eleven months following sex hormone treatment. Examinations include blood samples, skeletal muscle-, adipose- and skin tissue biopsies, arteriography, echocardiography, carotid Doppler examination, whole body MRI, CT of muscle and measurements of muscle strength. Results: The primary outcome measure is transcriptomic and epigenomic changes in skeletal muscle. Secondary outcome measures include transcriptomic and epigenomic changes associated with metabolism in adipose and skin, muscle strength, fat cell size and ability to release fatty acids from adipose tissue, cardiovascular function, and body composition. Conclusions: This study will provide novel information on the role of sex hormone treatment in skeletal muscle, adipose and skin, and its relation to cardiovascular and metabolic disease. Keywords: Transgender, Sex hormone, Adipose tissue, Skeletal muscle, Epigenetics, Sex change |
| first_indexed | 2024-12-19T09:16:19Z |
| format | Article |
| id | doaj.art-5ad1f734c819490e83d66f973c6db60f |
| institution | Directory Open Access Journal |
| issn | 2451-8654 |
| language | English |
| last_indexed | 2024-12-19T09:16:19Z |
| publishDate | 2018-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj.art-5ad1f734c819490e83d66f973c6db60f2022-12-21T20:28:05ZengElsevierContemporary Clinical Trials Communications2451-86542018-06-0110148153Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) studyAnna Wiik0Daniel P. Andersson1Torkel B. Brismar2Setareh Chanpen3Cecilia Dhejne4Tomas J. Ekström5John N. Flanagan6Mats Holmberg7Juha Kere8Mats Lilja9Malene E. Lindholm10Tommy R. Lundberg11Eva Maret12Michael Melin13Sofie M. Olsson14Eric Rullman15Kerstin Wåhlén16Stefan Arver17Thomas Gustafsson18Department of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden; Corresponding author. Department of Medicine (H7) C2:94, Karolinska Institutet, 14186 Stockholm, Sweden.Division of Radiology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SwedenANOVA, Andrology, Sexual Medicine and Transgender Medicine, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden; ANOVA, Andrology, Sexual Medicine and Transgender Medicine, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, SwedenANOVA, Andrology, Sexual Medicine and Transgender Medicine, Karolinska University Hospital, Stockholm, SwedenDepartment of Biosciences and Nutrition, Karolinska Institutet, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenHeart and Vascular Theme, Karolinska University Hospital, Karolinska Institutet, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Vascular Theme, Karolinska University Hospital, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, SwedenBackground: Although the divergent male and female differentiation depends on key genes, many biological differences seen in men and women are driven by relative differences in estrogen and testosterone levels. Gender dysphoria denotes the distress that gender incongruence with the assigned sex at birth may cause. Gender-affirming treatment includes medical intervention such as inhibition of endogenous sex hormones and subsequent replacement with cross-sex hormones. The aim of this study is to investigate consequences of an altered sex hormone profile on different tissues and metabolic risk factors. By studying subjects undergoing gender-affirming medical intervention with sex hormones, we have the unique opportunity to distinguish between genetic and hormonal effects. Methods: The study is a single center observational cohort study conducted in Stockholm, Sweden. The subjects are examined at four time points; before initiation of treatment, after endogenous sex hormone inhibition, and three and eleven months following sex hormone treatment. Examinations include blood samples, skeletal muscle-, adipose- and skin tissue biopsies, arteriography, echocardiography, carotid Doppler examination, whole body MRI, CT of muscle and measurements of muscle strength. Results: The primary outcome measure is transcriptomic and epigenomic changes in skeletal muscle. Secondary outcome measures include transcriptomic and epigenomic changes associated with metabolism in adipose and skin, muscle strength, fat cell size and ability to release fatty acids from adipose tissue, cardiovascular function, and body composition. Conclusions: This study will provide novel information on the role of sex hormone treatment in skeletal muscle, adipose and skin, and its relation to cardiovascular and metabolic disease. Keywords: Transgender, Sex hormone, Adipose tissue, Skeletal muscle, Epigenetics, Sex changehttp://www.sciencedirect.com/science/article/pii/S2451865417301606 |
| spellingShingle | Anna Wiik Daniel P. Andersson Torkel B. Brismar Setareh Chanpen Cecilia Dhejne Tomas J. Ekström John N. Flanagan Mats Holmberg Juha Kere Mats Lilja Malene E. Lindholm Tommy R. Lundberg Eva Maret Michael Melin Sofie M. Olsson Eric Rullman Kerstin Wåhlén Stefan Arver Thomas Gustafsson Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study Contemporary Clinical Trials Communications |
| title | Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study |
| title_full | Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study |
| title_fullStr | Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study |
| title_full_unstemmed | Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study |
| title_short | Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS) study |
| title_sort | metabolic and functional changes in transgender individuals following cross sex hormone treatment design and methods of the gender dysphoria treatment in sweden gets study |
| url | http://www.sciencedirect.com/science/article/pii/S2451865417301606 |
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