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The following is a summary of “Effects of gender-affirming hormone therapy on myocardial, hepatic, pancreatic lipid content, body fat distribution and other cardiometabolic risk factors: A magnetic resonance-based study in transgender individuals,” published in the March 2025 issue of Journal of Clinical & Translational Endocrinology by Sluková et al. 

Researchers conducted a retrospective study to evaluate changes in body fat distribution, intraorgan lipid accumulation, and cardiometabolic risk factors after 6 months of gender-affirming hormone therapy (GAHT) in transgender men (TM) and transgender women (TW).  

They assessed 15 TW and 20 TM at the Medical University of Vienna from 2019 to 2022. Magnetic resonance imaging and spectroscopy measured visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), the VAT/SAT ratio, and intraorgan lipid content in the liver, pancreas, and myocardium. Bloodwork and an oral glucose tolerance test were performed at baseline and after 6 months of GAHT.  

The results showed no significant changes in pancreatic, hepatic, or intramyocardial lipid content in either group after 6 months of GAHT. In TW, the VAT/SAT ratio significantly decreased from 0.930 (IQR 0.649–1.287) to 0.758 (IQR 0.424–0.900; P = 0.011). Insulin sensitivity, measured by the updated homeostatic model assessment for insulin sensitivity (HOMA2- %S), declined from 83.03% (±31.11) to 64.27% (±18.01; P = 0.047), while β-cell function (HOMA2-%β) increased from 128.11% (±35.80) to 156.80% (±39.49; P = 0.020). In TM, no changes were observed in glucose metabolism, except for an increase in HbA_1c from 5.1% (±0.3) to 5.3% (±0.4; P = 0.001).  

Investigators concluded that while 6 months of GAHT did not significantly alter myocardial, hepatic, or pancreatic lipid content, it did result in a notable body fat redistribution, specifically a decreased VAT/SAT ratio in TW. 

Source: sciencedirect.com/science/article/pii/S2214623724000504