Effect of hormone therapy on lean body mass, falls, and fractures
| Autor: | Jane A. Cauley, Andrea Z. LaCroix, Cora E. Lewis, Qiuhong Zhao, Frances A. Tylavsky, Tamsen Bassford, Zhao Chen, Rebecca D. Jackson, Jennifer W. Bea |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Aging
Time Factors medicine.medical_treatment Physiology Medical and Health Sciences Fractures Bone Absorptiometry Photon Bone Density Medicine Longitudinal Studies Injuries and Accidents Adiposity Women's Health Initiative Estrogen Replacement Therapy Obstetrics and Gynecology Skeletal Middle Aged Photon Postmenopause Menopause Muscle Female Android fat distribution medicine.medical_specialty Double-Blind Method Clinical Research Internal medicine Humans Body Weights and Measures Absorptiometry Muscle Skeletal Bone Obstetrics & Reproductive Medicine Proportional Hazards Models Aged business.industry Estrogens medicine.disease Estrogen Obesity Endocrinology Sarcopenia Lean body mass Osteoporosis Accidental Falls Hormone therapy Progestins business Fractures Body mass index |
| Zdroj: | Menopause (New York, N.Y.), vol 18, iss 1 |
| ISSN: | 1072-3714 |
| DOI: | 10.1097/gme.0b013e3181e3aab1 |
| Popis: | Women after menopause often experience a decrease in lean body mass,1 an increase in body fat mass and a shift to central or android fat distribution 2, which may increase their risk for sarcopenia, diabetes and cardiovascular diseases. These body composition changes are believed to be, at least in part, due to a sudden decline in endogenous estrogen production at the time of menopause. Therefore, it has been hypothesized that menopausal hormone therapy (HT) may help counter these changes in body composition among postmenopausal women.2–4 most of the previous investigations in this area have been limited to observational studies and clinical trials, with small sample sizes or short intervention times. Techniques for assessing body composition have varied widely across the studies and many findings have been based on anthropometric measurements, such as body mass index or hip and waist circumferences, as proxies for obesity and body fat distribution, but lacking assessments of lean body mass. Recently, a subsample of the Women’s Health Initiative (WHI) Estrogen Plus Progestogen (EPT) Trial was used to investigate the affect of EPT on body composition.5 This subsample included women who had body composition measurements at baseline and year 3 from the three WHI bone mineral density (BMD) centers. The findings from the subsample indicated that a 3-year EPT intervention significantly helped to maintain lean body mass and prevented the shift toward android fat distribution in postmenopausal women. The effect size of EPT on lean body mass was relatively small (< 1 kg), however, we should expect that the beneficial treatment effect of E alone from the WHI ET trial on body composition to be at least as large as the findings from the WHI EPT trial, because previous studies have suggested that the magnitude of the impact of estrogen alone therapy on body composition might be larger than that of the EPT therapy6. It has been reported that both EPT and E alone interventions significantly reduced fracture risk among postmenopausal women.7,8 In order to understand the clinical implications of the beneficial effect of HT on lean body mass, we proposed to investigate whether the preserved lean body mass by HT contributed to the reduction of fracture risks among women assigned to hormone interventions in both the EPT and the ET trials. Most fractures occur because of a fall. Hence, we also tested whether the lean body mass effects of HT also influence fall risk. We hypothesized that long-term use of postmenopausal HT (estrogen plus progestogen therapy, EPT; estrogen therapy alone, ET) would favorably affect age-related changes in lean body mass and that this favorable effect on lean body mass would contribute to a decrease in fractures. |
| Databáze: | OpenAIRE |
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