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Alice S Ryan VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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John C McLenithan VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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Gretchen M Zietowski VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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protocol as previously described (11) with validation for attainment of VO 2 max. Seated blood pressures were determined twice before the exercise test and the average determination was used in the statistical analyses. Body composition Height (cm) and

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Lisa Arnetz Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Neda Rajamand Ekberg Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Kerstin Brismar Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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Michael Alvarsson Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes
Departments of Endocrinology, Molecular Medicine and Surgery, Metabolism and Diabetes

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unpaired t -tests, whereas variables that were not normally distributed were analyzed using the Wilcoxon and Mann–Whitney U tests. Repeated measurements were studied using repeated measures ANOVA. Body composition has a well-established impact on the

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Miranda Scharff Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Chantal Maria Wiepjes Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Maartje Klaver Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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Thomas Schreiner Department of Endocrinology, Oslo University Hospital, Oslo, Norway

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Guy T’Sjoen Department of Endocrinology & Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium

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Martin den Heijer Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands

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). Earlier studies on effects of HT in trans people focused on bone mineral density (BMD) and body composition. These studies found an increase in lean body mass in transmen and a decrease in lean body mass in transwomen ( 4 , 5 ). BMD increased in both

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M Jensterle Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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A Podbregar University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia

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K Goricar University of Ljubljana, Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, Ljubljana, Slovenia

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N Gregoric Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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A Janez Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

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) should be recommended as the first-line approach ( 2 , 3 ), yet in clinical practice LSM often fails. On the other hand, testosterone replacement therapy (TRT) appears to improve body composition and glycometabolic profile without clearly affecting

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Agnieszka Adamska Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland

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Vitalii Ulychnyi Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland

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Katarzyna Siewko Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland

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Anna Popławska-Kita Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland

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Małgorzata Szelachowska Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland

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Marcin Adamski Faculty of Computer Science, Bialystok University of Technology, Białystok, Poland

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Angelika Buczyńska Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland

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Adam Jacek Krętowski Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Bialystok, Poland
Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland

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tolerance and hyperinsulinemia ( 22 ). Accordingly, in a recently published study, it was found that patients with NFAT have abnormal body composition, with increased subcutaneous and visceral fat and decreased muscle mass when compared to sex-, age- and BMI

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Xiaobing Lu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jiang Yue Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Qianjing Liu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Shengyun He Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ying Dong Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ming Zhang Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Yicheng Qi Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Minglan Yang Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Wang Zhang Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Hua Xu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Qing Lu Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jing Ma Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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, magnetic resonance imaging (MRI) has gained increasing attention in the measurement of adipose depots. With excellent image resolution, MRI is considered to be the most accurate method for determining body composition at the tissue-organ level, specifically

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Andre Madsen Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

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Lise Aksglaede Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

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that testosterone replacement therapy (TRT) in adults with KS may have positive effects on metabolic health, body composition, and bone mineral density ( 25 ). Equally, studies in infants and children with KS indicate that early TRT may improve body

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Alessandra Gambineri Endocrinology Unit, Department of Medical and Surgical Sciences, St Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna, Italy

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Carla Pelusi Endocrinology Unit, Department of Medical and Surgical Sciences, St Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna, Italy

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such as changes in body composition, insulin resistance and lipid profiles that worsen with time ( 39 ). In particular, ADT induces fat accumulation that, differently from what is observed in the metabolic syndrome, is mostly at subcutaneous levels and

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Eric M Ndombi Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Valentine Budambula Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Mark K Webale Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Francis O Musumba Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Jesca O Wesongah Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Erick Mibei Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Aabid A Ahmed
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Raphael Lihana Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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Tom Were Bomu Hospital, Department of Pathology, Department of Environment and Health Sciences, Department of Biomedical Sciences and Technology, Department of Medical Laboratory Sciences, Kapkatet Campus, Centre for Virus Research, Department of Medical Laboratory Sciences, Mombasa, Kenya

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of anthropometric indices to abdominal and total body fat in youth: sex and race differences . Obesity 2014 22 1345 – 1350 . ( doi:10.1002/oby.20714 ). 12 Jaswant S Nitish M . Use of upper-arm anthropometry as measure of body-composition

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N K Stepto Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
Australian Institute for Musculoskeletal Science, Victoria University, Melbourne, Victoria, Australia
Medicine-Western Health, Faculty of Medicine, Dentistry and Health Science, Melbourne University, Melbourne, Victoria, Australia

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D Hiam Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia

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M Gibson-Helm Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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S Cassar Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia

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C L Harrison Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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S K Hutchison Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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A E Joham Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia

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B J Canny School of Medicine, University of Tasmania, Hobart, Tasmania, Australia

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A Moreno-Asso Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
Australian Institute for Musculoskeletal Science, Victoria University, Melbourne, Victoria, Australia

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B J Strauss Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
Division of Diabetes, Endocrinology & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

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N Hatzirodos The Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia

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R J Rodgers The Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia

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H J Teede Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
Diabetes and Endocrine Units, Monash Health, Clayton, Victoria, Australia

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individually progressed and increased over the duration of the intervention ( 28 , 29 , 30 ). Clinical and biochemical measurements Participants were assessed for anthropometric measures including body weight, height, body composition, abdominal

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