Hormone therapy offsets adverse metabolic effects of menopause

By medwireNews Reporters

Long-term hormone therapy helps prevent the adverse metabolic effects that occur following menopause, research shows.

Estrogen-based hormone therapy used long term was associated with healthier amounts of body fat, as well as an improved distribution of body fat, and better adipocytokine profile.

"Interestingly, although no difference was found in serum lipid concentrations between the groups, fasting serum glucose and HbA1c levels were lower among hormone therapy users than among nonusers," Maarit Ahtiainen (University of Jyväskylä, Finland) and colleagues report in Menopause.

Regarding adipokines, the researchers observed a 15% lower level of monocyte chemotactic protein-1 (MCP-1) in hormone therapy users than in nonusers.

Given the improved insulin sensitivity of women in this study, the researchers say the reduction of MCP-1 with hormone therapy supports "its suggested mediator role between obesity and insulin resistance."

The study included 10 monozygotic twin pairs discordant for hormone therapy, and an additional 14 premenopausal women who had not initiated hormone therapy. The postmenopausal women taking estrogen-based hormone therapy had been doing so for between 2 and 10 years.

Among the twin sisters discordant for hormone therapy, the percentage of body fat was significantly lower among hormone therapy users and they had smaller, albeit not significantly, hip and waist circumferences compared with nonusers. There was also a trend toward lower body mass indices among hormone therapy-treated postmenopausal women (25.3 vs 28.1 kg/m² in nonusers.

Overall, the findings suggest that women with long-term hormone therapy use "have les visceral fat than their nonusing co-twins have," say Ahtiainen and colleagues.

Serum glucose levels and glycated hemoglobin levels were a significant 5% and 3% lower, respectively, in the twins taking long-term hormone therapy compared with their co-twins not taking therapy.

In the comparison between pre- and postmenopausal women, the postmenopausal women had significantly higher waist-to-hip ratios and tended to have higher percentages of body fat and waist circumferences.

Increased insulin resistance and harmful changes in lipid concentrations in the postmenopausal women were no longer statistically significant when compared with premenopausal women after adjustments for body fat.

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