Changes in body composition during post-menopausal hormone therapy: a 2 year prospective study.
BACKGROUND
Post-menopausal hormone therapy (pHT) induces changes in both body composition and bone mineral density (BMD).


METHODS
In 109 post-menopausal women beginning either tibolone 2.5 mg (n=29), tibolone 1.25 mg (n=42) or estradiol 2 mg plus norethisterone acetate 1 mg (E2 + NETA) (n=38), we assessed body composition, total and regional BMD by dual energy X-ray absorptiometry, and the serum bone alkaline phosphatase (BAP), osteocalcin and the urinary excretion to type I collagen C-telopeptide (CTX) at baseline and after 2 years.


RESULTS
At baseline, BMD at all sites correlated negatively with age and years since menopause, and positively with lean mass and fat mass (r=0.42, P<0.001 and r=0.26, P=0.006 at the total femur). During treatment, BMD increased at all sites (P<0.001), and serum BAP, osteocalcin, and urinary CTX decreased in all groups (P<0.001). Lean mass increased whereas android fat and android obesity index decreased. The increase in BMD at all sites correlated positively with changes of lean mass at 2 years.


CONCLUSIONS
Both fat mass and lean mass are related to BMD in post-menopausal women, the relationship being strongest with lean mass; an increase in lean mass and a change in distribution of body fat are observed during treatment with E2 + NETA and tibolone.
Arabi
A
A
Centre d'Evaluation des Maladies Osseuses, Département de Rhumatologie, Hôpital Cochin, Université René Descartes, Paris, France.
Garnero
P
P
Porcher
R
R
Pelissier
C
C
Benhamou
C L
CL
Roux
C
C
D000273:Adipose Tissue / Q000033:anatomy & histology; D000469:Alkaline Phosphatase / Q000097:blood; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects / Q000201:enzymology; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D009652:Norpregnenes / Q000008:administration & dosage; D015675:Osteocalcin / Q000097:blood; D010455:Peptides / Q000652:urine; D011446:Prospective Studies; D013851:Thinness
D024042:Collagen Type I; D009652:Norpregnenes; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D004958:Estradiol; D003094:Collagen; D000077563:Norethindrone Acetate; D000469:Alkaline Phosphatase; C027385:tibolone; D009640:Norethindrone