title: Sex hormone changes during weight loss and maintenance in overweight and obese postmenopausal African-American and non-African-American women.
abstract: BACKGROUND
  Changes in sex hormones with weight loss might have implications for breast cancer prevention but have not been examined extensively, particularly in African-American (AA) women.
  
  
  METHODS
  We conducted a prospective study of 278 overweight/obese postmenopausal women (38% AA) not taking hormone therapy within the Weight Loss Maintenance Trial. All participants lost at least 4 kg after a 6-month weight-loss phase and attempted to maintain weight loss during the subsequent 12 months. We evaluated the percentage changes in estrone, estradiol, free estradiol, testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and sex hormone-binding globulin (SHBG) using generalized estimating equations.
  
  
  RESULTS
  In all study phases, AA women had higher levels of estrogen and testosterone concentrations, independent of adiposity. On average, participants lost 7.7 kg during the weight-loss phase, and concentrations of estrone (-5.7%, P = 0.006), estradiol (-9.9%, P <0.001), free estradiol (-13.4%, P <0.0001), and free testosterone (-9.9%, P <0.0001) decreased, while the SHBG concentration (16.2%, P <0.001) increased. Weight change did not significantly affect total testosterone or other androgen concentrations. Compared with non-AA women, AA women experienced less change in estrogens per kilogram of weight change (that is, per 1 kg weight loss: estrone, -0.6% vs. -1.2%, P-interaction = 0.10; estradiol, -1.1% vs. -1.9%, P-interaction = 0.04; SHBG, 0.9% vs. 1.6%, P-interaction = 0.006; free estradiol, -1.4% vs. -2.1%, P-interaction = 0.01).
  
  
  CONCLUSIONS
  To the best of our knowledge this is the first study to examine and compare the effects of intentional weight loss and maintenance on a panel of sex hormones in AA women and non-AA women. Although speculative, these data suggest hormonal differences may contribute to different racial patterns of breast cancer incidence and mortality and encourage further investigations to understand the long-term effects of weight loss on sex hormones in obese postmenopausal women.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00054925.
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.forename: Roni T
authors.initials: RT
authors.lastname: Falk
authors.forename: Frank
authors.initials: F
authors.lastname: Stanczyk
authors.forename: Robert N
authors.initials: RN
authors.lastname: Hoover
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.forename: Jamy D
authors.initials: JD
authors.lastname: Ard
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.forename: Janelle
authors.initials: J
authors.lastname: Coughlin
authors.forename: Xu
authors.initials: X
authors.lastname: Han
authors.forename: Lillian F
authors.initials: LF
authors.lastname: Lien
authors.forename: Christina M
authors.initials: CM
authors.lastname: Pinkston
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.forename: Hormuzd A
authors.initials: HA
authors.lastname: Katki
mesh_terms: D001741:Black or African American; D000368:Aged; D005006:Ethnicity; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000453:epidemiology; D050177:Overweight / Q000097:blood* / Q000453:epidemiology; D017698:Postmenopause; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D015431:Weight Loss
chemical_list: D012739:Gonadal Steroid Hormones