. Author manuscript; available in PMC: 2021 Sep 16.

Published in final edited form as: J Sex Med. 2021 Aug 5;18(9):1662–1675. doi: 10.1016/j.jsxm.2021.06.011

Table 6.

Summary of the published studies evaluating changes in ALT and AST concentrations in relation to masculinizing GAHT

Reference	Data source	Age (y)	GAHT	ALT (IU/L)^*	AST (IU/L)^*	Analysis	Statistical test results
Jacobeit et al, 2009 ³⁸	Prospective evaluation of 17 patients followed at a clinical left in Hamburg, Germany	Mean: 34 Range: 23–47	TU: 1000 mg IM every 12 wk. first 2 injections were 6 wk apart	Baseline: 22 6 mo: 23 12 mo: 21 18 mo: 24 24 mo: 22 30 mo: 24 36 mo: 22	Baseline: 24 6 mo: 25 12 mo: 23 18 mo: 24 24 mo: 25 30 mo: 22 36 mo: 23	Wilcoxon test for each follow up vs baseline	All P > .05 for ALT All P > .05 for AST
Chandra et al, 2010⁴⁰	Prospective evaluation of 12 patients followed at a clinical center in Boston, MA	Mean: 29 SD: 9	TC or TE: 50–125 mg IM every 2 wk.	Baseline: 19 12 mo: 24	Baseline: 21 12 mo: 25	Paired t-test	P = .22 for ALT P = .22 for AST
Mueller et al, 2010^37,†	Prospective evaluation of 45 patients followed at a clinical center in Erlangen, Germany	Mean: 30.4 SD: 9	TU: 1000 mg IM every 12 wk.	Baseline: 20 12 mo: 24 24 mo: 23	Baseline: 19 12 mo: 22 24 mo: 21	Tukey-Kramer test for each follow up vs baseline	All P = .01 for ALT P = .08 for AST at 12 mo P = .30 for AST at 24 mo
Wierckx et al, 2014⁴¹	Prospective evaluation of 53 patients from 2 sites of the European Network for the Investigation of Gender Incongruence (ENIGI): Ghent, Belgium and Oslo, Norway	Ghent Mean: 27 SD: 9 Oslo Mean: 22 SD: 5	TU: 1000 mg IM first 2 injections were 6 wk apart then every 12 wk	Baseline: 16 12 mo: 20	Baseline: 20 12 mo: 24	Paired t-test or Wilcoxon test (not specified)	P = .02 for ALT P = .01 for AST
Tack et al., 2016⁴²	Chart review of 38 patients followed at a clinical left in Ghent, Belgium	Mean: 17	T esters: 50–125 mg IM every 2 wk	Baseline: 17 6 mo: 19 12 mo: 20	Baseline: 19 6 mo: 21 12 mo: 21	Student t-test or Wilcoxon test (not specified) for each follow up vs baseline	P = .08 for ALT at 6 mo P = .045 for ALT at 12 mo P = .03 for AST at 6 mo P = .003 for AST at 12 mo
Jarin et al, 2017³¹	Chart review on 72 patients followed at 4 clinical lefts in DC (2), MD and OH	Mean: 16 Range: 13–22	T NOS: 25–100 mg SQ weekly	Baseline: 21.1 1–3 mo: 21.7 4–6 mo: 26.9 >6 mo: 20.0	Baseline: 18.8 1–3 mo: 20.1 4–6 mo: 25.9 >6 mo: 19.5	Repeated measures ANOVA	P > .05 for ALT P > .05 for AST
Fernandez et al, 2017³²	Chart review on 19 patients followed at a clinical center in Lexington, KY	Mean: 27 Range: 19–47	T NOS: IM, mean dose 11 mg/d.	Baseline: 23 3–6 mo: 19 6–18 mo: 16	Baseline: 23 3–6 mo: 23 6–18 mo: 22	Paried t-test for each follow up vs baseline	All P > .05 for ALT All P > .05 for AST
SoRelle et al. 2019³⁴	Chart review on 62 GAHT naïve and 89 patients on GAHT from a county hospital and community clinic in Dallas, TX	Mean: 30	TC: 25–300 mg IM every 1–2 wk [98% subjects]	Baseline: 17 >6 mo: 23	Baseline: 18 >6 mo: 23	Mann-Whitney test	P < .001 for ALT P < .005 for AST

Reported as a mean or median value, converted from SI units, if necessary.

^†

Data overlap with earlier study Mueller et al, 2007.ALT = alanine aminotransferase; AST = aspartate amniotransferase; GAHT = gender affirming hormone therapy; IM = intramuscular; IU/L = international units/liter; NOS = not otherwise specified; SQ = subcutaneous; T = testosterone; TU = testosterone undecanoate; TC = testosterone cypionate, TE = testosterone enanthate.