{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:02:15Z","timestamp":1787169735340,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University, China","award":["JNU1AF-CFTP-2022-a01227"],"award-info":[{"award-number":["JNU1AF-CFTP-2022-a01227"]}]},{"name":"Science and Technology Program of Guangzhou, China","award":["2023A03J0602"],"award-info":[{"award-number":["2023A03J0602"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lipids Health Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is insufficient research on how gender-affirming hormone therapy (GAHT) affects body fat modifications in transwomen from China. It is unclear whether hormone therapy affects the prevalence of obesity and blood lipid levels within this population. The current research aimed to assess how GAHT and treatment duration had an impact on the change in and redistribution of body fat in Chinese transwomen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 40 transwomen who had not received GAHT and 59 who had. Body fat, blood lipid, and blood glucose levels were measured. GAHT is mainly a pharmacologic (estrogen and anti-androgen) treatment. The study also stratified participants based on the duration of GAHT to assess its impact on body fat distribution. The duration of GAHT was within one year, one to two years, two to three years, or more than three years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After receiving GAHT, total body fat increased by 19.65%, and the percentage of body fat increased by 17.63%. The arm, corrected leg, and leg regions showed significant increases in fat content (+\u200924.02%, +\u200950.69%, and +\u200941.47%, respectively) and percentage (+\u200925.19%, +\u200934.90%, and +\u200930.39%, respectively). The total visceral fat content decreased (-37.49%). Based on the diagnostic standards for a body mass index\u2009\u2265\u200928 or total body fat percentage\u2009\u2265\u200925% or 30%, the chance of developing obesity did not change significantly. Blood glucose levels significantly increased (+\u200912.31%). Total cholesterol levels (-10.45%) decreased significantly. Fat changes in those who received GAHT for one to two years were significantly different from those who did not receive GAHT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After receiving GAHT, total body fat and regional fat increased in Chinese transwomen, and the body fat distribution changed from masculine to feminine, especially during the first two years. However, neither the increase in total body fat percentage nor the decrease in visceral fat content didn\u2019t bring about significant changes in the incidence of obesity, nor did triglycerides or low-density lipoprotein-cholesterol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12944-024-02131-y","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T07:03:09Z","timestamp":1715929389000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of gender-affirming hormone therapy on body fat: a retrospective case\u2012control study in Chinese transwomen"],"prefix":"10.1186","volume":"23","author":[{"given":"Qin","family":"Pei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongwei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongkun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunda","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2153-8319","authenticated-orcid":false,"given":"Lvfen","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5643-2633","authenticated-orcid":false,"given":"Jian","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2503-2151","authenticated-orcid":false,"given":"Xiaoying","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"2131_CR1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1590\/S2317-17822013000200017","volume":"25","author":"DE Battle","year":"2013","unstructured":"Battle DE. Diagnostic and statistical Manual of Mental disorders (DSM). Codas. 2013;25:191\u20132.","journal-title":"Codas"},{"key":"2131_CR2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.maturitas.2019.04.220","volume":"126","author":"V Libby","year":"2019","unstructured":"Libby V, Lee M, Liu JH. Transgender health: hormonal management at 50 years and beyond. Maturitas. 