Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Effects of hormone replacement therapy on weight, abdominal fat distribution, and lipid levels in Japanese postmenopausal women

International Journal of Obesity volume 27, pages 1044–1051 (2003)Cite this article

Abstract

OBJECTIVE: To investigate the effects of hormone replacement therapy (HRT) on weight, abdominal fat distribution, and fasting lipid levels in Japanese postmenopausal women (PMW).

DESIGN: Prospective, 12-month-controlled clinical comparison of women with and without HRT.

SUBJECTS: In all, 35 PMW with HRT (conjugated estrogens, 0.625?mg daily; medroxyprogesterone acetate, 2.5?mg daily; HRT group) and 26 PMW without HRT (control group).

MEASUREMENTS: Weight, abdominal fat distribution by computed tomographic measurements, lipid profiles, and sex hormones were determined at baseline and after 12 months of treatment or observation.

RESULTS: Weight did not change in any group. Visceral abdominal fat increased in controls, but not in the HRT group. Total and low-density lipoprotein cholesterol decreased, and triglyceride (TG) and high-density lipoprotein cholesterol increased in the HRT group; these did not change in the control group. When we divided women into those with android and gynoid types of abdominal fat distribution. Subjects with an android distribution showed reduced visceral fat with HRT, which also decreased the proportion of patients maintaining an android distribution. HRT did not alter abdominal fat distribution in subjects with a gynoid distribution. HRT increased serum TG in the android and the gynoid subgroups.

CONCLUSION: Improved distribution of abdominal fat and fasting lipid levels except for TG may represent beneficial effects of HRT with respect to cardiovascular disease, but caution is warranted concerning TG elevation from HRT performed in PMW.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Hjortland MC, McNamara PM, Kannel WB . Some atherogenic concomitants of menopause: The Framingham Study. Am J Epidemiol 1976; 103: 304–311.

    Article  CAS  PubMed  Google Scholar 

  2. Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga PL . Weight gain at the time of menopause. Arch Intern Med 1991; 151: 97–102.

    Article  CAS  PubMed  Google Scholar 

  3. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–889.

    Article  CAS  PubMed  Google Scholar 

  4. Poehlman ET, Toth MJ, Gardner AW . Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med 1995; 123: 673–675.

    Article  CAS  PubMed  Google Scholar 

  5. Ley CJ, Lees B, Stevenson JC . Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 1992; 55: 950–954.

    Article  CAS  PubMed  Google Scholar 

  6. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L . Distribution of adipose tissue and risk of cardiovascular disease and death: a 12-year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J 1984; 289: 1257–1261.

    Article  CAS  Google Scholar 

  7. Nachtigall LE . Enhancing patient compliance with hormone replacement therapy at menopause. Obstet Gynecol 1990; 75: 77S–80S.

    Article  CAS  PubMed  Google Scholar 

  8. Manolio TA, Furberg CD, Shemanski L, Psaty BM, O'Leary DH, Tracy RP, Bush TL . Associations of postmenopausal estrogen use with cardiovascular disease and its risk factors in older women. The CHS Collaborative Research Group. Circulation 1993; 88: 2163–2171.

    Article  CAS  PubMed  Google Scholar 

  9. Espeland MA, Stefanick ML, Kritz-Silverstein D, Fineberg SE, Waclawiw MA, James MK, Greendale GA . Effect of postmenopausal hormone therapy on body weight and waist and hip girths. Postmenopausal Estrogen–Progestin Interventions Study Investigators. J Clin Endocrinol Metab 1997; 82: 1549–1556.

    CAS  PubMed  Google Scholar 

  10. Sites CK, Brochu M, Tchernof A, Poehlman ET . Relationship between hormone replacement therapy use with body fat distribution and insulin sensitivity in obese postmenopausal women. Metabolism 2001; 50: 835–840.

