leptin and tibolone

To compare the changes in body composition and in leptin levels in postmenopausal women receiving hormone therapy (HT) or tibolone.. Prospective comparative study.. Menopause Unit in a tertiary Hospital.. One hundred twenty women were recruited.. Women were assigned into a control group, HT, and tibolone group.. Anthropometric indices, leptin levels, tissue fat percentage, total fat, and lean mass measurements were performed at baseline and after 6 months.. The serum leptin levels were in strong correlation with the total fat percentage and total fat mass at baseline. Untreated women had weight gain and a gradual decrease in leptin levels. Women receiving HT had significantly increased leptin levels. Women in the tibolone group, however, had a significant decrease in leptin levels accompanied by decreased total fat mass, fat percentage, and increased total lean mass. The changes in leptin levels were more pronounced in lean women.. Postmenopausal women tend to gain weight accompanied with a reduction in leptin concentrations. Hormone therapy administration increases leptin levels while maintaining body weight and body fat distribution, whereas tibolone use decreases leptin levels, total fat percentage, and total fat mass.

Topics: Adiposity; Adult; Body Mass Index; Estrogen Replacement Therapy; Estrogens, Conjugated (USP); Female; Humans; Leptin; Medroxyprogesterone Acetate; Middle Aged; Norpregnenes; Postmenopause; Time Factors; Treatment Outcome; Waist-Hip Ratio; Weight Gain

Leptin and ghrelin are increasingly being recognized as cardiotropic hormones, promoting or inhibiting the atherosclerotic process, respectively. Apoptosis may be one pathway through which the actions of these hormones are mediated. Sex hormones are reported to influence the secretion and action of ghrelin and leptin.. To evaluate (1) the association of circulating ghrelin and leptin with selected markers of receptor-mediated apoptosis and (2) the effect of estrogen monotherapy, low dose estrogen-progestin therapy, tibolone and raloxifene on serum ghrelin and leptin in healthy postmenopausal women.. Eighty eight postmenopausal women aged 44-62 years were randomly allocated to daily (1) conjugated equine estrogens 0.625 mg (CEE), (2) 17beta-estradiol 1mg plus norethisterone acetate 0.5 mg (E(2)/NETA), (3) tibolone 2.5mg, (4) raloxifene HCl 60 mg or (5) no treatment. Serum markers of apoptosis sFas, Fas-ligand (Fas-L) and caspase-1 were measured at baseline. Serum leptin and ghrelin were measured at baseline and at 3 months.. Body Mass Index (BMI) and estradiol levels correlated positively, while FSH correlated negatively with serum leptin (BMI: r=0.646, p=0.005, estradiol: r=0.432, p=0.001, FSH: r=-0.401, p=0.002). Insulin levels associated positively with circulating leptin (r=0.394, p=0.011) and negatively with circulating ghrelin (r=-0.401, p=0.009). Serum leptin decreased significantly in E2/NETA group (baseline: 2.882+/-0.76 ng/ml, 3 months: 2.687+/-0.66 ng/ml, p=0.043), while it increased significantly in the raloxifene group (baseline: 2.671+/-0.54 ng/ml, 3 months: 2.839+/-0.47 ng/ml). Ghrelin levels decreased significantly only in the raloxifene group (baseline: 1634+/-592 pg/ml, 3 months: 1408+/-534 pg/ml).. Apoptosis may be a pathway through which leptin exerts a pro-atherogenic effect. Low dose HT may act cardioprotectively by decreasing leptin levels in healthy recently menopaused women.

Topics: Adult; Body Mass Index; Contraceptives, Oral, Synthetic; Estradiol; Estrogen Receptor Modulators; Estrogens; Estrogens, Conjugated (USP); Fas Ligand Protein; Female; Follicle Stimulating Hormone; Ghrelin; Hormone Replacement Therapy; Humans; Insulin; Leptin; Middle Aged; Norethindrone; Norethindrone Acetate; Norpregnenes; Raloxifene Hydrochloride; Sex Hormone-Binding Globulin

Leptin has a significant role in body weight regulation and energy balance. We examined the effect of tibolone on the body weight and serum leptin levels in postmenopausal women.. Twenty women (aged 43-60 years) participated in this prospective study. All women in this study protocol received 2.5 mg/day of tibolone. Absolute and body mass index (BMI)-corrected serum leptin concentrations and BMI values were measured at baseline, after 3 months, and after 6 months of the tibolone therapy.. Tibolone did not affect absolute and BMI-corrected serum leptin levels, and BMI values during the treatment. A significant linear correlation between BMI values and serum leptin levels was observed (p<0.05, r=0.67).. Tibolone seems not to affect serum leptin levels, body weight and BMI values of postmenopausal women. There is a significant correlation between serum leptin levels and BMI values.

