Van Pelt R E, Gozansky W S, Wolfe P, Kittelson J M, Jankowski C M, Schwartz R S, Kohrt W M
Division of Geriatric Medicine Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Obesity (Silver Spring). 2014 Apr;22(4):1024-31. doi: 10.1002/oby.20653. Epub 2013 Dec 6.
Estrogen-based hormone therapy (HT) attenuates abdominal fat gain after menopause, but whether HT improves abdominal fat loss during weight loss is unknown. It was hypothesized that HT or a selective estrogen receptor modulator (raloxifene) would augment reductions in abdominal visceral fat during weight loss when compared to placebo, potentially increasing improvements in glucose tolerance and lipid profile.
Healthy postmenopausal women (n = 119; age 50-70 yr) underwent a 6-month weight-loss (primarily exercise) intervention with randomization to raloxifene (60 mg/d), HT (conjugated estrogens, 0.625 mg/d), or placebo. Outcomes were change in total and abdominal (visceral and subcutaneous) fat mass, lipid profile, and fasting and post-challenge glucose and insulin.
Neither HT nor raloxifene augmented loss of total or abdominal fat mass during exercise-induced weight loss when compared with placebo. Weight loss-induced improvements in risk factors were similar among the three groups, except for a greater reduction in fasted glucose in the HT group (difference in change [95%CI] from placebo; -0.40 [-0.76, -0.05]) and greater reductions in LDL (-0.36 [-0.63, -0.09]) and increases in HDL (0.15 [0.07, 0.24]) in both treatment groups.
Postmenopausal HT and raloxifene did not increase abdominal fat loss during weight loss, but did improve some cardiometabolic outcomes.
基于雌激素的激素疗法（HT）可减轻绝经后腹部脂肪增加，但HT是否能改善减肥期间的腹部脂肪减少尚不清楚。研究假设，与安慰剂相比，HT或选择性雌激素受体调节剂（雷洛昔芬）在减肥期间会增强腹部内脏脂肪的减少，可能会增加葡萄糖耐量和血脂水平的改善。
健康绝经后女性（n = 119；年龄50 - 70岁）接受为期6个月的减肥（主要是运动）干预，并随机分为雷洛昔芬组（60毫克/天）、HT组（结合雌激素，0.625毫克/天）或安慰剂组。观察指标包括总体脂肪量和腹部（内脏和皮下）脂肪量的变化、血脂水平、空腹及餐后葡萄糖和胰岛素水平。
与安慰剂相比，在运动诱导的减肥过程中，HT和雷洛昔芬均未增加总体或腹部脂肪量的减少。三组之间因减肥导致的危险因素改善情况相似，但HT组空腹血糖降低幅度更大（与安慰剂相比变化差异[95%CI]；-0.40[-0.76, -0.05]），且两个治疗组的低密度脂蛋白降低幅度更大（-0.36[-0.63, -0.09]），高密度脂蛋白升高幅度更大（0.15[0.07, 0.24]）。
绝经后HT和雷洛昔芬在减肥期间并未增加腹部脂肪减少，但确实改善了一些心血管代谢指标。
