Menopausal hormone therapy reduces total, visceral adiposity
Use of menopausal hormone therapy (MHT) is associated with significant decreases in visceral adipose tissue (VAT), body mass index (BMI) and android fat mass, a recent study has found. In addition, MHT appears to confer no benefit for lean body mass (LBM), and the benefits are not maintained in past users, suggesting caution when therapy is discontinued.
This cross-sectional study included women of the OsteoLaus cohort (aged 50–80 years) who underwent dual energy X-ray absorptiometry (DXA) with body composition assessment. Women under oestrogen-modifying medications were excluded. A total of 1,053 participants were categorized into current users, past users and never users of MHT.
The primary outcome was VAT measured by DXA. The investigators also assessed subtotal and android fat mass, LBM, muscle strength (hand grip) and confounding factors (caloric intake, physical activity, biomarkers).
Age significantly differed among participants: never users < current users < past users. Current users had lower age-adjusted VAT than never users (p=0.03), and they also showed lower age-adjusted BMI (–0.9 kg/m2) and a trend for lower fat mass (–1.3 kg).
Moreover, current users prevented a 10-year gain of VAT (p<0.01) and subtotal and android fat mass (p<0.05). There was no difference in LBM or hand grip.
Past users, including for early MHT discontinuers, did not display any residual effect. No significant between-group difference was observed for the confounding factors, except for higher caloric intake in past users vs never users.
“After menopause, fat mass and VAT increase and nonbone LBM decreases,” according to the investigators.