Topics: Adult; Body Weight; Estrogen Receptor Modulators; Female; Humans; Leptin; Middle Aged; Norpregnenes; Postmenopause; Prospective Studies

To evaluate the effect of estrogen replacement therapy (ERT), continuous combined hormone replacement therapy (HRT) and tibolone on serum leptin levels in healthy postmenopausal women.. Eighty-four healthy postmenopausal women aged 43-63 years were studied prospectively. Hysterectomized women (n = 16) received conjugated equine estrogens (CEE) 0.625 mg. Women with an intact uterus were randomly allocated either to CEE+medroxyprogesterone acetate (CEE/MPA) 5 mg or tibolone 2.5 mg. Serum leptin levels were assessed at baseline and after 6 months of treatment.. The three groups did not differ with respect to age, body mass index (BMI) or baseline serum leptin levels. Overweight women (BMI > 25 kg/m2) had higher baseline leptin levels (27.0 +/- 11.4 ng/ml) compared to their lean counterparts (BMI < or = 25 kg/m2; leptin: 16.5 +/- 8.1 ng/ml, P = 0.0001). Neither CEE nor CEE/MPA had any effect on serum leptin levels at the end of 6 months either in overweight or in lean women (overweight: CEE baseline 34.4 +/- 13.3 ng/ml, 6 months 36.9 +/- 15.8, P = 0.89, CEE/MPA baseline 22.4 +/- 9.8 ng/ml, 6 months 26.8 +/- 8.7 ng/ml, P = 0.1; lean: CEE baseline 12.6 +/- 4.4 ng/ml, 6 months 13.2 +/- 5.8 ng/ml, P = 0.36, CEE/MPA baseline 17.2 +/- 10.6 ng/ml, 6 months 18.8 +/- 8.8 ng/ml, P = 0.31). Similarly serum leptin remained unchanged at the end of the study in both lean and overweight women on tibolone (overweight: baseline 22.9 +/- 8.1 ng/ml, 6 months 18.5 +/- 12 ng/ml, P = 0.37; lean: baseline 13.2 +/- 5.6 ng/ml, 6 months 17.3 +/- 8.4 ng/ml).. BMI is a strong determinant of serum leptin levels in healthy postmenopausal women. Neither ERT/HRT nor tibolone exert any effect on serum leptin after 6 months in lean or overweight postmenopausal women. Further studies are required to verify the exact role of estrogen and tibolone on leptin production and function in postmenopausal women.

Topics: Adult; Body Mass Index; Estrogen Receptor Modulators; Estrogens, Conjugated (USP); Female; Hormone Replacement Therapy; Humans; Leptin; Medroxyprogesterone Acetate; Middle Aged; Norpregnenes; Postmenopause; Prospective Studies; Treatment Outcome

To examine the relationships between serum leptin and bone metabolism, we measured bone mineral density (BMD) at the spine and the hip, fasting serum leptin, and osteocalcin and urinary excretion of C-terminal crosslinking telopeptide of type I collagen (CTX), as markers of bone formation and resorption, respectively, in 121 postmenopausal women aged 54 +/- 5 years. These parameters were also assessed at 6 months and 2 years of treatment with either 2.5 mg tibolone (n = 34), 1.25 mg tibolone (n = 45), or 2 mg estradiol plus 1 mg norethindrone acetate (n = 42). At baseline, serum leptin correlated positively with spine (r = 0.21, P = 0.02) and total hip (r = 0.26, P = 0.0044) BMD and negatively with CTX (r = -0.38, P < 0.0001) and osteocalcin (r = 0.21, P = 0.025). After adjustment for BMI and for fat mass, the association between serum leptin and CTX persisted with a partial correlation coefficient of -0.18 (P = 0.046) and of -0.22 (P = 0.03), respectively. Women in the highest quartile of leptin levels had 11% higher total hip (P = 0.0039) and lumbar spine BMD (P = 0.016), 21% lower osteocalcin (P = 0.01), and 38% lower CTX (P = 0.0005) than women in the lowest quartile (P < 0.05). During treatment, serum leptin levels increased (+14.7 +/- 47.3%, P = 0.019), without significant difference between the groups. This increase correlated with the increase in body weight (r = 0.46, P < 10(-4)). No correlation was found between the changes in leptin and the changes in bone parameters. In conclusion, leptin may play a role as a determinant of bone resorption in healthy, untreated postmenopausal women, but the effect of estradiol or tibolone on bone are not mediated by leptin.

Topics: Aged; Biomarkers; Bone Density; Bone Resorption; Double-Blind Method; Female; Humans; Leptin; Middle Aged; Norpregnenes; Osteoporosis, Postmenopausal; Postmenopause; Prospective Studies; Statistics, Nonparametric

