Effect of percutaneous androgen replacement therapy on body composition and body weight in postmenopausal women
Introduction
Obesity and weight gain appear in ≈60% of postmenopausal women. Abdominal fat distribution, independent of total adiposity, has been shown to be an important risk factor for metabolic and cardiovascular disease in women [1], as well as men [2]. A number of factors are known to influence abdominal fat distribution, including aging [3], smoking, alcohol consumption and hormones 4, 5.
Considerable attention has been focused on the role of androgens and estrogens in modulating abdominal fat distribution. In clinical studies, correlations between testosterone levels and visceral fat accumulation have been shown in both men and women [6]. On the one hand, the increase of visceral and truncal fat is observed in patients with ovarian hyperandrogenism and PCO syndrome [7]. On the other hand, it is well known that hypoandrogenemia in postmenopausal women results in increased subcutaneous abdominal fat 8, 9. Marin et al. [10], demonstrated that administration of testosterone decreased visceral fat without significantly affecting subcutaneous fat or overall body composition. Lovejoy et al. [11], recently demonstrated that the administration of exogenous androgens modulates body composition in obese postmenopausal women and independently reduces visceral and subcutaneous fat.
Data on this field are conflicting. Furthermore, it is known that androgen treatment can decrease abdominal fat as the expression of lipolytic β-adrenergic receptors is positively autoregulated by testosterone [12]and, therefore, enhancement of lipolysis can be expected. To our knowledge there are no data available on the effect of topically administered androgen upon female adipose tissue and body fat distribution. The purpose of this placebo-controlled trial was to determine the effect of topical androgen replacement therapy (Andractim®) on body composition and subcutaneous fat distribution in postmenopausal women.
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Subjects
The data of the present study were collected from 39 healthy postmenopausal women, (mean: 51.4±2.24 years), who were recruited from the Menox® Vienna outpatient menopause clinic between January 1996 and January 1997, to which they had been referred for hormonal check up and body composition measurement because of increasing body weight. None of the women had undergone uni- or bilateral oophorectomy or hysterectomy. All of the patients had already experienced natural menopause 3 months to 2
Results
As all of the women who entered the study completed the trial after 6 months, data of 39 subjects could be evaluated.
In group A, significant changes were observed after 6 months of treatment in respect of the following parameters: total body weight (P<0.05), body mass index (P<0.05), percentage of abdominal fat (P<0.05), percentage of gluteo-femoral fat (P<0.05) and percentage of total body fat (P<0.05). Absolute fat reduction in the abdominal and gluteo-femoral region, measured in kilograms,
Discussion
In our placebo-controlled, prospective, clinical study, we investigated the lipolytic effect of androgen replacement therapy on adipose tissue, body weight and body composition by applying a steroidal substance in a topical-administration formula to the subcutaneous abdominal and gluteo-femoral region of adipose postmenopausal women. Within 24 weeks of topical treatment with androstanolone, we were able to evaluate a highly significant decrease of adipose tissue in the abdominal region but not
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Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data
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Endocrinology of anorexia of ageing
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