Inverse relationship between the changes in trunk lean and fat mass during gonadotropin-releasing hormone agonist therapy

Douchi, Tsutomu; Kuwahata, Riki; Yamasaki, Hideki; Yamamoto, Shinako; Oki, Toshimichi; Nakae, Mitsuhiro; Nagata, Yukihiro

doi:10.1016/s0378-5122(02)00004-x

Cited by 20 publications

(32 citation statements)

References 13 publications

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“…In support of our hypotheses, we observed that ovarian hormone suppression resulted in decreases in FFM and lumbar spine and proximal femur BMD that were prevented by E 2 add-back therapy. Unexpectedly, we did not find an increase in FM in response to GnRH AG +PL, as has been observed by others, 2,3,5,6 but there was an increase in abdominal adiposity as measured by CT.…”

Section: Discussionsupporting

confidence: 81%

“…Although there are many behavioral, environmental and biological factors that contribute to the development of obesity, 1 there is evidence that the loss of ovarian hormones increases the propensity for weight gain in women. For example, fat mass (FM) increases in response to ovarian hormone suppression in premenopausal women 2-6 and estrogen-based hormone therapy (HT) attenuates weight gain in postmenopausal women. 7-18 Ovarian hormone deficiency may also alter fat distribution, resulting in a disproportionate increase in abdominal adiposity.…”

Section: Introductionmentioning

confidence: 99%

“…7-18 Ovarian hormone deficiency may also alter fat distribution, resulting in a disproportionate increase in abdominal adiposity. 2,6,7,12,13,15 Because accumulation of abdominal fat increases the risk of obesity-related diseases (i.e., type 2 diabetes mellitus, coronary artery disease, hypertension), 19 it is important to understand how the loss of gonadal function influences regional adiposity and whether this is specifically related to the decline in serum estradiol (E 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…20,21 Less well known is whether E 2 deficiency triggers a decline in lean tissue other than bone, such as skeletal muscle. The suppression of ovarian function in premenopausal women has been observed to result in a decline in fat-free mass (FFM) in some studies, 2,3,5,6 but it is not clear whether this is specifically related to the decline in serum E 2 concentration.…”

Section: Introductionmentioning

confidence: 99%

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Body composition and bone mineral density after ovarian hormone suppression with or without estradiol treatment

et al. 2015

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Suppression of ovarian hormones in premenopausal women with gonadotropin releasing hormone agonist therapy (GnRHAG) can cause fat mass (FM) gain and fat-free mass (FFM) loss. It is unknown if this is specifically due to the decline in serum estradiol (E2). Objective To evaluate the effects of GnRHAG with add-back of placebo (PL) or E2 on FM, FFM, and bone mineral density (BMD). An exploratory aim evaluated the effects of resistance exercise on body composition during the drug intervention. Methods Seventy healthy, premenopausal women underwent 5 months of GnRHAG and were randomized to add-back of transdermal E2 (GnRHAG+E2, n=35) or placebo (GnRHAG+PL, n=35). As part of an exploratory aim to evaluate whether exercise can minimize effects of hormone suppression, some women within each drug arm were randomized to a resistance exercise program (GnRHAG+E2+Ex, n=12; GnRHAG+PL+Ex, n=12). Results The groups did not differ in age (mean±SD) (36±8yr, 35±9yr) or BMI (both 28±6kg/m2). FFM declined in response to GnRHAG+PL (mean; 95% CI) (−0.6kg; −1.0, −0.3) but not GnRHAG+E2 (0.3kg; −0.2, 0.8) or GnRHAG+PL+Ex (0.1kg;−0.6, 0.7). Although FM did not change in either group, visceral fat area increased in response to GnRHAG+PL but not GnRHAG+E2. GnRHAG+PL caused decreased BMD at the lumbar spine and proximal femur that were prevented by E2. Preliminary data suggest that exercise may have favorable effects on FM, FFM, and hip BMD. Conclusions Suppression of ovarian E2 resulted in loss of bone and FFM and expansion of abdominal adipose depots. Failure of hormone suppression to increase total FM conflicted with previous studies of the effects of GnRHAG. Further research is necessary to understand the role of estrogen in the regulation of energy balance and fat distribution.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body composition and bone mineral density after ovarian hormone suppression with or without estradiol treatment

et al. 2015

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“…The authors also document a decrease in fat-free mass (FFM), a change seen in some studies. [9][10][11][12] This is also an important observation as FFM determines metabolic rate 13 and, thus, is an important factor in the propensity to gain weight. Because this tissue, which consists primarily of skeletal muscle, diminishes, 13 caloric utilization decreases and adiposity may ensue.…”

mentioning

confidence: 99%

Visceral fat accumulation

Warren

2015

Menopause

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A Randomized Controlled Trial of Ovarian Suppression in Premenopausal Women: No Change in Free‐Living Energy Expenditure

Gavin

Melanson

Hildreth

et al. 2020

Obesity

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Objective The purpose of this study was to determine whether suppression of ovarian function (gonadotropin‐releasing hormone agonist [GnRHAG]) for 24 weeks in premenopausal women approaching menopause causes changes in body composition and a decline in free‐living physical activity energy expenditure (PAEE) and whether endurance exercise training attenuates the changes. Methods Premenopausal women who were approaching menopause (mean [SD]: age 46 [3] years, BMI 26.3 [4.8] kg/m2) were randomized to 24 weeks of GnRHAG (n = 14), GnRHAG + Exercise (n = 11), or placebo (n = 9). Endurance exercise was performed 4 days per week with the goal of expending 200 to 300 kcal per session. Primary outcome measurements included body composition by dual‐energy x‐ray absorptiometry, total daily energy expenditure (TDEE), and PAEE by doubly labeled water, and resting energy expenditure (REE) by indirect calorimetry. Results Changes in TDEE, PAEE, REE, or body composition were not different between groups. However, within the GnRHAG group, fat mass increased (mean [SE]: total 1.7 [0.4] kg, trunk 0.9 [0.2] kg, leg 0.6 [0.2] kg) and fat‐free leg mass decreased (mean [SE]: −0.4 [0.2] kg) significantly. Conclusions In premenopausal women approaching menopause, ovarian hormone suppression resulted in increased adiposity without alterations in TDEE, PAEE, or REE.

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Inverse relationship between the changes in trunk lean and fat mass during gonadotropin-releasing hormone agonist therapy

Cited by 20 publications

References 13 publications

Body composition and bone mineral density after ovarian hormone suppression with or without estradiol treatment

Body composition and bone mineral density after ovarian hormone suppression with or without estradiol treatment

Visceral fat accumulation

A Randomized Controlled Trial of Ovarian Suppression in Premenopausal Women: No Change in Free‐Living Energy Expenditure

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