Eating Behavior Clinical Trial
— HHSOfficial title:
Investigation of the Effects of Testosterone and Estrogen on Eating Behavior, Metabolism, Energy Balance and Cardiovascular System in Transsexual Patients Undergoing Cross-sex Hormone Therapy
NCT number | NCT04838249 |
Other study ID # | 023/20-ek |
Secondary ID | |
Status | Recruiting |
Phase | |
First received | |
Last updated | |
Start date | May 5, 2021 |
Est. completion date | May 2026 |
Current study aims to characterize five highly interconnected physiological systems in patients undergoing cross-sex hormone therapy - namely glucose and lipid metabolism, energy balance, eating behavior, functional brain networks involved in the regulation of eating behavior and the cardiovascular system - to gain novel insights into the effects of sex hormones on the human body. Gathered information will help to identify pathophysiological mechanisms for the development of overeating/obesity, insulin resistance, and cardiovascular disease. Secondarily, the relationships between the gut and oral microbiomes and metabolomes and circulating bacterial signatures will be investigated in relation to the other pervasive physiological systems. Current study is an observational study. The decision if the patient's request for cross-sex hormone therapy can complied with (i.e., if cross-sex hormone therapy is medically indicated) is made prior to the first contact with the study center and with the outpatients clinic for Endocrinology at the University Hospital in Leipzig. Decision ifor treatment is made according to national and international guidelines. Treatment of study participants with testosterone and estradiol/antiandrogens is not affected by the study. During the course of the study no invasive interventions are being performed.
Status | Recruiting |
Enrollment | 80 |
Est. completion date | May 2026 |
Est. primary completion date | May 2026 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - transsexual patients undergoing cross-sex hormone therapy versus controls - able to give informed consent, if <18 years from all legal guardians - only for part B (patients will participate in all other study parts): weight stable (± 5%) for last 3 months, BMI = 30 kg/m2 Exclusion Criteria: - severe medical impairments (e.g., uncontrolled cardiovascular disease, severe heart failure, uncontrolled hypertension, cerebral insult, active malign disease, etc.) - self-initiated cross-sex hormone therapy before study start only for part B (patients will participate in all other study parts): Insufficiently controlled endocrine disorders (Cushing's disease, other uncontrolled pituitary disorders, uncontrolled hypothyroidism, hyperthyroidism, etc.) - Chronic pulmonary disorders, including chronic obstructive pulmonary disease that would limit ability to follow the protocol (investigator judgment) and obstructive sleep apnea syndrome; only subjects with mild or exercise-induced asthma on no medications or on beta-adrenergic agonists only will be allowed to enter the study (provided use of these agents is not required for 1 week before - Diagnosed gastrointestinal diseases, including inflammatory bowel diseases (e.g. Crohn's disease and ulcerative colitis), malabsorption syndromes (e.g. celiac disease), gastric ulcer (active); only subjects with gastro-esophageal reflux will be allowed to enter the study entry). - History of HIV infection or ongoing chronic infection (such as tuberculosis) - only for part D (patients will participate in all other study parts): Contraindication against performance of an MRI scan (i.e., presence of metal in body, tattoos in head/neck region, claustrophobia etc.) |
