A prospective, cohort study of body composition in postmenopausal women: adipose and muscle tissue
Background: Menopausal hormone therapy (MHT) is part of the overall strategy for maintaining health in peri and postmenopausal women. MHT effectively suppresses menopausal manifestations and reduces the manifestations of late metabolic disorders. The use of a minimum clinically significant dose is recommended, which allows you to get an effect without increasing the risk of unwanted changes. Aims: the study of the relationship between indicators of body composition (fat and muscle mass) and the use of MHT in various doses in postmenopausal women. Materials and methods: A prospective, cohort study of 50 women with menopausal syndrome was conducted. Women were randomized into 3 groups. The first group included patients (n = 15) who were taking a combined low-dose MHT combination drug (estradiol 1 mg, drospirenone 2 mg) continuously, the second group (n = 15), patients taking a microdosed MHT drug (estradiol 0.25 mg , drospirenone 0.5 mg), the third group (n = 20) was formed by patients with natural postmenopause who refused to take MHT. Analysis of physical and clinical laboratory examinations: biochemical blood analysis, hormone testing, dual-energy absorptiometry were performed before treatment and after 12 months of observation . Results: When assessing the initial indicators of body composition in postmenopausal women, no significant differences between the compared groups were revealed. Adipose tissue averaged 37% (33-45), muscle in 52% (46-62), and visceral fat weight 980 g (780-1600). After a year of observation in groups 1 and 2, the total fat mass significantly decreased due to visceral fat (p = 0.021) and muscle mass increased (p = 0.022). In the third group, on the contrary, there is a tendency to increase adipose tissue due to visceral fat and the progression of sarcopenia. No significant differences between groups with different dosages of MHT were found, p = 0.080 . Conclusions: his study showed that systemic combined MHT, regardless of the dose of the components, contributes to a decrease in visceral adipose tissue and an increase in lean body mass (p = 0.022).