Effects of postmenopausal hormone replacement therapy on body fat composition

Aim. To evaluate the effects of different types, regimens and administration routes of hormone replacement therapy (HRT) on body fat composition indices in postmenopausal women at increased risk of anthropometry-related cardiovascular disease (CVD). Methods. Fifty-nine postmenopausal women (aged 41-57 years, mean ± standard deviation: 49.9 ± 3.8 years) with body mass index (BMI) ≥25 kg m2 participated in this 6-month, prospective, randomized single-blind study. Subjects were assigned into three groups and received transdermal estradiol (E2) norethisterone acetate (NETA) (50 μg E2 daily for 14 days followed by 50 μg E2 0.25 μg NETA daily for 14 days; transdermal group, n = 19), transdermal continuous E2 oral medroxyprogesterone acetate (MPA) (50 μg E2 5 mg MPA daily; transdermal oral group, n = 19) or oral continuous E2 NETA (1 mg E2 0.5 mg NETA daily; oral group, n = 21). Anthropometric indices (body weight, height, and hip and waist circumferences) were measured, and BMI and waist-to-hip ratio (WHR) were calculated, before and after treatment. Also, the thickness of subcutaneous abdominal fat was measured by ultrasound. Depending on waist circumference (WC), the subjects were divided into two risk groups: increased-risk group with WC 0.05) between HRT groups. In each group, all types of HRT significantly decreased WC and subcutaneous fat (transdermal group: p < 0.001 and p < 0.05; transdermal oral group: p < 0.001 and p < 0.01; oral group: p < 0.001 and p < 0.001, respectively), while body weight, BMI and WHR changed only insignificantly (p > 0.05). In the increased-risk group, body weight increased significantly (p < 0.05) while WC and subcutaneous fat decreased significantly (p < 0.001 and p < 0.001). As for the high-risk group, there was a significant decrease in WC and subcutaneous fat (p < 0.001, p < 0.001) while the remaining parameters did not change significantly. However, BMI showed a tendency to increase in the increased-risk group, while there was a decrease in all measurements in the high-risk gr