The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women.

O’Sullivan, Anthony J; Crampton, L; Freund, Judith; Ho, Ken K. Y.

doi:10.1172/jci2773

Cited by 195 publications

(168 citation statements)

References 46 publications

(50 reference statements)

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“…While we lacked estradiol levels among the women in ARIC, the duration of these fluctuations in estradiol before stabilization coincides temporally with the time frame of more rapid MetS changes during the menopausal transition. As mentioned previously, oral estradiol decreases fatty acid oxidation 23. Nevertheless, it remains unclear why endogenous increases and then decreases in estradiol would be involved in a rise in triglycerides and/or other MetS components.…”

Section: Discussionmentioning

confidence: 88%

“…While we lacked data regarding the route of estrogen administration during the study, visit 4 of ARIC completed in 1998, at which point >75% of estrogen replacement was oral 24. Topical or vaginal estrogen replacement, as is more common currently, was found to improve lean body mass without affecting fat mass 21, 22, 23. We did not note differences in the rate of change in MetS severity by current estrogen use—although we lacked data regarding dose and adherence to estrogen use, which may have further influenced any effect.…”

Section: Discussionmentioning

confidence: 99%

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Progression of Metabolic Syndrome Severity During the Menopausal Transition

Gurka

Vishnu

Santen

et al. 2016

JAHA

120

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BackgroundAfter menopause, women exhibit a higher prevalence of the metabolic syndrome (MetS) and higher risk of cardiovascular disease. However, the timing of changes in MetS severity over the menopausal transition and whether these changes differ by racial/ethnic group remain unclear.Methods and ResultsWe assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1–4). We used linear mixed models to evaluate changes by menopausal status (premenopause, perimenopause, and postmenopause) in a MetS severity Z‐score and in the individual MetS components. While there were gradual increases in MetS severity over time across menopause stages, black women in particular exhibited more rapid progression in MetS severity during the premenopausal and perimenopausal periods than during the postmenopausal period. In the postmenopausal period (compared with prior periods), white women exhibited unfavorable decreases in high‐density lipoprotein, while black women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, high‐density lipoprotein, and glucose, contributing to the slowed progression of MetS severity. These changes were all observed after adjusting for hormone replacement treatment.ConclusionsDuring menopausal transition, women exhibited rapid increases in MetS severity during the premenopausal and perimenopausal periods, with black women having significant reductions in this increase in severity during the postmenopausal period. These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause. These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Progression of Metabolic Syndrome Severity During the Menopausal Transition

Gurka

Vishnu

Santen

et al. 2016

JAHA

120

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“…Oral oestrogen administration reduces serum IGF-I levels (6), probably through direct hepatic action of oestrogen. Oral oestrogen may in a similar manner also increase the amount of BF and reduce lean tissue mass in postmenopausal women (7). Oestrogen has also in vitro been shown to attenuate GH receptor signalling (8).…”

Section: Introductionmentioning

confidence: 98%

Body composition during GH replacement in adults – methodological variations with respect to gender

Korányi

Bosæus²,

Alpsten³

et al. 2006

eur j endocrinol

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Objective: Men with growth hormone deficiency (GHD) may be more sensitive to GH treatment than women in terms of changes in body composition. We have studied whether age, body-mass index (BMI) and the different types of methodology used to assess body composition may explain these differences. Design: Forty-four men and forty-four women with GHD, closely matched for age and BMI, were studied before and after 6 months of GH replacement. The dose of GH was individually adjusted. Body composition was assessed by measurements of potassium-40, total body nitrogen (TBN), tritiated water dilution, dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Four-and five-compartment models for body composition were also calculated. Results: The total daily dose of GH was similar in men and women at 6 months. Serum insulin-like growth factor-I (IGF-I) was higher in men than women at baseline and after 6 months of treatment (P ¼ 0.01, paired t-test). The increment was, however, similar. In women, GH treatment reduced body weight and increased TBN. In both men and women, total body water and body cell mass increased, while total body fat (BF) mass decreased. At baseline, mean total BF varied considerably depending on the methodology used, with the highest value obtained from DXA. The changes in BF were, however, less dependent on the methodology, but DXA and BIA demonstrated the largest inconsistency between men and women. Conclusions: These results suggest that gender differences in body composition in response to GH treatment are small, if adjustments are made for baseline factors such as age, BMI and dose of GH. Different methods of body composition measurements produce different results, but changes in response to GH administration are less inconsistent.European Journal of Endocrinology 154 545-553

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Sumino

Ichikawa²,

Yoshida

et al. 2003

Int J Obes

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OBJECTIVE:To investigate the effects of hormone replacement therapy (HRT) on weight, abdominal fat distribution, and fasting lipid levels in Japanese postmenopausal women (PMW). DESIGN: Prospective, 12-month-controlled clinical comparison of women with and without HRT. SUBJECTS: In all, 35 PMW with HRT (conjugated estrogens, 0.625 mg daily; medroxyprogesterone acetate, 2.5 mg daily; HRT group) and 26 PMW without HRT (control group). MEASUREMENTS: Weight, abdominal fat distribution by computed tomographic measurements, lipid profiles, and sex hormones were determined at baseline and after 12 months of treatment or observation. RESULTS: Weight did not change in any group. Visceral abdominal fat increased in controls, but not in the HRT group. Total and low-density lipoprotein cholesterol decreased, and triglyceride (TG) and high-density lipoprotein cholesterol increased in the HRT group; these did not change in the control group. When we divided women into those with android and gynoid types of abdominal fat distribution. Subjects with an android distribution showed reduced visceral fat with HRT, which also decreased the proportion of patients maintaining an android distribution. HRT did not alter abdominal fat distribution in subjects with a gynoid distribution. HRT increased serum TG in the android and the gynoid subgroups. CONCLUSION: Improved distribution of abdominal fat and fasting lipid levels except for TG may represent beneficial effects of HRT with respect to cardiovascular disease, but caution is warranted concerning TG elevation from HRT performed in PMW.

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The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women.

Cited by 195 publications

References 46 publications

Progression of Metabolic Syndrome Severity During the Menopausal Transition

Progression of Metabolic Syndrome Severity During the Menopausal Transition

Body composition during GH replacement in adults – methodological variations with respect to gender

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

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