Long-term postmenopausal hormone use, obesity, and fat distribution in older women

D. Kritz-Silverstein and E. Barrett-Connor
Department of Family and Preventive Medicine, University of California, San Diego, USA.

OBJECTIVE--To determine whether long-term postmenopausal hormone replacement is associated with measures of obesity and body composition in elderly women. DESIGN--A 15-year prospective and cross-sectional cohort study. SETTING--Rancho Bernardo, a geographically defined community in Southern California. PARTICIPANTS--A total of 671 women aged 65 to 94 years, who were initially enrolled in the Rancho Bernardo Study between 1972 and 1974 and participated in a 1988 to 1991 follow-up clinic visit. These women had never used hormone replacement therapy (n = 194), used hormones intermittently (n = 331), or used hormones continuously (n = 146) for the 15 years between baseline and follow-up. MAIN OUTCOME MEASURES--Height and weight were obtained at both clinic visits; differences in body mass index (BMI) between baseline and follow-up were computed. At follow-up, waist and hip circumferences and bioelectric impedance were measured. RESULTS--Age-adjusted comparisons indicated intermittent and continuous hormone users had significantly lower mean BMIs at baseline than women who had never used hormone replacement therapy. After adjustment for potentially confounding covariates, there were no significant differences between estrogen users and nonusers in BMI at follow-up, change in weight or BMI between baseline and follow-up, or waist-hip ratio or fat mass at follow-up. CONCLUSION--Hormone replacement therapy, whether used intermittently or continuously for 15 or more years, is not associated with the weight gain and central obesity that is commonly observed in postmenopausal women.

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