Cardiovascular disease risk factors among transgender women in Chiang Mai, Thailand

Transgender individuals take hormone therapy (HT) for transitioning secondary sexual characteristics, especially by transgender women assigned male at birth (AMAB). The transgender drug is a relatively new field in health care, but limited data exist to inform the cardiovascular risk factor profile among younger individuals undergoing HT. Therefore, this study was to evaluate the relationship between HT and cardiovascular (CVD) risk factors in Thai transgender women. A cross-sectional study was conducted from October 1 2018-November 30 2018 in 100 transgender women not receiving HT (Control group) and 100 transgender women receiving HT (HT group) in Chiang Mai, Thailand. Demographic data were recorded for each consenting subject. Non-invasive arterial examinations were undertaken, including carotid intima-media thickness (CIMT), ankle-brachial index (ABI), and cardio-ankle vascular index (CAVI). CVD risk factors including lipid profiles, fasting plasma glucose (FPG), C-reactive protein (CRP), cardiovascular risk markers (pro b-type natriuretic peptide (proBNP) and cardiac troponin I), and sex hormone levels were determined. The average age in both groups was 24±5.1 years. The average time of HT use was 6.65±0.52 years in the HT group. Mean waist circumference was significantly lower in the HT group compared with the control group (77.50±14.00 81.20±12.90 cm; P=0.004) while CRP (3.44±6.82 3.28±5.80 mg/L; P=0.031) and cardiac troponin I (0.029±0.051 0.014±0.014 ng/mL; P=0.040) values were greater in HT group than the control group. Mean CIMT was lower in the HT group the control group (P=0.094). Among transgender women, receiving HT was associated with enhanced levels of a subset of CVD risk factors. More research is necessary to inform the need for novel CVD prevention and treatment strategies in transgender women.