Anderson E J, Lavoie H B, Strauss C C, Hubbard J L, Sharpless J L, Hall J E
General Clinical Research Center and the Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Metabolism. 2001 Mar;50(3):265-9. doi: 10.1053/meta.2001.21015.
Postmenopausal women (PMW) commonly believe that hormone replacement (HR) leads to weight gain, and fear of weight gain and/or an actual increase in weight is one of the principle reasons evoked for the discontinuation of HR. However, the potential effects of physiologic HR on body composition have yet to be separated from the effects of lifestyle or aging. Therefore, we examined the effect of short-term hormone replacement and age on alterations in weight, body composition, and energy balance. A prospective study of 28 healthy PMW aged 45 to 55 years (younger PMW, studies completed n = 18) and 70 to 80 years (older PMW, studies completed n = 15) was conducted. The last menstrual period was more than 12 months previously. The women had a body mass index (BMI) less than 30 kg/m(2) and were taking no medication. Subjects were studied at baseline, after 1 month of transdermal estrogen (Estraderm, 50 microg/day) administration (E2), followed by a further month of transdermal estrogen with progesterone (100 mg per vagina twice daily) for the final 7 days (E2 + P). Anthropometric measurements and energy assessments were performed at each visit. Physiologic HR was achieved in each subject, and there was no difference between levels achieved in older and younger women. Resting energy expenditure and activity level were positively correlated with fat-free mass (P <.0001), while energy intake was not. Resting energy expenditure was lower in older compared with younger PMW when adjusted for fat-free mass (P <.005). Energy intake was also lower in the older PMW when corrected for fat-free mass (P <.0001); as was activity level (P <.05). There was no effect of hormonal treatment on any of the parameters measured. Changes in weight from baseline for E2 (0.37 +/- 0.25 and 0.61 +/- 0.27 kg in younger and older) and E2 + P (0.11 +/- 0.38 and 0.28 +/- 0.31 kg) were not statistically significant. In addition, there was no difference in BMI, fat mass, fat-free mass, total body water, or waist-to-hip ratio (WHR) between groups or with hormonal treatment. In conclusion, short-term transdermal HR is not associated with significant changes in weight or other anthropometric measures in younger or older PMW. These studies confirm the decrease in energy expenditure that occurs with aging, but indicates that there is no effect of HR on resting energy expenditure.
绝经后女性（PMW）普遍认为激素替代疗法（HR）会导致体重增加，而对体重增加的恐惧和/或实际体重增加是导致停用HR的主要原因之一。然而，生理性HR对身体成分的潜在影响尚未与生活方式或衰老的影响区分开来。因此，我们研究了短期激素替代疗法和年龄对体重、身体成分及能量平衡变化的影响。对28名年龄在45至55岁（年轻PMW，完成研究的n = 18）和70至80岁（年长PMW，完成研究的n = 15）的健康PMW进行了一项前瞻性研究。末次月经时间在12个月以前。这些女性的体重指数（BMI）小于30kg/m²，且未服用任何药物。在基线期、经皮给予雌激素（雌二醇贴片，50μg/天）1个月后（E2），以及在最后7天进一步经皮给予雌激素加孕激素（每天经阴道给予100mg，每日两次）1个月后（E2 + P）对受试者进行研究。每次访视时均进行人体测量和能量评估。每位受试者均实现了生理性HR，且年长女性和年轻女性所达到的水平无差异。静息能量消耗和活动水平与去脂体重呈正相关（P <.0001），而能量摄入则不然。在根据去脂体重进行调整后，年长PMW的静息能量消耗低于年轻PMW（P <.005）。在根据去脂体重进行校正后，年长PMW的能量摄入也较低（P <.0001）；活动水平也是如此（P <.05）。激素治疗对所测量的任何参数均无影响。E2组（年轻组和年长组分别为0.37±0.25kg和0.61±0.27kg）和E2 + P组（0.11±0.38kg和0.28±0.31kg）相对于基线的体重变化无统计学意义。此外，两组之间或激素治疗前后在BMI、脂肪量、去脂体重、全身水含量或腰臀比（WHR）方面均无差异。总之，短期经皮HR与年轻或年长PMW的体重或其他人体测量指标的显著变化无关。这些研究证实了随着年龄增长能量消耗会减少，但表明HR对静息能量消耗无影响。