    Article  CAS  PubMed  Google Scholar 

  11. Sites CK, L'Hommedieu GD, Brochu M, Poehlman ET . Previous exposure to hormone replacement therapy and confounders in metabolic studies. Menopause 2001; 8: 281–285.

    Article  CAS  PubMed  Google Scholar 

  12. Kritz-Silverstein D, Barrett-Connor E . Long-term postmenopausal hormone use, obesity, and fat distribution in older women. JAMA 1996; 275: 46–49.

    Article  CAS  PubMed  Google Scholar 

  13. Kristensen K, Pedersen SB, Vestergaard P, Mosekilde L, Richelsen B . Hormone replacement therapy affects body composition and leptin differently in obese and non-obese postmenopausal women. J Endocrinol 1999; 163: 55–62.

    Article  CAS  PubMed  Google Scholar 

  14. Reubinoff BE, Wurtman J, Rojansky N, Adler D, Stein P, Schenker JG, Brzezinski A . Effects of hormone replacement therapy on weight, body composition, fat distribution, and food intake in early postmenopausal women: a prospective study. Fertil Steril 1995; 64: 963–968.

    Article  CAS  PubMed  Google Scholar 

  15. The Writing Group for the PEPI Trial . Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 1995; 273: 199–208.

    Article  Google Scholar 

  16. O'Sullivan AJ, Crampton LJ, Freund J, Ho KK . The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women. J Clin Invest 1998; 102: 1035–1040.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Dallongeville J, Marecaux N, Isorez D, Zylberg G, Fruchart JC, Amouyel P . Multiple coronary heart disease risk factors are associated with menopause and influenced by substitutive hormonal therapy in a cohort of French women. Atherosclerosis 1995; 118: 123–133.

    Article  CAS  PubMed  Google Scholar 

  18. Gambacciani M, Ciaponi M, Cappagli B, Piaggesi L, De Simone L, Orlandi R, Genazzani AR . Body weight, body fat distribution, and hormonal replacement therapy in early postmenopausal women. J Clin Endocrinol Metab 1997; 82: 414–417.

    Article  CAS  PubMed  Google Scholar 

  19. Haarbo J, Marslew U, Gotfredsen A, Christiansen C . Postmenopausal hormone replacement therapy prevents central distribution of body fat after menopause. Metabolism 1991; 40: 1323–1326.

    Article  CAS  PubMed  Google Scholar 

  20. Aloia JF, Vaswani A, Russo L, Sheehan M, Flaster E . The influence of menopause and hormonal replacement therapy on body cell mass and body fat mass. Am J Obstet Gynecol 1995; 172: 896–900.

    Article  CAS  PubMed  Google Scholar 

  21. O'Sullivan AJ, Hoffman DM, Ho KK . Estrogen, lipid oxidation, and body fat. N Engl J Med 1995; 333: 669–670.

    Article  CAS  PubMed  Google Scholar 

  22. Borkan GA, Gerzof SG, Robbins AH, Hults DE, Silbert CK, Silbert JE . Assessment of abdominal fat content by computed tomography. Am J Clin Nutr 1982; 36: 172–177.

    Article  CAS  PubMed  Google Scholar 

  23. Kvist H, Sjostrom L, Tylen U . Adipose tissue volume determinations in women by computed tomography: technical considerations. Int J Obes Relat Metab Disord 1986; 10: 53–67.

    CAS  Google Scholar 

  24. Terry JG, Hinson WH, Evans GW, Schreiner PJ, Hagaman AP, Crouse III JR . Evaluation of magnetic resonance imaging for quantification of intraabdominal fat in human beings by spin-echo and inversion-recovery protocols. Am J Clin Nutr 1995; 62: 297–301.

    Article  CAS  PubMed  Google Scholar 

  25. Matthews KA, Meilahn E, Kuller LH, Kelsey SF, Caggiula AW, Wing RR . Menopause and risk factors for coronary heart disease. N Engl J Med 1989; 321: 641–646.

