EP140 - ECE_3179 - Android/gynoid fat ratio correlates with atherogenic and insulin resistance indices after 6 months of testosterone therapy in trans men

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Abstract Background Testosterone used as gender-affirming hormone therapy (GAHT) in trans men may alter regional fat distribution and cardiometabolic risk. We evaluated DXA-derived adiposity indices and their associations with the atherogenic index of plasma (AIP) and triglyceride–glucose (TyG) index during early testosterone therapy. Methods Twenty-one trans men initiating intramuscular testosterone esters (every 3 weeks) were assessed at baseline and month 6. Anthropometrics, fasting glucose/insulin and lipid parameters were obtained; body composition was measured by DXA. AIP was calculated as log(triglycerides/HDL-C), HOMA-IR was derived, and TyG index was calculated as log(triglycerides [mmol/L] × glucose [mg/dL]). Results Mean age was 27.43 ± 4.98 years. HOMA-IR did not change significantly (baseline 1.9 [IQR 2.65] vs month 6 2.07; P = .156). DXA demonstrated decreased trunk fat percentage (37.47 ± 9.04-35.00 ± 9.10; P = .007) and total fat percentage (39.84 ± 7.58-36.26 ± 7.68; P < .001), with increased trunk lean + BMC (20 140.55 ± 3418-22 581 ± 4193.7 g; P < .001). Android/gynoid ratio increased (0.924 ± 0.14-0.97 ± 0.14; P < .001) and correlated positively with AIP (r = 0.653, P = .003) and TyG index (r = 0.512, P = .03) at month 6. Conclusions DXA-derived android/gynoid ratio is associated with AIP and TyG index in trans men receiving testosterone GAHT, suggesting that regional fat distribution may serve as an early marker of cardiometabolic risk during therapy.ParameterTestosterone (Month 0)Testosterone (Month 6)P valueArm fat (g)2761.5 (2122.5)2627.5 (1579.75).011Arm lean + BMC (g)3161.5 (1175.25)3747.0 (563.25).011Arm total (g)5481.0 (2557.75)6232.5 (2528.25).011Leg fat (g)10 102.0 (5188.0)8522.0 (5839.5).008Leg lean (g)11 680.0 (2862.0)12 548.5 (3583.0).193Leg total (g)21 578.0 ± 6386.5720 893.0 ± 6217.61.567Trunk fat (g)13 183.0 ± 6112.2613 253.44 ± 6487.54.930Trunk lean + BMC (g)20 140.55 ± 3418.0022 581.00 ± 4193.70<.001Trunk total (g)33 323.0 ± 9202.0035 834.0 ± 10 034.19.003Android fat (g)1977.50 ± 1059.421900.16 ± 1030.12.417Android lean (g)2487.05 ± 499.982618.66 ± 492.23.033Android total (g)4464.50 ± 1505.184518.72 ± 1457.35.668Gynoid fat (g)4912.35 ± 1900.904593.72 ± 2034.78.090Gynoid lean (g)5877.15 ± 1094.476375.38 ± 1199.33<.001Gynoid total (g)10 789.55 ± 2886.1010 857.39 ± 2948.64.894Android/Gynoid ratio0.924 ± 0.1400.970 ± 0.140<.001

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