Transgender Youth at Risk for Obesity and Cardio-Metabolic Abnormalities: Presented at ENDO

By Michael Bassett

CHICAGO -- March 23, 2018 -- Transgender youth have higher obesity rates compared with non-transgender youth, and are at higher risk for cardio-metabolic abnormalities, according to results of a retrospective chart review presented here on March 19 at the 2018 Annual Meeting of The Endocrine Society (ENDO). Transgender youth are also less likely to meet recommendations for physical activity.

Between 2015 and 2017, Akhila Ramakrishna, MD, Mayo Clinic, Rochester, Minnesota and colleagues sought to determine the prevalence and cardio-metabolic risk factors of 55 transgender children and adolescents (aged 7 to 18 years; 42 female at birth) prior to the initiation of feminising/masculinising hormone therapy. The team used the most recent National Heart Lung and Blood Institute guidelines to define abnormal lipids and blood pressure.

The median body mass index (BMI) percentile of those who were female at birth was 90.5 (58 to 96), with 59.5% having a BMI > 85th percentile. Of those patients, 21.4% were overweight, 26.2% were obese, and 11.9% were severely obese (BMI > 99th percentile). The median BMI percentile of those who were male at birth was 93 (67 to 97) and 69.2% patients had a BMI > 85th percentile, 23.1% of these patients were overweight, 30.8 % were obese, and 15.3% were severely obese.

In addition, 10.9% and 3.6% of all patients, respectively, had prehypertension and hypertension based on systolic blood pressure, while 9.1% and 5.4% had prehypertension and hypertension based on diastolic blood pressure.

These patients also had a high prevalence of abnormalities regarding total cholesterol (borderline high 39.1%, high 21.7%), high-density lipoprotein (HDL) cholesterol (borderline low in 30.4% and low in 34.7%), and triglycerides (borderline high in 26.1% and high in 4.3%).

Fifteen percent of participants had abnormal liver-function studies.

Dr. Ramakrishna suggests that clinicians incorporate lifestyle interventions and assessments of obesity and cardio-metabolic risk factors in the routine care of transgender children and adolescents -- “especially given the potential risk of worsening of metabolic parameters on cross-sex hormone therapy.”

It is well known that paediatric obesity is a serious health problem in the United States, with 17% of children and adolescents (age 2 to 19 years) classified as obese. That percentage is even higher (20.6%) for the group aged 12 to 19 years.

[Presentation title: Obesity and Cardio-etabolic Risk Factors in the Adolescent Transgender Population.]

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