Leptin seems to regulate reproductive function and it has been hypothesised that its secretion may be induced by oestrogens. Changes in its levels has been advocated as a determinant in the pathogenesis of premenstrual syndrome (PMS). We evaluated serum leptin levels in patients affected by PMS and in controls to establish: (i) if induced hypoestrogenism has an impact on leptin concentrations; (ii) if the administration of tibolone modifies the effects of hypoestrogenism on serum leptin levels; and (iii) if the improvement in PMS symptomatology can be correlated to changes in serum leptin levels.. Prospective, randomized study.. Twenty-eight women affected by PMS and 20 unaffected controls. Affected patients were randomly assigned to two groups to receive leuprolide acetate (3.75 mg intramuscularly) plus tibolone (2.5 mg/day) (group A; n = 14) or plus placebo (group B; n = 14), at the onset of the vasomotor symptoms.. Serum leptin, oestradiol and progesterone levels, PMS signs and symptoms evaluated during a 2 months' pretreament period and after 2 months of therapy.. No differences in leptin levels among the three groups and within the same group at all time evaluated were observed. Oestradiol and progesterone concentrations were significantly lower in all groups during treatment in comparison with pretreatment values. Before therapy, leptin levels were positively correlated both with oestradiol and progesterone in the follicular and luteal phase in all groups. This correlation was lost after treatment. All PMS patients showed a significant improvement of the symptomatology.. Hypoestrogenism induced by GnRH analogues (GnRHa) does not seem to influence leptin levels in normal women and those with PMS, and the addition of tibolone does not impact on these levels. Because PMS symptomatology did significantly improve during treatment with GnRHa alone, or in associtation with tibolone, it is unlikely that changes in leptin levels could have an important role in the pathophysiology of PMS.

Topics: Adult; Androgen Antagonists; Case-Control Studies; Estradiol; Female; Fertility Agents; Humans; Leptin; Leuprolide; Menstrual Cycle; Norpregnenes; Premenstrual Syndrome; Progesterone; Prospective Studies; Treatment Outcome

Several studies suggest that changes in estrogens and androgens during menopause play a role in the regulation of leptin production. Some authors present hypothesis that sex hormone replacement therapy can modulate leptin levels but up to date evidence shows that the influence of endogenous estrogens, androgens levels and sex hormone therapy on leptin concentration remains uncertain.. To evaluate the influence of surgically induced menopause on serum leptin levels and the influence of different types of hormonal therapy on serum leptin concentrations.. 58 women with surgically induced menopause were divided into three groups. Women who did not receive any hormonal substitution (group 1), women who received Estradiol l mg per day (group 2) and women who received Tibolone 2,5 mg per day (group 3). The levels of leptin, estradiol, testosterone, testosterone, dehydroepiandrosterone sulfate, FSH, LH and progesterone were measured in all subjects on the 5th day and after 3 months following the surgical procedure.. Mean serum leptin concentrations did not differ statistically in any of the studied groups in the beginning and in the end of the study. There was no correlations between serum leptin and estradiol, LH, FSH, progesterone, testosterone, free testosterone and DHEAS concentrations in any of groups before and after treatment.. Changes in sex hormone concentrations caused by ovariectomy do not influence serum leptin concentrations. Also the short term administration of low dose estrogen therapy or tibolone in postmenopausal subjects does not change serum leptin levels.

Topics: Adult; Estradiol; Estrogen Receptor Modulators; Estrogen Replacement Therapy; Female; Humans; Hysterectomy; Leptin; Menopause, Premature; Middle Aged; Norpregnenes; Ovariectomy

To estimate serum leptin levels in post-menopausal women, to relate these to the duration of the post-menopausal period, and to body mass index (BMI), and to assess the influence of tibolone on them.. Fifteen women (age 49-64 years) were included. Three groups were studied; I, those with normal BMI taking tibolone; II, those with a raised BMI taking tibolone, and III, a group with raised BMI not taking tibolone. Blood samples were drawn before and 1, 2, 6, 9 and 12 months after the initiation of tibolone or, in group III, after the start of the study.. Serum leptin concentrations were high in all women with abnormal BMI. Long-term tibolone administration did not have any significant effect on serum leptin concentrations. There was no correlation between serum leptin levels and the age and the duration of post-menopausal period. There was a high positive correlation between serum leptin levels and BMI values.. BMI values affect serum leptin concentrations but long-term tibolone administration does not seem to have any effect on serum leptin levels.

Topics: Age Factors; Aged; Anabolic Agents; Body Weight; Female; Humans; Leptin; Middle Aged; Norpregnenes; Postmenopause

After informed consent, blood samples were obtained to measure leptin, FSH, LH, insulin, 17-beta-estradiol, and IGF-1. No differences in serum leptin was observed between the women on Tibolone (8.1 +/- 4.2 ng/mL) and the control group (7.4 +/- 3.7 ng/mL). Women on Tibolone had lower insulin levels (16.4 +/- 1.8) than women without therapy (19.4 +/- 1.3 mU/mL) (p < 0.05). On the contrary IGF-I levels were elevated (150.0 +/- 16.4) as compared with those in non-treated women (121.0 +/- 13.4 ng/mL) (p < 0.05). Body weight was similar between the two groups. From these data it is concluded that Tibolone, as replacement therapy, does not increase circulating leptin and seems to have no effect on body weight.

Topics: Aged; Body Weight; Estradiol; Estrogen Replacement Therapy; Follicle Stimulating Hormone; Humans; Insulin; Insulin-Like Growth Factor I; Leptin; Luteinizing Hormone; Middle Aged; Norpregnenes; Postmenopause; Prodrugs; Selective Estrogen Receptor Modulators