Changes in fat cell size and in vitro lipolytic activity of abdominal and gluteal adipocytes after a one-year cross-sex hormone administration in transsexuals

Metabolism. 1999 Nov;48(11):1371-7. doi: 10.1016/s0026-0495(99)90146-4.


We prospectively studied the effects of cross-sex hormone administration on fat cell size and in vitro lipolytic activity in subcutaneous abdominal and gluteal fat biopsies obtained from 19 male-to-female (M-F) transsexuals and 17 female-to-male (F-M) transsexuals. The amount of subcutaneous fat at the abdominal and gluteal levels was quantified with the use of magnetic resonance imaging (MRI). Before cross-sex hormone administration, M-F transsexuals had less subcutaneous fat with smaller fat cells compared with F-M transsexuals, with a higher baseline in vitro lipolytic activity expressed as glycerol release per milligram of triglyceride (TG) in the abdominal region (P < .05). Before cross-sex hormone treatment, no differences in lipolytic activity stimulated with arterenol (ART), isoproterenol (ISO), or ISO + insulin (INS) were observed between groups or regions. After a 1-year treatment with estrogens and antiandrogens in M-F transsexuals, subcutaneous fat areas on MRI and fat cell size were increased (P < .001) and reductions were observed in the basal lipolytic activity of gluteal and abdominal fat biopsies (P < .05). Following administration of testosterone to F-M transsexuals, subcutaneous fat and fat cell size at the gluteal and abdominal depots were decreased (P < .01) and basal lipolysis was increased significantly at the abdominal level (P < .05) but not at the gluteal level. In both M-F and F-M transsexuals, no effect of sex hormone administration was observed on stimulated lipolytic activities. In conclusion, regional sex differences in the amount of subcutaneous fat, adipocyte size, and in vitro basal lipolytic activity were demonstrated that could be largely reversed by cross-sex hormone treatment in adult subjects, providing evidence for their dependence on the sex steroid milieu.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen
  • Adipocytes / metabolism*
  • Adult
  • Buttocks
  • Drug Administration Schedule
  • Estradiol Congeners / administration & dosage
  • Estradiol Congeners / pharmacology
  • Ethinyl Estradiol / administration & dosage
  • Ethinyl Estradiol / pharmacology
  • Female
  • Gonadal Steroid Hormones / administration & dosage*
  • Gonadal Steroid Hormones / pharmacology*
  • Humans
  • Lipid Metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Prospective Studies
  • Testosterone / administration & dosage
  • Testosterone / pharmacology
  • Transsexualism / metabolism*


  • Estradiol Congeners
  • Gonadal Steroid Hormones
  • Testosterone
  • Ethinyl Estradiol