P4691 - Liver Changes Among Transgender People Receiving Gender Affirming Hormone Therapy: A Systematic Review

Camille K. Pascasio, MD¹, Kate Marielle K. Pascasio, ², Mark Ronver K. Engracia, MD^1
1St. Luke's Medical Center- Global City, Taguig City, National Capital Region, Philippines; ²University of Santo Tomas, Taguig City, National Capital Region, Philippines

Introduction: Gender dysphoria treatment includes gender-affirming hormone therapy (GAHT). Its effect on the liver is still an area of uncertainty in transgender health. Several studies showed modest increases in ALT and AST levels. However, its overall influence in long-term GAHT and whether it produces clinically significant changes in liver function is still unclear. This study aimed to investigate the effect of gender-affirming hormone therapy on liver enzyme levels among the transgender population.

Methods: A comprehensive search was conducted using PubMed Central, Google Scholar, and Embase Cochrane Library databases for studies published within the last 10 years. Reference mining was also done. Titles and abstracts were reviewed for relevance. Studies with transgender people receiving GAHT for at least 3 months and with outcomes exploring the changes in the liver were included.

Results: The electronic search initially yielded 25 potential studies, out of which, 8 studies were relevant and were included in the systematic review. Results showed that there is no significant impact from either masculinizing or feminizing HT on the ALT and AST levels among transgender adults on GAHT. However, one study showed that treatment with Testosterone increases liver fat content in trans men while a reduction in liver fat was seen among trans women on combined estradiol and anti-androgen treatment.

Discussion: Based on this systematic review, the influence of GAHT on ALT and AST levels appear to be minimal and not likely to reflect clinically significant changes in liver function. However, the current literature exploring the impact of GAHT on the liver is highly heterogeneous in terms of prescribed hormone regimen, included participants, and methodologies applied. Moreover, more studies exploring the potential effects of GAHT on liver fat content are still warranted.


Disclosures:


Camille K. Pascasio, MD¹, Kate Marielle K. Pascasio, ², Mark Ronver K. Engracia, MD¹. P4691 - Liver Changes Among Transgender People Receiving Gender Affirming Hormone Therapy: A Systematic Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.