2019;126:34\u20137.","journal-title":"Maturitas"},{"key":"2131_CR3","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1210\/er.2018-00011","volume":"40","author":"G T\u2019Sjoen","year":"2019","unstructured":"T\u2019Sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of Transgender Medicine. Endocr Rev. 2019;40:97\u2013117.","journal-title":"Endocr Rev"},{"key":"2131_CR4","first-page":"37","volume":"12","author":"G Lvfen","year":"2022","unstructured":"Lvfen G, Linzhi G, Xingmei X, Lishan X, Yuwei S, Shunkai L, Yanbin J, Xiaoyu W. Strategies for gender-affirming hormone therapy for transgender women. Obstetrics-Gynecology Genet (Electronic Edition). 2022;12:37\u201345.","journal-title":"Obstetrics-Gynecology Genet (Electronic Edition)"},{"key":"2131_CR5","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1530\/EJE-17-0496","volume":"178","author":"M Klaver","year":"2018","unstructured":"Klaver M, de Blok CJM, Wiepjes CM, Nota NM, Dekker M, de Mutsert R, Schreiner T, Fisher AD. T\u2019Sjoen G, den Heijer M. Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study. Eur J Endocrinol. 2018;178:163\u201371.","journal-title":"Eur J Endocrinol"},{"key":"2131_CR6","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1210\/jc.2017-02316","volume":"103","author":"LJW Tack","year":"2018","unstructured":"Tack LJW, Craen M, Lapauw B, Goemaere S, Toye K, Kaufman JM, Vandewalle S, T\u2019Sjoen G, Zmierczak HG, Cools M. Proandrogenic and antiandrogenic progestins in transgender youth: Differential effects on body composition and bone metabolism. J Clin Endocrinol Metab. 2018;103:2147\u201356.","journal-title":"J Clin Endocrinol Metab"},{"key":"2131_CR7","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1111\/cen.13607","volume":"88","author":"TM Fighera","year":"2018","unstructured":"Fighera TM, Da SE, Lindenau JD, Spritzer PM. Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen. Clin Endocrinol (Oxf). 2018;88:856\u201362.","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2131_CR8","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.yhbeh.2007.05.012","volume":"52","author":"IR Haraldsen","year":"2007","unstructured":"Haraldsen IR, Haug E, Falch J, Egeland T, Opjordsmoen S. Cross-sex pattern of bone mineral density in early onset gender identity disorder. Horm Behav. 2007;52:334\u201343.","journal-title":"Horm Behav"},{"key":"2131_CR9","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s00198-014-2805-3","volume":"26","author":"E Van Caenegem","year":"2015","unstructured":"Van Caenegem E, Wierckx K, Taes Y, Schreiner T, Vandewalle S, Toye K, Kaufman JM, T\u2019Sjoen G. Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study. Osteoporos Int. 2015;26:35\u201347.","journal-title":"Osteoporos Int"},{"key":"2131_CR10","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.1111\/j.1743-6109.2012.02876.x","volume":"9","author":"K Wierckx","year":"2012","unstructured":"Wierckx K, Mueller S, Weyers S, Van Caenegem E, Roef G, Heylens G, T\u2019Sjoen G. Long-term evaluation of cross-sex hormone treatment in transsexual persons. J Sex Med. 2012;9:2641\u201351.","journal-title":"J Sex Med"},{"key":"2131_CR11","doi-asserted-by":"publisher","first-page":"59","DOI":"10.11005\/jbm.2021.28.1.59","volume":"28","author":"Y Yun","year":"2021","unstructured":"Yun Y, Kim D, Lee ES. Effect of Cross-sex hormones on Body Composition, Bone Mineral density, and muscle strength in Trans Women. J Bone Metab. 2021;28:59\u201366.","journal-title":"J Bone Metab"},{"key":"2131_CR12","first-page":"1","volume":"7","author":"L Yanrong","year":"2023","unstructured":"Yanrong L, Yifan S, Piao Y, Lili Y. Regulation mechanism of adipocyte differentiation and its effect on metabolism. Int J Clin Res. 2023;7:1\u20138.","journal-title":"Int J Clin Res"},{"key":"2131_CR13","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1210\/jc.2018-02138","volume":"104","author":"DM van Velzen","year":"2019","unstructured":"van Velzen DM, Paldino A, Klaver M, Nota NM, Defreyne J, Hovingh GK, Thijs A, Simsek S. T Sjoen G, den Heijer M. Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen. J Clin Endocrinol Metabolism. 2019;104:1937\u201347.","journal-title":"J Clin Endocrinol Metabolism"},{"key":"2131_CR14","doi-asserted-by":"publisher","first-page":"3914","DOI":"10.1210\/jc.2017-01643","volume":"102","author":"S Maraka","year":"2017","unstructured":"Maraka S, Singh ON, Rodriguez-Gutierrez R, Davidge-Pitts CJ, Nippoldt TB, Prokop LJ, Murad MH. Sex steroids and cardiovascular outcomes in transgender individuals: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2017;102:3914\u201323.","journal-title":"J Clin Endocrinol Metab"},{"key":"2131_CR15","doi-asserted-by":"publisher","first-page":"e64","DOI":"10.1038\/nutd.2013.5","volume":"3","author":"MA Stults-Kolehmainen","year":"2013","unstructured":"Stults-Kolehmainen MA, Stanforth PR, Bartholomew JB, Lu T, Abolt CJ, Sinha R. DXA estimates of fat in abdominal, trunk and hip regions varies by ethnicity in men. Nutr Diabetes. 