The Effects of Orchiectomy and Age on Vascular and Metabolic Health in Older Versus Younger Transgender Women

September 13, 2024 updated by: University of Colorado, Denver
This study plans to learn more about differences in heart disease risk after gender-affirming orchiectomy (i.e., testes removal) in older transgender (trans) women compared to younger trans women.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The global aim of this study is to characterize cardiometabolic risk (measured by vascular, metabolic and biochemical factors-which have not been extensively studied prospectively) in trans women before and after orchiectomy. Trans women appear to be at greater risk for cardiovascular disease (CVD) and blood clots compared to non-trans adults. The effect of orchiectomy on CVD risk among trans women is unknown, but orchiectomy may change blood vessel function and metabolic health. The investigators will examine blood vessel function and metabolic profiles of trans women before and at several timepoints after orchiectomy to identify age-related differences in CVD risk factors. This knowledge may lead to new approaches to prevent CVD in trans women as well as all people regardless of gender identity.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
17

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • United States
    • Colorado
      • Aurora, Colorado, United States, 80045
        • University of Colorado

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 99 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Transgender women from the Denver metropolitan area and/or who utilize health care at University of Colorado Hospital.

Description

Inclusion Criteria:

  • Aged 18 years and older
  • Identify as a transgender woman
  • Have taken estradiol and spironolactone for at least one year
  • Currently taking oral or transdermal or injectable estradiol
  • Have not yet undergone but desire orchiectomy

Exclusion Criteria:

  • Under 18 years of age
  • Don't identify as a transgender woman
  • Not currently taking estradiol or spironolactone
  • Have been on estradiol and spironolactone for less than one year
  • History of orchiectomy
  • Not deemed a candidate for orchiectomy
  • Current tobacco smoker
  • Current illicit drug use
  • History of prior or active estrogen-dependent neoplasms
  • Acute liver or gallbladder disease
  • Venous thromboembolism
  • Hypertriglyceridemia >500 mg/dL
  • Fasted plasma glucose >7.0 mmol/L or previously treated diabetes
  • Resting blood pressure >140/90 mmHg

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Older transgender women
This cohort will consist of healthy transgender women aged 45 and above who have not undergone but desire orchiectomy, who have been on estrogen (history of oral, transdermal or injectable) and spironolactone for at least one year.
Other: No intervention
There was no intervention
Younger transgender women
This cohort will consist of healthy transgender women aged 18-44 who have not undergone but desire orchiectomy, who have been on estrogen (history of oral, transdermal or injectable) and spironolactone for at least one year.
Other: No intervention
There was no intervention

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Evaluation of endothelial function (flow-mediated dilation (FMD) at Baseline
Time Frame: Baseline
Brachial artery flow-mediated dilation (FMD), as measured by ultrasound.
Baseline
Evaluation of endothelial function (flow-mediated dilation (FMD) at 1 Month
Time Frame: 1 month
Brachial artery flow-mediated dilation (FMD), as measured by ultrasound.
1 month
Evaluation of endothelial function (flow-mediated dilation (FMD) at 6 Months
Time Frame: 6 month
Brachial artery flow-mediated dilation (FMD), as measured by ultrasound.
6 month
Evaluation of endothelial function (flow-mediated dilation (FMD) at 12 Months
Time Frame: 12 month
Brachial artery flow-mediated dilation (FMD), as measured by ultrasound.
12 month

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Evaluation of carotid artery compliance
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
The carotid artery compliance index indicates how elastic the artery is. The index describes the change in arterial blood volume in response to a change in arterial blood pressure. Lower numbers are associated with worse outcomes (less elastic arteries).
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of carotid artery beta stiffness index
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
The carotid artery beta stiffness index indicates how stiff the artery is. Higher numbers are associated with worse outcomes (stiffer artery).
Baseline, 1 mo., 6 mo., 12 mo.
Carotid artery intimal-medial thickness
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of oxidant burden: oxidized LDL
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Oxidized low-density lipoprotein (LDL) measured in the blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of oxidant burden: nitrotyrosine
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Nitrotyrosine measured in the blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of vascular endothelial cell inflammation: nuclear factor kappa-light-chain-enhancer of activated B cells (NFkB)
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Protein NFkB (nuclear factor kappa-light-chain-enhancer of activated B cells) measured in blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of vascular endothelial cell inflammation: MCP-1
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Monocyte Chemoattractant Protein-1 (MCP-1) measured in blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of vascular endothelial cell inflammation: IL-6
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Interleukin 6 (IL-6) measured in blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Evaluation of vascular endothelial cell inflammation: CRP
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
C-reactive protein (CRP) measured in blood and endothelial cells.
Baseline, 1 mo., 6 mo., 12 mo.
Blood pressure
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Blood pressure will be measured at baseline, 1 mo., 6 mo. 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Plasma lipid concentrations: total cholesterol
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Total cholesterol will be determined at baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Plasma lipid concentrations: triglycerides
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Triglycerides will be determined at baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Insulin sensitivity
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Whole body composition: Percent Lean Mass
Time Frame: Baseline, 6 mo., 12 mo.
Percent lean mass will be determined using dual energy x-ray absorptiometry.
Baseline, 6 mo., 12 mo.
Whole body composition: Percent Fat Mass
Time Frame: Baseline, 6 mo., 12 mo.
Percent fat mass will be determined using dual energy x-ray absorptiometry.
Baseline, 6 mo., 12 mo.
Regional body composition: Percent Lean Mass
Time Frame: Baseline, 6 mo., 12 mo.
Regional percent lean mass will be determined using dual energy x-ray absorptiometry.
Baseline, 6 mo., 12 mo.
Regional body composition: Percent Fat Mass
Time Frame: Baseline, 6 mo., 12 mo.
Regional percent fat mass will be determined using dual energy x-ray absorptiometry.
Baseline, 6 mo., 12 mo.
Bone density
Time Frame: Baseline, 12 mo.
Bone density of femur and spine will be determined using dual energy x-ray absorptiometry.
Baseline, 12 mo.
Weight changes
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Body weight will be measured at baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Appetite ratings
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Appetite-related peptides
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
D-Dimer
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Alcohol use
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Depression symptoms
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Baseline, 1 mo., 6 mo., 12 mo.
Physical activity monitoring
Time Frame: 7 days at baseline, 1 mo., 6 mo., 12 mo.
Physical activity will me monitored for 7 days with an ActivPAL monitor
7 days at baseline, 1 mo., 6 mo., 12 mo.
Energy intake
Time Frame: 3 days at baseline, 1 mo., 6 mo., 12 mo.
Energy intake will be estimated with a 3-day food diary
3 days at baseline, 1 mo., 6 mo., 12 mo.
Sex hormone concentrations
Time Frame: Baseline, 1 mo., 6 mo., 12 mo.
Sex hormone concentrations of estradiol, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH) and sex hormone-binding globulin (SHBG) will be measured
Baseline, 1 mo., 6 mo., 12 mo.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Colorado, Denver

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Center for Advancing Translational Sciences (NCATS)

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Sean Iwamoto, MD, University of Colorado, Denver

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 22, 2021

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 31, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 22, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 12, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 18, 2022

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 19, 2024

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 13, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 20-2141
  • NIH 5 K12 HD057022 (Other Grant/Funding Number: Building Interdisciplinary Research Careers in Women's Health (BIRCWH) - K12)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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