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Body Weight, Body Fat Distribution, and Hormonal Replacement Therapy in Early Postmenopausal Women

Department of Obstetrics and Gynecology "Piero Fioretti," University of Pisa, and Medical Department, Schering S.p.A. (R.O.), Milan, Italy

Address all correspondence and requests for reprints to: Marco Gambacciani, M.D., Department of Obstetrics and Gynecology, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Body weight was measured, and body fat distribution was determined by dual energy x-ray in early postmenopausal women given either oral calcium (500 mg/day; control group; n = 12) or hormonal replacement therapy (HRT), a combination of estradiol valerate (2 mg/day for 21 days) with cyproterone acetate (1 mg/day in the last 10 days of the treatment cycle; n = 15). There were no differences in basal body weight or body fat distribution in the two groups before the study. In the control group, a significant (P < 0.05) increase in body weight (from 61.8 ± 2.1 to 63.3 ± 1.9 kg after 12 months) paralleled a slight, but significant (P < 0.05), increase in total body fat mass (from 23.8 ± 2.2 to 24.7 ± 2.2 kg), with an increase in fat in the trunk (from 10.2 ± 0.4 to 11.3 ± 0.4 kg; P < 0.01) and arms (from 2.4 ± 0.5 to 2.7 ± 0.2 kg; P < 0.05). These findings demonstrate a shift to a prevalent central android fat distribution after 12 months of observation in untreated postmenopausal women. Conversely, in the HRT group, total body bone mineral showed a significant (from 1089 ± 28 to 1106 ± 29 mg/cm²; P < 0.05) increase after 12 months, with no significant increase in body weight (from 62.2 ± 1.6 to 62.7 ± 1.6 kg), and no modifications in trunk (from 10.0 ± 0.2 to 9.8 ± 0.3 kg) and arm (from 2.43 ± 0.2 to 2.5 ± 0.1 kg) fat, but a significant increase in leg fat (from 7.1 ± 0.3 to 8.3 ± 0.4 kg; P < 0.05). The present results suggest that HRT can counteract at least in part the postmenopausal increase in body weight and body fat and prevent central body fat distribution after menopause.

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