Country | Name | City | State |
---|---|---|---|
Germany | Helmholtz Institute for Metabolic, Obesity and Vascular Research | Leipzig | Saxony |
Lead Sponsor | Collaborator |
---|---|
University of Leipzig | Göteborg University |
Germany,
Asarian L, Geary N. Sex differences in the physiology of eating. Am J Physiol Regul Integr Comp Physiol. 2013 Dec;305(11):R1215-67. doi: 10.1152/ajpregu.00446.2012. Epub 2013 Jul 31. — View Citation
Berry C, Sidik N, Pereira AC, Ford TJ, Touyz RM, Kaski JC, Hainsworth AH. Small-Vessel Disease in the Heart and Brain: Current Knowledge, Unmet Therapeutic Need, and Future Directions. J Am Heart Assoc. 2019 Feb 5;8(3):e011104. doi: 10.1161/JAHA.118.011104. No abstract available. — View Citation
Butler E, Chin M, Aneman A. Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a Systematic Review in Post-Cardiac Surgical Patients. J Cardiothorac Vasc Anesth. 2017 Aug;31(4):1407-1416. doi: 10.1053/j.jvca.2016.07.035. Epub 2016 Jul 28. No abstract available. — View Citation
Coleman E, Bockting W, Botzer M, et al. (2012) Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism 13:165-232
Coutinho T, Borlaug BA, Pellikka PA, Turner ST, Kullo IJ. Sex differences in arterial stiffness and ventricular-arterial interactions. J Am Coll Cardiol. 2013 Jan 8;61(1):96-103. doi: 10.1016/j.jacc.2012.08.997. Epub 2012 Nov 1. Erratum In: J Am Coll Cardiol. 2013 Jun 25;61(25):2573-4. — View Citation
Defreyne J, Van de Bruaene LDL, Rietzschel E, Van Schuylenbergh J, T'Sjoen GGR. Effects of Gender-Affirming Hormones on Lipid, Metabolic, and Cardiac Surrogate Blood Markers in Transgender Persons. Clin Chem. 2019 Jan;65(1):119-134. doi: 10.1373/clinchem.2018.288241. — View Citation
Diehl JM, Staufenbiel T (2006) Inventar zum Essverhalten und Gewichtsproblemen (IEG). 4th ed. Verlag Dietmar Klotz, Eschborn, Germany
Draijer M, Hondebrink E, van Leeuwen T, Steenbergen W. Review of laser speckle contrast techniques for visualizing tissue perfusion. Lasers Med Sci. 2009 Jul;24(4):639-51. doi: 10.1007/s10103-008-0626-3. Epub 2008 Dec 3. — View Citation
DuPont JJ, Kenney RM, Patel AR, Jaffe IZ. Sex differences in mechanisms of arterial stiffness. Br J Pharmacol. 2019 Nov;176(21):4208-4225. doi: 10.1111/bph.14624. Epub 2019 May 11. — View Citation
Erdener SE, Dalkara T. Small Vessels Are a Big Problem in Neurodegeneration and Neuroprotection. Front Neurol. 2019 Aug 16;10:889. doi: 10.3389/fneur.2019.00889. eCollection 2019. — View Citation
Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979 May;9(2):273-9. doi: 10.1017/s0033291700030762. — View Citation
Goldman RL, Borckardt JJ, Frohman HA, O'Neil PM, Madan A, Campbell LK, Budak A, George MS. Prefrontal cortex transcranial direct current stimulation (tDCS) temporarily reduces food cravings and increases the self-reported ability to resist food in adults with frequent food craving. Appetite. 2011 Jun;56(3):741-6. doi: 10.1016/j.appet.2011.02.013. Epub 2011 Feb 23. — View Citation
Horstmann A, Busse FP, Mathar D, Muller K, Lepsien J, Schlogl H, Kabisch S, Kratzsch J, Neumann J, Stumvoll M, Villringer A, Pleger B. Obesity-Related Differences between Women and Men in Brain Structure and Goal-Directed Behavior. Front Hum Neurosci. 2011 Jun 10;5:58. doi: 10.3389/fnhum.2011.00058. eCollection 2011. — View Citation
Houben K. Overcoming the urge to splurge: influencing eating behavior by manipulating inhibitory control. J Behav Ther Exp Psychiatry. 2011 Sep;42(3):384-8. doi: 10.1016/j.jbtep.2011.02.008. Epub 2011 Feb 24. — View Citation
