Hormone replacement therapy affects body composition and leptin differently in obese and non-obese postmenopausal women

Abstract

Leptin and oestrogen are both involved in the regulation of adipose tissue deposition and feeding behaviour. We investigated whether 5 years of hormone replacement therapy (HRT) affected serum leptin and body composition differently in 89 postmenopausal women treated with HRT compared with 178 controls. At baseline, leptin was significantly correlated with oestradiol (r=0·13, P<0·05) and in multiple backward regression analysis including oestradiol and any estimate of body fat, oestradiol remained a significant determinant of leptin levels. In the control group, all estimates of body fat determined by dual energy X-ray absorptiometry (DEXA) or anthropometry were increased (3·6-16·9%) and leptin increased 31·3% (16·03 1·02 to 20·84 1·2 ng/ml (...), P<0·001). In the HRT group all estimates of body composition also increased during the 5-year observation but to a lesser extent than observed in the control group (1·0-8·5%). Leptin was raised by 19·7% (17·81 1·32 to 20·57 1·65 ng/ml, P<0·001). However, the DEXA scans revealed that the control group gained 2·4-fold more fat during the 5-year observation (1·9 0·3 vs 0·8 0·4 kg, P<0·05), and especially the trunk fat increased (1·4 0·2 vs 0·7 0·3 kg, P<0·05). This was reflected in the increase in leptin levels, which were increased by 7·4% in the control group compared with the HRT group (4·81 0·60 vs 2·76 0·87 ng/ml, P<0·05). Adjusting for the difference in adipose tissue revealed that HRT had no independent effect on leptin levels. Comparisons between obese (body mass index>25 kg/m 2 ) and non-obese (<25 kg/m 2 ) subjects by stratifying for HRT treatment using multiple linear regression revealed that the change in fat mass was significantly less among treated subjects (P=0·038) and especially in the non-obese subjects (P=0·001). The change in trunk fat was similarly correlated with treatment status (P=0·029) and with the degree of obesity (P=0·006). In conclusion, 5 years of HRT treatment significantly reduced fat mass accumulation, especially in the trunk region. This effect of HRT was more pronounced in non-obese as compared with obese subjects. The HRT-induced reduction in fat mass seems not to be mediated by leptin.

Effects of hormone therapy and tibolone on body composition and serum leptin levels in postmenopausal women

“…High leptin levels (independently of adiposity) shown in girls at the higher Tanner stage (30), were suggestive of the regulatory function of leptin on reproductive system (7,31,32). This hypothesis was supported by documentation of increasing leptin levels in late follicular phase of the normal menstrual cycle accompanied by an estrogen concentration that is twofold higher (33).…”

Effects of hormone replacement therapy on weight, abdominal fat distribution, and lipid levels in Japanese postmenopausal women

“…Numerous studies have indicated that HRT prevented or reduced weight gain [8][9][10][11][12][13][14][15]18 and android (central) fat accumulation. [8][9][10][11][12][13][14][15]18,19 Manolio et al 8 reported that estrogen users had lower weight, BMI, and WHR than subjects never treated. Espeland et al 9 showed that women randomly assigned to take conjugated equine estrogen (CEE) with or without a progestational agent averaged 1.0 kg less weight gain at the end of 3 y than those assigned to take placebo.…”

“…5,6 Many menopausal women believe that hormone replacement therapy (HRT) causes weight gain, 7 but whether this impression is correct remains uncertain. In fact, many clinical studies indicated that HRT prevented or reduced weight gain [8][9][10][11][12][13][14][15][16][17][18] and body fat gain, [8][9][10][11][12][13][14][15]18,19 although other investigators found the opposite both for weight 20,21 and body fat. 20,21 Thus, the effect of HRT concerning weight and body fat remains controversial.…”

Degree of fatness after treatment of malignant lymphoma in childhood

“…For postmenopausal women, reports of body composition changes with and without hormone replacement therapy are conflicting [45,46]. Women with Turners syndrome have reduced lean body mass, which increases with oestrogen and gestagen therapy [18].…”