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Sex-differential Host-microbiome CVD Risk - A Longitudinal Cohort Approach

Recruiting
Conditions
Immune System
Transgender
Cardiovascular Risk Factors
Gut Microbiome
Registration Number
NCT05334888
Lead Sponsor
Charite University, Berlin, Germany
Brief Summary

The XCVD study investigates the influence of sex hormones on the composition of the gut microbiome and the possible emergence of cardiovascular risk factors. It will follow 200 healthy transgender individuals for two years during their hormone replacement therapy (HRT) and analyze them for the possible emergence of cardiovascular risk factors in relation to changes in the gut microbiome, metabolome, and immunome. We would also like to phenotype cardiovascular disease.

Detailed Description

Conducting this innovative study using established scientific methods such as omics platforms, systems biology, and careful CVD phenotyping will allow, for the first time, extensive data collection on the influence of sex hormones on the development of CVD risk factors as well as the role of the gut microbiome. In doing so, the influence of circulating sex hormones can also be quantified to potentially predict CVD risk markers.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Age 18-50
  • Language requirements: German, English
  • Previous gender hormone replacement therapy (HRT).
  • Ability to give consent and written consent to participate.
  • Health insurance (for clarification of incidental findings)
Exclusion Criteria
  • Diseases or functional disorders that, in the opinion of the study physician, preclude participation in the study.
  • Incapacity or other circumstances that do not allow study participants to fully understand the nature, significance and scope of this study.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Changes in relative species abundance of intestinal bacteria comparedBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

baseline and 2 years after initiation of hormone replacement therapy. stool samples: Analysis with 16s rRNA sequencing

Secondary Outcome Measures
NameTimeMethod
Changes in the oral species abundanceBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

saliva sample / oral / mouth: species abundance of oral bacteria (sequencing)

Changes in BMIBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

body mass index (kg/m²)

Changes in physical activityBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: International Physical Activity Questionnaire / IPAQ

Changes in quality of lifeBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: quality of life / PROMIS

Changes in depressionBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: Beck-Depressions-Inventar Revision / BDI II \& The Patient Health Questionnaire (PHQ-9)

Changes in cardio markerBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

sera: following cardio marker can be determined by Electro Chemiluminescence Immuno-Assay: BNP and hs-troponin.

Changes in Immune cell marker / regulatory T-cellsBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

Whole blood samples for Immune cell populations and peripheral blood mononuclear cells RNA isolation for whole-transcriptome shotgun sequencing.

Changes in mental healthBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: Generalized Anxiety Disorder / GAD-7

Changes in chrono type / sleep-wake behaviourBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: Munich ChronoType Questionnaire (MCTQ)

Changes in hormone parametersBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

sera: following hormones can be determined by mass spectrometry: Free Androgen Index (fAI), Beta-CrossLaps (BCTX), Carboxy-terminal Propeptide of Procollagen I (P1CP), Luteinizing Hormone, Oestradiol, Progesterone, Testosterone, Free Testosterone, Sex Hormone Binding Globulin, Dihydrotestosterone, Oestron, Free Oestriol.

Changes in immune markerBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

sera: pro- and anti-inflammatory cytokines using cytokine - multiplex panel and Immune cell populations with shotgun sequencing

Changes in Perceived StressBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: Perceived Stress Questionnaire / PSQ

Changes in socio-demographicsBaseline, 2 years Follow Up

Family status, education level, current working status, and living situation

Changes in the concentration of of cortisol, progesterone, testosterone and dehydroepiandrosteroneBaseline, 2 years Follow Up

Hair sample: Hair steroid analysis with Immunoassay and LC-MS/MS

Changes in ProteomicsBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

sera: MS and ELISA

Changes in dietary habitsBaseline, 6, 12, 18 and 24 months Follow Up

Food Frequency Quenstionnaire /FFQ, special diet and intake of dietary supplements, prebiotics and probiotics

Changes in CVD risk scoresBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

Framingham risk scores (FRS) and Systematic Coronary Risk Evaluation (SCORE)

Changes in EpigenomicsBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

Whole blood samples for Immune cell populations and peripheral blood mononuclear cells RNA isolation for whole-transcriptome shotgun sequencing.

Changes in MetabolomicsBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

sera: MS and ELISA

Changes in relative species abundance of skin microbiomaBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

skin swab: DNA - sequencing

Changes in circumferenceBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

circumference measurement (cm): waist and hip

Gender identityBaseline, 6, 12, 18 and 24 months Follow Up

questionnaire: Transgender Congruence Scale (TCS) \& gender dysphoria

Changes in vital signsBaseline, 2 years Follow Up (optional: after 1 year Follow Up)

Systolic and diastolic blood pressure and heart rate

Changes in life style risk parametersBaseline, 2 years Follow Up

Smoking status, alcohol consumption and use of recreational drugs

Documentation of HRTBaseline - HRT start, 6, 12, 18 and 24 months Follow Up

HRT medication, dosing, regimes, and progress as well as all transition -relevant surgery and physical changes

Trial Locations

Locations (1)

Experimental and Clinical Research Center, Clinical Research Unit

🇩🇪

Berlin, Germany

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