Effects of hormone replacement therapy on weight, abdominal fat distribution, and lipid levels in Japanese postmenopausal women

Objective: To investigate the effects of hormone replacement therapy (HRT) on weight, abdominal fat distribution, and fasting lipid levels in Japanese postmenopausal women (PMW). Design: Prospective, 12-month-controlled clinical comparison of women with and without HRT. Subjects: In all, 35 PMW with HRT (conjugated estrogens, 0.625 mg daily; medroxyprogesterone acetate, 2.5 mg daily; HRT group) and 26 PMW without HRT (control group). Measurements: Weight, abdominal fat distribution by computed tomographic measurements, lipid profiles, and sex hormones were determined at baseline and after 12 months of treatment or observation. Results: Weight did not change in any group. Visceral abdominal fat increased in controls, but not in the HRT group. Total and low-density lipoprotein cholesterol decreased, and triglyceride (TG) and high-density lipoprotein cholesterol increased in the HRT group; these did not change in the control group. When we divided women into those with android and gynoid types of abdominal fat distribution. Subjects with an android distribution showed reduced visceral fat with HRT, which also decreased the proportion of patients maintaining an android distribution. HRT did not alter abdominal fat distribution in subjects with a gynoid distribution. HRT increased serum TG in the android and the gynoid subgroups. Conclusion: Improved distribution of abdominal fat and fasting lipid levels except for TG may represent beneficial effects of HRT with respect to cardiovascular disease, but caution is warranted concerning TG elevation from HRT performed in PMW.