Huxley VH, Wang J. Cardiovascular sex differences influencing microvascular exchange. Cardiovasc Res. 2010 Jul 15;87(2):230-42. doi: 10.1093/cvr/cvq142. Epub 2010 May 21. — View Citation
Kautzky-Willer A, Harreiter J. Sex and gender differences in therapy of type 2 diabetes. Diabetes Res Clin Pract. 2017 Sep;131:230-241. doi: 10.1016/j.diabres.2017.07.012. Epub 2017 Jul 13. — View Citation
Kim JY, Park JB, Kim DS, Kim KS, Jeong JW, Park JC, Oh BH, Chung N; KAAS investigators. Gender Difference in Arterial Stiffness in a Multicenter Cross-Sectional Study: The Korean Arterial Aging Study (KAAS). Pulse (Basel). 2014 May;2(1-4):11-7. doi: 10.1159/000365267. Epub 2014 Aug 14. — View Citation
Lyle AN, Raaz U. Killing Me Unsoftly: Causes and Mechanisms of Arterial Stiffness. Arterioscler Thromb Vasc Biol. 2017 Feb;37(2):e1-e11. doi: 10.1161/ATVBAHA.116.308563. — View Citation
Meerwijk EL, Sevelius JM. Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples. Am J Public Health. 2017 Feb;107(2):e1-e8. doi: 10.2105/AJPH.2016.303578. — View Citation
Meule A, Muller A, Gearhardt AN, Blechert J. German version of the Yale Food Addiction Scale 2.0: Prevalence and correlates of 'food addiction' in students and obese individuals. Appetite. 2017 Aug 1;115:54-61. doi: 10.1016/j.appet.2016.10.003. Epub 2016 Oct 4. — View Citation
Nadort A, Kalkman K, van Leeuwen TG, Faber DJ. Quantitative blood flow velocity imaging using laser speckle flowmetry. Sci Rep. 2016 Apr 29;6:25258. doi: 10.1038/srep25258. — View Citation
Nota NM, Wiepjes CM, de Blok CJM, Gooren LJG, Kreukels BPC, den Heijer M. Occurrence of Acute Cardiovascular Events in Transgender Individuals Receiving Hormone Therapy. Circulation. 2019 Mar 12;139(11):1461-1462. doi: 10.1161/CIRCULATIONAHA.118.038584. No abstract available. — View Citation
Pudel V, Westhöfer J (1989) Fragebogen zum Eßverhalten (FEV). Göttingen, Toronto, Zürich, Verlag für Psychologie Dr. C. J. Hogrefe
Puschel J, Miehle K, Muller K, Villringer A, Stumvoll M, Fasshauer M, Schlogl H. Beneficial effects of leptin substitution on impaired eating behavior in lipodystrophy are sustained beyond 150 weeks of treatment. Cytokine. 2019 Jan;113:400-404. doi: 10.1016/j.cyto.2018.10.012. Epub 2018 Oct 24. — View Citation
Raaz U, Schellinger IN, Chernogubova E, Warnecke C, Kayama Y, Penov K, Hennigs JK, Salomons F, Eken S, Emrich FC, Zheng WH, Adam M, Jagger A, Nakagami F, Toh R, Toyama K, Deng A, Buerke M, Maegdefessel L, Hasenfuss G, Spin JM, Tsao PS. Transcription Factor Runx2 Promotes Aortic Fibrosis and Stiffness in Type 2 Diabetes Mellitus. Circ Res. 2015 Aug 28;117(6):513-24. doi: 10.1161/CIRCRESAHA.115.306341. Epub 2015 Jul 24. — View Citation
Raaz U, Zollner AM, Schellinger IN, Toh R, Nakagami F, Brandt M, Emrich FC, Kayama Y, Eken S, Adam M, Maegdefessel L, Hertel T, Deng A, Jagger A, Buerke M, Dalman RL, Spin JM, Kuhl E, Tsao PS. Segmental aortic stiffening contributes to experimental abdominal aortic aneurysm development. Circulation. 2015 May 19;131(20):1783-95. doi: 10.1161/CIRCULATIONAHA.114.012377. Epub 2015 Apr 22. — View Citation
Ruaro B, Smith V, Sulli A, Decuman S, Pizzorni C, Cutolo M. Methods for the morphological and functional evaluation of microvascular damage in systemic sclerosis. Korean J Intern Med. 2015 Jan;30(1):1-5. doi: 10.3904/kjim.2015.30.1.1. Epub 2014 Dec 30. — View Citation
S3-Leitlinie zur Diagnostik, Beratung und Behandlung: Geschlechtsinkongruenz, Geschlechtsdysphorie und Trans-Gesundheit. AWMF-Register-Nr. 138, 001. Available at https://www.awmf.org/uploads/tx_szleitlinien/138-001l_S3_Geschlechtsdysphorie-Diagnostik-Beratung-Behandlung_2019-02.pdf, accessed 3.1.2020