2013;3:e64.","journal-title":"Nutr Diabetes"},{"key":"2131_CR16","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1093\/ajcn\/51.6.1106","volume":"51","author":"RB Mazess","year":"1990","unstructured":"Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J Clin Nutr. 1990;51:1106\u201312.","journal-title":"AM J CLIN NUTR"},{"key":"2131_CR17","doi-asserted-by":"publisher","first-page":"e0175110","DOI":"10.1371\/journal.pone.0175110","volume":"12","author":"MT Imboden","year":"2017","unstructured":"Imboden MT, Welch WA, Swartz AM, Montoye AH, Finch HW, Harber MP, Kaminsky LA. Reference standards for body fat measures using GE dual energy x-ray absorptiometry in caucasian adults. PLoS ONE. 2017;12:e0175110.","journal-title":"PLoS ONE"},{"key":"2131_CR18","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s12944-017-0532-4","volume":"16","author":"N Seyed-Sadjadi","year":"2017","unstructured":"Seyed-Sadjadi N, Berg J, Bilgin AA, Grant R. Visceral fat mass: is it the link between uric acid and diabetes risk? Lipids Health Dis. 2017;16:142.","journal-title":"Lipids Health Dis"},{"key":"2131_CR19","unstructured":"Group COWG. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Chin J Epidemiol 2002:10\u20135."},{"key":"2131_CR20","first-page":"76","volume":"20","author":"S Mai","year":"2014","unstructured":"Mai S, Yanbo Z. Research Progress on the diagnostic criteria of obesity and lts clinical application. Food Nutr China. 2014;20:76\u201380.","journal-title":"Food Nutr China"},{"key":"2131_CR21","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.beem.2007.04.007","volume":"21","author":"JC Wells","year":"2007","unstructured":"Wells JC. Sexual dimorphism of body composition. Best Pract Res Clin Endocrinol Metab. 2007;21:415\u201330.","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2131_CR22","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1016\/j.jsxm.2021.01.185","volume":"18","author":"C Cocchetti","year":"2021","unstructured":"Cocchetti C, Castellini G, Iacuaniello D, Romani A, Maggi M, Vignozzi L, Schreiner T, den Heijer M, T\u2019Sjoen G, Fisher AD. Does gender-affirming hormonal treatment affect 30-Year cardiovascular risk in transgender persons? A two-year prospective European study (ENIGI). J Sex Med. 2021;18:821\u20139.","journal-title":"J Sex Med"},{"key":"2131_CR23","doi-asserted-by":"crossref","unstructured":"Milionis C, Ilias I, Venaki E, Koukkou E. Glucose homeostasis, diabetes mellitus, and gender-affirming treatment. Biomedicines 2023; 11.","DOI":"10.3390\/biomedicines11030670"},{"key":"2131_CR24","doi-asserted-by":"publisher","first-page":"118","DOI":"10.3389\/fendo.2014.00118","volume":"5","author":"R Root-Bernstein","year":"2014","unstructured":"Root-Bernstein R, Podufaly A, Dillon PF. Estradiol binds to insulin and insulin receptor decreasing insulin binding in vitro. Front Endocrinol (Lausanne). 2014;5:118.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2131_CR25","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/S2213-8587(22)00033-X","volume":"10","author":"M Kivim\u00e4ki","year":"2022","unstructured":"Kivim\u00e4ki M, Strandberg T, Pentti J, Nyberg ST, Frank P, Jokela M, Ervasti J, Suominen SB, Vahtera J, Sipil\u00e4 PN, et al. Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study. Lancet Diabetes Endocrinol. 2022;10:253\u201363.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2131_CR26","doi-asserted-by":"publisher","first-page":"7381","DOI":"10.1038\/s41598-021-86336-6","volume":"11","author":"HY Hsu","year":"2021","unstructured":"Hsu HY, Tsai MC, Yeh TL, Hsu LY, Hwang LC, Chien KL. Association of baseline as well as change in lipid levels with the risk of cardiovascular diseases and all-cause deaths. Sci Rep. 2021;11:7381.","journal-title":"Sci Rep"},{"key":"2131_CR27","doi-asserted-by":"crossref","unstructured":"Santangelo G, Moscardelli S, Simeoli PS, Guazzi M, Faggiano P. Management of dyslipidemia in secondary prevention of cardiovascular disease: the gap between theory and practice. 