    Article  CAS  PubMed  Google Scholar 

  26. Stevenson JC, Crook D, Godsland IF . Influence of age and menopause on serum lipids and lipoproteins in healthy women. Atherosclerosis 1993; 98: 83–90.

    Article  CAS  PubMed  Google Scholar 

  27. Sumino H, Nakamura T, Ichikawa S, Kanda T, Sakamaki T, Sato K, Kobayashi I, Nagai R . Serum level of vascular endothelial growth factor is decreased by hormone replacement therapy in postmenopausal women without hypercholesterolemia. Atherosclerosis 2000; 148: 189–195.

    Article  CAS  PubMed  Google Scholar 

  28. Walsh BW, Schiff I, Rosner B, Greenberg L, Ravnikar V, Sacks FM . Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N Engl J Med 1991; 325: 1196–1204.

    Article  CAS  PubMed  Google Scholar 

  29. Lobo RA . Effects of hormonal replacement on lipids and lipoproteins in postmenopausal women. J Clin Endocrinol Metab 1991; 73: 925–930.

    Article  CAS  PubMed  Google Scholar 

  30. Rendell M, Hulthen UL, Tornquist C, Groop L, Mattiasson I . Relationship between abdominal fat compartments and glucose and lipid metabolism in early postmenopausal women. J Clin Endocrinol Metab 2001; 86: 744–749.

    CAS  PubMed  Google Scholar 

  31. Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C . Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis 1990; 10: 497–511.

    Article  CAS  PubMed  Google Scholar 

  32. Lundgren H, Bengtsson C, Blohme G, Ladidus L, Sjostrom L . Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg, Sweden. Int J Obes Relat Metab Disord 1989; 13: 413–423.

    CAS  Google Scholar 

  33. Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.

    Article  CAS  PubMed  Google Scholar 

  34. Enzi G, Gasparo M, Biondetti PR, Fiore D, Semisa M, Zurlo F . Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr 1986; 44: 739–746.

    Article  CAS  PubMed  Google Scholar 

  35. Zamboni M, Armellini F, Milani MP, De Marchi M, Todesco T, Robbi R, Bergamo-Andreis IA, Bosello O . Body fat distribution in pre- and post-menopausal women: metabolic and anthropometric variables and their inter-relationships. Int J Obes Relat Metab Disord 1992; 16: 495–504.

    CAS  PubMed  Google Scholar 

  36. Rebuffe-Scrive M . Steroid hormones and distribution of adipose tissue. Acta Med Scand Suppl 1988; 723: 143–146.

    CAS  PubMed  Google Scholar 

  37. Rebuffe-Scrive M, Lonnroth P, Marin P, Wesslau C, Bjorntorp P, Smith U . Regional adipose tissue metabolism in men and postmenopausal women. Int J Obes Relat Metab Disord 1987; 11: 347–355.

    CAS  Google Scholar 

  38. Rebuffe-Scrive M, Eldh J, Hafstrom LO, Bjorntorp P . Metabolism of mammary, abdominal, and femoral adipocytes in women before and after menopause. Metabolism 1986; 35: 792–797.

    Article  CAS  PubMed  Google Scholar 

  39. Wakatsuki A, Ikenoue N, Okatani Y, Fukaya T . Estrogen-induced small low density lipoprotein particles may be atherogenic in postmenopausal women. J Am Coll Cardiol 2001; 37: 425–430.

    Article  CAS  PubMed  Google Scholar 

  40. Stampfer MJ, Colditz GA, Willett WC . Menopause and heart disease. A review. Ann NY Acad Sci 1990; 592: 193–203.

    Article  CAS  PubMed  Google Scholar 

  41. Wenger NK, Speroff L, Packard B . Cardiovascular health and disease in women. N Engl J Med 1993; 329: 247–256.

    Article  CAS  PubMed  Google Scholar 

  42. Kannel WB, Hjortland MC, McNamara PM, Gordon T . Menopause and risk of cardiovascular disease: the Framingham study. Ann Intern Med 1976; 85: 447–452.