Schellinger IN, Mattern K, Raaz U. The Hardest Part. Arterioscler Thromb Vasc Biol. 2019 Jul;39(7):1301-1306. doi: 10.1161/ATVBAHA.118.311578. Epub 2019 May 9. — View Citation
Schlogl H, Kabisch S, Horstmann A, Lohmann G, Muller K, Lepsien J, Busse-Voigt F, Kratzsch J, Pleger B, Villringer A, Stumvoll M. Exenatide-induced reduction in energy intake is associated with increase in hypothalamic connectivity. Diabetes Care. 2013 Jul;36(7):1933-40. doi: 10.2337/dc12-1925. Epub 2013 Mar 5. — View Citation
Schlogl H, Muller K, Horstmann A, Miehle K, Puschel J, Villringer A, Pleger B, Stumvoll M, Fasshauer M. Leptin Substitution in Patients With Lipodystrophy: Neural Correlates for Long-term Success in the Normalization of Eating Behavior. Diabetes. 2016 Aug;65(8):2179-86. doi: 10.2337/db15-1550. Epub 2016 May 10. — View Citation
Volgman AS, Bairey Merz CN, Aggarwal NT, Bittner V, Bunch TJ, Gorelick PB, Maki P, Patel HN, Poppas A, Ruskin J, Russo AM, Waldstein SR, Wenger NK, Yaffe K, Pepine CJ. Sex Differences in Cardiovascular Disease and Cognitive Impairment: Another Health Disparity for Women? J Am Heart Assoc. 2019 Oct;8(19):e013154. doi: 10.1161/JAHA.119.013154. Epub 2019 Sep 24. No abstract available. — View Citation
Wang X, Wang Y, Ma Z, Xu Y, Wu Q. Indirect calorimetry using a ventilated hood may be easier than using a facemask to achieve steady state when measuring resting energy expenditure. Nutr Res. 2017 Dec;48:33-39. doi: 10.1016/j.nutres.2017.10.010. Epub 2017 Oct 10. — View Citation
* Note: There are 33 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Energy expenditure | To examine short-term and longer-term effects of cross-sex hormone therapy on changes in resting energy expenditure (kcal/d). | up to one year | |
Primary | Vascular stiffness | To examine short-term and longer-term effects of cross-sex hormone therapy on changes in vascular stiffness (change from baseline using cm/s to assess arterial stiffness). | up to five years | |
Primary | Insulin sensitivity | To examine short-term and longer-term effects of cross-sex hormone therapy on changes in insulin sensitivity (change from baseline using HOMA-IR to assess insulin sensitivity). | up to five years | |
Primary | Food intake | To examine short-term and longer-term effects of cross-sex hormone therapy on changes ad libitum food intake (change from baseline in kcal). | up to one year | |
Primary | Weight change | To examine short-term and longer-term effects of cross-sex hormone therapy on weight change (change from baseline in kg). | up to one year | |
Secondary | Taste perception | To examine short-term and longer-term effects of cross-sex hormone therapy on taste perception (change from baseline score during test assessing taste perception). | up to five years | |
Secondary | Olfaction | To examine short-term and longer-term effects of cross-sex hormone therapy on olfaction (change from baseline score during test assessing taste perception). | up to five years | |
Secondary | Gut, oral and circulating microbiomes and metabolomes | To examine short-term and longer-term effects of cross-sex hormone therapy on gut and oral microbiome composition (change of overall diversity, functional potential) as well as decompartmentalization effects on bacterial signature in the blood. These analyses will be coupled to metabolomics to delineate the metabolic outputs of the microbial niches and relate this system to the other studied physiological systems in the study. | up to five years |
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