title: Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: a 2 year follow-up study.
abstract: OBJECTIVE
  Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected.
  
  
  METHODS
  From a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems.
  
  
  RESULTS
  When treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems.
  
  
  CONCLUSIONS
  This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals.
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Electronic address: marco.colizzi@hotmail.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Colizzi
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy; Gender Identity Development Service, The Tavistock and Portman NHS Foundation Trust, Tavistock Centre, London, United Kingdom.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Costa
authors.affiliation: Second Department of Obstetrics and Gynecology, University of Bari "A. Moro", Bari, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Scaramuzzi
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Palumbo
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Margarita
authors.initials: M
authors.lastname: Tyropani
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Pace
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Quagliarella
authors.affiliation: Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Bari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brescia
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Lilia Carmen
authors.initials: LC
authors.lastname: Natilla
authors.affiliation: Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Loverro
authors.affiliation: Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari "A. Moro", Bari, Italy.
authors.forename: Orlando
authors.initials: O
authors.lastname: Todarello
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy*; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000150:complications; D008875:Middle Aged; D015995:Prevalence; D055105:Waist Circumference
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Concomitant psychiatric problems; Gender dysphoria; Hormone replacement therapy; Metabolic syndrome