Endocrine Abstracts

Background: We previously showed that menopausal hormone therapy (MHT) favorably affects both bone density and microarchitecture with persistent benefit after its withdrawal (1). Looking for indirect factors contributing to bone effects, we investigated the relation between MHT and changes on fat and lean (muscular) tissue. Existing results on MHT and body composition are conflicting and large cohort studies are lacking.

Material and methods: The OsteoLaus cross-sectional population-based study includes 1’500 women aged 50 to 80 years (Lausanne, Switzerland). Current or past MHT use was assessed by questionnaire. Body composition evaluation by DXA was performed in a subgroup (n=1094). After exclusion of participants with hormone modifying treatments, the remaining women were divided in 3 groups based on MHT status: Never (NU, n=549), Current (CU, n=216) and Past (PU, n=288) Users.

Results: The 3 groups differed in age: 66.8±6.3, 62.6±6.7 and 61.3±7.9 years for PU, CU and NU respectively. Average time since MHT withdrawal in PU was 8.5 years. All the results were age-adjusted. CU exhibited lower BMI (−0.9 kg/m²), compared to NU (P=.02). In particular, reduced intravisceral and android fat was noted (CU vs PU, P=.02 and .03 respectively). Total fat mass tended to be lower for CU (P=.06) with absolute values of 22.0±0.5 and 23.3±0.5 kg in CU and NU respectively. PU did not present any benefit regarding fat tissue in comparison with NU. That was the case even when only early MHT discontinuers (<2 years) were analyzed. There was no difference between groups regarding gynoid fat mass. Both CU and PU showed did not statistically exceed NU regarding total or regional lean mass nor muscle strength assessed by handgrip measurement. Assessment of caloric intake and physical activity did not reveal differences that could explain MHT-related fat mass reduction.

Conclusion: MHT is associated with less adiposity, due to reduction in android fat mass. The significant decrease of intravisceral fat mass in CU is of particular interest, given the strong link of the latter with cardiovascular risk. In contrast to our previous data for bone parameters, the benefit of MHT for fat mass reduction is not preserved in PU.

(1): Papadakis G. et al. The Benefit of Menopausal Hormone Therapy on Bone Density and Microarchitecture Persists After its Withdrawal. J Clin Endocrinol Metab. 2016 Dec; 101(12):5004-5011.