Estrogen or raloxifene during postmenopausal weight loss: adiposity and cardiometabolic outcomes

Obesity (Silver Spring). 2014 Apr;22(4):1024-31. doi: 10.1002/oby.20653. Epub 2013 Dec 6.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: Postmenopausal HT and raloxifene did not increase abdominal fat loss during weight loss, but did improve some cardiometabolic outcomes.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity / drug effects*
  • Aged
  • Blood Glucose / metabolism
  • Body Composition / drug effects
  • Energy Metabolism
  • Estrogen Replacement Therapy*
  • Estrogens / pharmacology*
  • Estrogens / therapeutic use
  • Exercise
  • Female
  • Humans
  • Insulin / blood
  • Lipids / blood
  • Middle Aged
  • Obesity / metabolism*
  • Obesity / prevention & control
  • Obesity / therapy
  • Postmenopause / blood
  • Raloxifene Hydrochloride / pharmacology*
  • Raloxifene Hydrochloride / therapeutic use
  • Selective Estrogen Receptor Modulators / pharmacology*
  • Selective Estrogen Receptor Modulators / therapeutic use
  • Treatment Outcome
  • Weight Loss / drug effects

Substances

  • Blood Glucose
  • Estrogens
  • Insulin
  • Lipids
  • Selective Estrogen Receptor Modulators
  • Raloxifene Hydrochloride