Lavoie H B, Taylor A E, Sharpless J L, Anderson E J, Strauss C C, Hall J E
PROCREA BioSciences Inc., Quebec, Canada.
Clin Endocrinol (Oxf). 1999 Oct;51(4):415-22. doi: 10.1046/j.1365-2265.1999.00796.x.
Leptin is a hormone which is secreted by adipocytes and appears to influence the reproductive axis. Previous studies have demonstrated higher leptin levels in relation to body fat mass in women compared to men, higher levels in normally cycling compared to postmenopausal women, and a decrease in leptin levels with increased age. The purpose of this study was to determine whether oestrogen replacement with or without progesterone increases serum leptin levels in postmenopausal women, independently of changes in body fat, and to determine if ageing affects leptin levels at baseline or in response to hormone replacement.
Twenty-one healthy postmenopausal women on no hormone replacement were studied at baseline, after 1 month of oestrogen (E2: estraderm 50 microg/day) and after a further month of oestrogen and 7 days of progesterone (P: progesterone 100 mg per vagina bid) designed to achieve physiological hormone levels. Subjects included 11 younger (45-55 years) and 10 older (70-80 years) postmenopausal women.
The relationship between leptin and the absolute fat mass (% body fat x weight [kg]) at baseline was not different between the younger and older postmenopausal women. The adequacy of physiological hormone replacement was confirmed in all subjects. Despite the absence of an effect of hormone replacement on weight, body mass index (BMI), % and absolute fat mass (bioimpedance) or waist-hip ratio, there was an increase in serum leptin levels with hormone replacement (15.4 +/- 1.7, 17.6 +/- 1.7, and 18.1 +/- 1.6 microg/l; mean +/- SEM at baseline, with E2, and with E2 + P, respectively; P < 0.001 vs. baseline) for the group as a whole. An increase in leptin with hormonal treatment was seen in both the younger (15.1 +/- 2.1, 18.1 +/- 2.4, and 18.5 +/- 1.9 microg/l; P < 0.01) and the older (15.7 +/- 2.8, 17.0 +/- 2.5, 17.7 +/- 2.8 microg/l; P = 0.06) postmenopausal women.
(1) Short-term physiological oestrogen replacement increases serum leptin levels in postmenopausal women independently of changes in fat mass; and (2) physiological progesterone replacement does not influence leptin levels in postmenopausal women.
瘦素是一种由脂肪细胞分泌的激素，似乎会影响生殖轴。先前的研究表明，与男性相比，女性体内瘦素水平与体脂量的关系更为密切；与绝经后女性相比，正常月经周期女性的瘦素水平更高；且随着年龄增长，瘦素水平会下降。本研究的目的是确定绝经后女性单独使用雌激素或联合使用孕激素进行替代治疗是否会增加血清瘦素水平，而不受体脂变化的影响，并确定衰老是否会影响基线时或激素替代治疗后的瘦素水平。
对21名未接受激素替代治疗的健康绝经后女性进行了研究，分别在基线时、接受1个月雌激素（雌二醇：50微克/天经皮给药）治疗后以及再接受1个月雌激素和7天孕激素（黄体酮：每天经阴道给药100毫克，分两次）治疗后进行观察，旨在达到生理激素水平。研究对象包括11名较年轻（45 - 55岁）和10名较年长（70 - 80岁）的绝经后女性。
较年轻和较年长的绝经后女性在基线时瘦素与绝对脂肪量（体脂百分比×体重[千克]）之间的关系并无差异。所有受试者的生理激素替代治疗效果均得到确认。尽管激素替代治疗对体重、体重指数（BMI）、体脂百分比和绝对脂肪量（生物电阻抗法）或腰臀比均无影响，但整个研究组在接受激素替代治疗后血清瘦素水平有所升高（基线时、接受雌激素治疗时和接受雌激素加孕激素治疗时的平均水平±标准误分别为15.4±1.7、17.6±1.7和18.1±1.6微克/升；与基线相比，P<0.001）。较年轻（15.1±2.1、18.1±2.4和18.5±1.9微克/升；P<0.01）和较年长（15.7±2.8、17.0±2.5、17.7±2.8微克/升；P = 0.06）的绝经后女性在接受激素治疗后瘦素水平均有所升高。
（1）短期生理剂量的雌激素替代治疗可使绝经后女性血清瘦素水平升高，且不受脂肪量变化的影响；（2）生理剂量的孕激素替代治疗不会影响绝经后女性的瘦素水平。
