Appetitive Behavior, Blood Pressure, Gender Identity, Insulin Sensitivity, Lipid Disorder, Transgender, Vascular Inflammation, Vascular Stiffness
Conditions
Brief summary
This study will examine markers of vascular endothelial function (vascular health) and metabolic profiles in younger versus older transgender women (people who were assigned male at birth but whose gender identity is female). Data will also be compared to those from cisgender women and men.
Interventions
There was no intervention in this study
Sponsors
Study design
Eligibility
Inclusion criteria
* Aged 18-40 years old or 50-75 years old * Identify as a transgender woman * Have taken estradiol and spironolactone for at least one year * Currently taking oral or transdermal estradiol
Exclusion criteria
* Don't identify as a transgender woman * Not currently taking estradiol or spironolactone * Have been on estradiol and spironolactone for less than one year * History of orchiectomy * Current tobacco smoker * Current illicit drug use * History of prior or active estrogen-dependent neoplasms * Acute liver or gallbladder disease * Venous thromboembolism * Hypertriglyceridemia \>500 mg/dL * Fasted plasma glucose \>7.0 mmol/L or previously treated diabetes * Resting blood pressure \>140/90 mmHg
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of endothelial function (flow-mediated dilation (FMD) | Baseline | Brachial artery flow-mediated dilation (FMD), as measured by ultrasound. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Plasma lipid concentrations: triglycerides | Baseline | Triglycerides will be determined at baseline. |
| Evaluation of carotid artery compliance | Baseline | The carotid artery compliance index indicates how elastic the artery is. The index describes the change in arterial blood volume in response to a change in arterial blood pressure. Lower numbers are associated with worse outcomes (less elastic arteries). |
| Evaluation of carotid artery beta stiffness index | Baseline | The carotid artery beta stiffness index indicates how stiff the artery is. Higher numbers are associated with worse outcomes (stiffer artery). |
| Carotid artery intimal-medial thickness | Baseline | — |
| Evaluation of oxidant burden: oxidized LDL | Baseline | Oxidized low-density lipoprotein (LDL) measured in the blood and endothelial cells. |
| Evaluation of oxidant burden: nitrotyrosine | Baseline | Nitrotyrosine measured in the blood and endothelial cells. |
| Evaluation of vascular endothelial cell inflammation: NFkB | Baseline | Protein NFkB (nuclear factor kappa-light-chain-enhancer of activated B cells) measured in blood and endothelial cells. |
| Evaluation of vascular endothelial cell inflammation: MCP-1 | Baseline | Monocyte Chemoattractant Protein-1 (MCP-1) measured in blood and endothelial cells. |
| Evaluation of vascular endothelial cell inflammation: IL-6 | Baseline | Interleukin 6 (IL-6) measured in blood and endothelial cells. |
| Evaluation of vascular endothelial cell inflammation: CRP | Baseline | C-reactive protein (CRP) measured in blood and endothelial cells. |
| Blood pressure | Baseline | — |
| Plasma lipid concentrations: total cholesterol | Baseline | Total cholesterol will be determined at baseline. |
| Whole body composition: Percent Lean Mass | Baseline | Percent lean mass will be determined using dual energy x-ray absorptiometry. |
| Whole body composition: Percent Fat Mass | Baseline | Percent fat mass will be determined using dual energy x-ray absorptiometry. |
| Regional body composition: Percent Lean Mass | Baseline | Regional percent lean mass will be determined using dual energy x-ray absorptiometry. |
| Regional body composition: Percent Fat Mass | Baseline | Regional percent fat mass will be determined using dual energy x-ray absorptiometry. |
| Weight changes | Baseline | — |
| Appetite ratings | Baseline | — |
| Appetite-related peptides | Baseline | — |
| D-Dimer | Baseline | — |
| Alcohol use | Baseline | — |
| Depression symptoms | Baseline | — |
| Physical activity monitoring | 7 days | Physical activity will me monitored for 7 days with an ActivPALmonitor |
| Insulin sensitivity | Baseline | — |
| Energy intake | 3 days | Energy intake will be estimated with a 3-day food diary |
Countries
United States