2022;11:pp. null.","DOI":"10.3390\/jcm11154608"},{"key":"2131_CR28","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1210\/clinem\/dgab616","volume":"107","author":"M Klaver","year":"2022","unstructured":"Klaver M, van Velzen D, de Blok C, Nota N, Wiepjes C, Defreyne J, Schreiner T, Fisher A, Twisk J, Seidell J, et al. Change in visceral fat and total body Fat and the effect on cardiometabolic risk factors during transgender hormone therapy. J Clin Endocrinol Metab. 2022;107:e153\u201364.","journal-title":"J Clin Endocrinol Metab"},{"key":"2131_CR29","first-page":"103","volume":"8","author":"GR Hunter","year":"2010","unstructured":"Hunter GR, Gower BA, Kane BL. Age related shift in visceral fat. Int J Body Compos Res. 2010;8:103\u20138.","journal-title":"Int J Body Compos Res"},{"key":"2131_CR30","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.clnu.2012.01.012","volume":"31","author":"A Coin","year":"2012","unstructured":"Coin A, Giannini S, Minicuci N, Rinaldi G, Pedrazzoni M, Minisola S, Rossini M, Del PA, Inelmen EM, Manzato E, Sergi G. Limb fat-free mass and fat mass reference values by dual-energy X-ray absorptiometry (DEXA) in a 20\u201380 year-old Italian population. Clin Nutr. 2012;31:506\u201311.","journal-title":"Clin Nutr"},{"key":"2131_CR31","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.1152\/jappl.1996.81.6.2580","volume":"81","author":"D Bracco","year":"1996","unstructured":"Bracco D, Thi\u00e9baud D, Chiol\u00e9ro RL, Landry M, Burckhardt P, Schutz Y. Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans. J Appl Physiol (1985). 1996;81:2580\u20137.","journal-title":"J Appl Physiol (1985)"},{"key":"2131_CR32","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1038\/oby.2011.300","volume":"20","author":"MA Stults-Kolehmainen","year":"2012","unstructured":"Stults-Kolehmainen MA, Stanforth PR, Bartholomew JB. Fat in android, trunk, and peripheral regions varies by ethnicity and race in college aged women. Obes (Silver Spring). 2012;20:660\u20135.","journal-title":"Obes (Silver Spring)"},{"key":"2131_CR33","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1111\/j.1475-097X.1992.tb00831.x","volume":"12","author":"NJ Fuller","year":"1992","unstructured":"Fuller NJ, Laskey MA, Elia M. Assessment of the composition of major body regions by dual-energy X-ray absorptiometry (DEXA), with special reference to limb muscle mass. Clin Physiol. 1992;12:253\u201366.","journal-title":"Clin Physiol"},{"key":"2131_CR34","unstructured":"The fifth National Physical Fitness Monitoring Bulletin. National Physical Fitness Monitoring Center; 2022."},{"key":"2131_CR35","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1111\/jhn.13027","volume":"35","author":"K Ford","year":"2022","unstructured":"Ford K, Huggins E, Sheean P. Characterising body composition and bone health in transgender individuals receiving gender-affirming hormone therapy. J Hum Nutr Diet. 2022;35:1105\u201314.","journal-title":"J Hum Nutr Diet"},{"key":"2131_CR36","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1161\/CIRCRESAHA.120.316101","volume":"126","author":"ME Pich\u00e9","year":"2020","unstructured":"Pich\u00e9 ME, Tchernof A, Despr\u00e9s JP. Obesity phenotypes, diabetes, and Cardiovascular diseases. Circ Res. 2020;126:1477\u2013500.","journal-title":"Circ Res"}],"container-title":["Lipids in Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12944-024-02131-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12944-024-02131-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12944-024-02131-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T07:06:29Z","timestamp":1715929589000},"score":1,"resource":{"primary":{"URL":"https:\/\/lipidworld.biomedcentral.com\/articles\/10.1186\/s12944-024-02131-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,17]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2131"],"URL":"https:\/\/doi.org\/10.1186\/s12944-024-02131-y","relation":{},"ISSN":["1476-511X"],"issn-type":[{"value":"1476-511X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,17]]},"assertion":[{"value":"26 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Jinan University (approval number: XJS 2023-04-18-05).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Informed consent was obtained from all the participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"146"}}