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Menopausal HT may prevent age-associated fat mass increase
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Postmenopausal women currently using hormone therapy had less visceral adipose tissue compared with those who never used HT, and this use prevented 10-year gains of visceral adipose tissue and android fat mass, study data show.
“This is the first large study on postmenopausal women specifically assessing intravisceral fat according to menopausal HT using high-accuracy measurement by DXA,” Georgios E. Papadakis, MD, chief resident in the service of endocrinology, diabetes and metabolism, CHUV, Lausanne University Hospital in Lausanne, Switzerland, told Endocrine Today. “Thus, the age-associated increase in fat mass is prevented in women on menopausal HT. However, this effect rapidly disappears after treatment withdrawal. In addition, this study showed no advantage of menopausal HT for enhancement of lean mass.”
Papadakis and colleagues evaluated data from the OsteoLaus cohort on 1,053 postmenopausal women who were current (n = 216; mean age, 62.6 years; mean HT duration, 12.2 years), past (n = 288; mean age, 66.8 years; mean HT duration, 7.9 years) and never (n = 549; mean age, 61.3 years) users of menopausal HT to determine the effect of HT on fat mass, visceral adipose tissue and nonbone lean mass.
Current HT users had lower visceral adipose tissue compared with never users (P = .03). Current use lowered the risk for 10-year gain of visceral adipose tissue (P < .01) and subtotal and android fat mass (P < .05) compared with past and never use.
Researchers did not observe any benefit of menopausal HT on nonbone lean mass, sarcopenia indices or handgrip strength. However, a trend for lower nonbone lean mass was observed among current users compared with never users (P = .05).
No significant differences were observed between the groups for glucose, insulin and adipokine levels.
“The decrease of intravisceral fat seen in menopausal HT users may have important cardiovascular and bone implications,” Papadakis said. “This favorable effect of menopausal HT on adiposity should be taken into account when assessing the benefit-risk ratio before prescribing menopausal HT. Nevertheless, as discussed in the article, the effect size is relative small. In addition, the absence of residual effect on past users indicates that physicians should be cautious when stopping menopausal HT and strongly encourage women to optimize nutrition and increase physical activity in order to counteract this eventual rebound effect.”
Future studies should examine the effects on body composition of different types and routes of administration for menopausal HT, as well as consequences of withdrawal, Papadakis said. – by Amber Cox
For more information:
Georgios E. Papadakis, MD, FMH, can be reached at georgios.papdakis@chuv.ch.
Disclosures: The authors report no relevant financial disclosures.
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