    Article  CAS  PubMed  Google Scholar 

  43. Gordon T, Kannel WB, Hjortland MC, McNamara PM . Menopause and coronary heart disease. The Framingham study. Ann Intern Med 1978; 89: 157–161.

    Article  CAS  PubMed  Google Scholar 

  44. Stampfer MJ, Colditz GA . Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence. Prev Med 1991; 20: 47–63.

    Article  CAS  PubMed  Google Scholar 

  45. Stampfer MJ, Colditz GA, Willett WC, Manson JE, Rosner B, Speizer FE, Hennekens CH . Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the nurses' health study. N Engl J Med 1991; 325: 756–762.

    Article  CAS  PubMed  Google Scholar 

  46. Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, Ernster VL, Cummings SR . Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992; 117: 1016–1037.

    Article  CAS  PubMed  Google Scholar 

  47. Grodstein F, Stampfer MJ, Colditz GA, Willett WC, Manson JE, Joffe M, Rosner B, Fuchs C, Hankinson SE, Hunter DJ . Postmenopausal hormone therapy and mortality. N Engl J Med 1997; 336: 1769–1775.

    Article  CAS  PubMed  Google Scholar 

  48. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E . Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998; 280: 605–613.

    Article  CAS  PubMed  Google Scholar 

  49. Grady D, Herrington D, Bittner V, Blumenthal R, Davidson M, Hlatky M, Hsia J, Hulley S, Herd A, Khan S, Newby LK, Waters D, Vittinghoff E, Wenger N . Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA 2002; 288: 49–57.

    Article  PubMed  Google Scholar 

  50. Writing Group for the Women's Health Initiative Investigators: Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288: 321–333.

  51. Gotto AM . Triglyceride as a risk factor for coronary artery disease. Am J Cardiol 1998; 82: 22Q–25Q.

    Article  PubMed  Google Scholar 

  52. Bassford TL . Health status of Hispanic elders. Clin Geriatr Med 1995; 11: 25–38.

    Article  CAS  PubMed  Google Scholar 

  53. Kumanyika SK . Special issues regarding obesity in minority populations. Ann Intern Med 1993; 119: 650–654.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful to Naoaki Tsunoda, Hiroyuki Takada, and Hiromitsu Takahashi for technical assistance. We thank Kazuo Sakaguchi, Miki Shirouzu, Mayumi Ashizaki, Tomoko Sakurai, Satomi Ono, Mina Aoki, Yuko Masuda, Kanae Kodaira, Setsuko Saito, Yoko Suetake, Setsuko Kobayashi, Yoshimi Matsuda, Masumi Tanimoto, and Emiko Ohkura for assisting with clinical coordination.

Author information

Authors and Affiliations

  1. Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan

    H Sumino & M Kurabayashi

  2. Cardiovascular Hospital of Central Japan, Gunma, Japan

    S Ichikawa

  3. Department of Laboratory Medicine, Gunma University School of Medicine, Maebashi, Japan

    A Yoshida & M Murakami

  4. Department of General Medicine, Kanazawa Medical University, Kanazawa, Japan

    T Kanda

  5. Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan

    H Mizunuma

  6. Medical Informatics and Decision Sciences, Gunma University School of Medicine, Maebashi, Japan

    T Sakamaki

Authors
  1. H Sumino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T Kanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H Mizunuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T Sakamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M Kurabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H Sumino.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sumino, H., Ichikawa, S., Yoshida, A. et al. Effects of hormone replacement therapy on weight, abdominal fat distribution, and lipid levels in Japanese postmenopausal women. Int J Obes 27, 1044–1051 (2003). https://doi.org/10.1038/sj.ijo.0802371

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802371

Keywords

This article is cited by

Search

Advanced search

Quick links