Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy.
OBJECTIVE
Menopause is linked to an increase in fat mass and a decrease in lean mass exceeding age-related changes, possibly related to reduced output of ovarian steroids. In this study we examined the effect of combined postmenopausal hormone replacement therapy (HRT) on the total and regional distribution of fat and lean body mass.


METHODS
Sixteen healthy postmenopausal women (age: 55 +/- 3 years) were studied in a placebo-controlled, crossover study and were randomized to 17beta estradiol plus cyclic norethisterone acetate (HRT) or placebo in two 12-week periods separated by a 3-month washout. Total and regional body composition was measured by DXA at baseline and in the 10th treatment week in both periods. Changes were compared by a paired Student's t test.


RESULTS
The change in body weight during HRT was equal to the change during placebo (-24.6 g vs. -164 g, p = 0.42), but relative fat mass was significantly reduced (-0.5% vs. +1.24%, p < 0.01). During HRT, compared with during placebo, lean body mass increased (+347 g vs. -996 g, p < 0.01) and total fat mass decreased (-400 g vs. +836 g, p = 0.06). Total bone mineral content increased (+28.9 g vs. -4.4 g, p = 0.04) and abdominal fat decreased (-185 g vs. +253 g, p = 0.04) during HRT compared with placebo.


CONCLUSIONS
HRT is linked to the reversal of both menopause-related obesity and loss of lean mass, without overall change in body weight. The increase in lean body mass during HRT is likely explained by muscle anabolism, which in turn, prevents disease in the elderly.
Sørensen
M B
MB
Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Denmark. m.sorensen@rbh.nthames.nhs.uk
Rosenfalck
A M
AM
Højgaard
L
L
Ottesen
B
B
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004958:Estradiol / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009133:Muscular Atrophy / Q000188:drug therapy*; D009640:Norethindrone / Q000627:therapeutic use*; D009765:Obesity / Q000188:drug therapy*; D017698:Postmenopause; D045167:Progesterone Congeners / Q000627:therapeutic use*
D045167:Progesterone Congeners; D004958:Estradiol; D009640:Norethindrone