Plasma leptin and adiponectin levels in hormone replacement therapy and contraception: effects of different progestogens.

OBJECTIVE

To evaluate the impact of hormone replacement therapy and oral contraceptives containing different progestogens on adiponectin and leptin serum levels.

DESIGN

Prospective, longitudinal, semi-randomized study.

SETTING

General gynecology clinic of a university hospital.

PATIENT(S): Forty-five healthy postmenopausal and 45 healthy premenopausal women.

INTERVENTION(S): Thirty postmenopausal women were randomized to receive either drospirenone (DRSP) 2 mg + E(2) 1 mg (n = 15) or norethisterone acetate (NETA) 0.5 mg + E(2) 1 mg (n = 15). Thirty premenopausal women were randomized to receive either ethinilestradiol (EE) 0.020 mg + DRSP 3 mg (n = 15) or EE 0.020 mg + desogestrel 0.15 mg (n = 15). Furthermore, 15 postmenopausal and 15 premenopausal untreated women served as controls.

MAIN OUTCOME MEASURE(S): Adiponectin and leptin serum levels before and after 6 months of hormonal therapy.

RESULT(S): No significant differences in leptin levels were detected in any group after 6 months. Adiponectin levels were significantly reduced in the NETA + E(2) group and increased in the EE + DRSP group, while remaining unmodified in all other groups.

CONCLUSION(S): Hormone replacement therapy with NETA, but not with DRSP, decreases serum adiponectin levels. Oral contraceptives containing DRSP increase serum adiponectin levels.