Multicenter Analysis of Cardiometabolic-related Diagnoses in Transgender and Gender-Diverse Youth: A PEDSnet Study

Anna Valentine, Shanlee Davis, Anna Furniss, Nadia Dowshen, Anne E. Kazak, Christopher Lewis, Danielle F. Loeb, Leena Nahata, Laura Pyle, Lisa M. Schilling, Gina M. Sequeira, Natalie Nokoff

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Context: Studies on cardiometabolic health in transgender and gender-diverse youth (TGDY) are limited to small cohorts. Objective: This work aimed to determine the odds of cardiometabolic-related diagnoses in TGDY compared to matched controls in a cross-sectional analysis, using a large, multisite database (PEDSnet). Methods: Electronic health record data (2009-2019) were used to determine odds of cardiometabolic-related outcomes based on diagnosis, anthropometric, and laboratory data using logistic regression among TGDY youth vs controls. The association of gender-affirming hormone therapy (GAHT) with these outcomes was examined separately among TGDY. TGDY (n=4172) were extracted from 6 PEDSnet sites and propensity-score matched on 8 variables to controls (n=16648). Main outcomes measures included odds of having cardiometabolic-related diagnoses among TGDY compared to matched controls, and among TGDY prescribed GAHT compared to those not prescribed GAHT. Results: In adjusted analyses, TGDY had higher odds of overweight/obesity (1.2; 95% CI, 1.1-1.3) than controls. TGDY with a testosterone prescription alone or in combination with a gonadotropin-releasing hormone agonist (GnRHa) had higher odds of dyslipidemia (1.7; 95% CI, 1.3-2.3 and 3.7; 95% CI, 2.1-6.7, respectively) and liver dysfunction (1.5; 95% CI, 1.1-1.9 and 2.5; 95% CI, 1.4-4.3) than TGDY not prescribed GAHT. TGDY with a testosterone prescription alone had higher odds of overweight/obesity (1.8; 95% CI, 1.5-2.1) and hypertension (1.6 95% CI, 1.2-2.2) than those not prescribed testosterone. Estradiol and GnRHa alone were not associated with greater odds of cardiometabolic-related diagnoses. Conclusion: TGDY have increased odds of overweight/obesity compared to matched controls. Screening and tailored weight management, sensitive to the needs of TGDY, are needed.

Original languageEnglish
Pages (from-to)E4004-E4014
JournalJournal of Clinical Endocrinology and Metabolism
Volume107
Issue number10
DOIs
StatePublished - Oct 1 2022

Keywords

  • body mass index
  • cardiometabolic
  • cholesterol
  • gender dysphoria
  • hormone therapy
  • pediatric

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