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Influence of transdermal estradiol in the regulation of leptin levels of postmenopausal women: a double-blind, placebo-controlled study

Cagnacci, Angelo MD1; Malmusi, Stefania MD1; Arangino, Serenella MD1; Zanni, Annalisa MD1; Rovati, Lucio PhD2; Cagnacci, Paolo MD3; Volpe, Annibale MD1


Objective: To investigate whether the administration of transdermal estradiol is capable of modifying circulating levels of leptin.

Design: Forty postmenopausal women randomly received in a double-blind fashion, a transdermal patch containing either placebo or estradiol (50 μg/day). After 2 months of treatment, they were switched to the alternate treatment for another 2 months. Leptin levels were measured at the end of the placebo and estradiol administration. In a subset of 28 women an evaluation of body composition via bioelectrical impedance and an oral glucose tolerance test (OGTT; 75 g) were also performed at the end of the placebo and estradiol administration. Glucose, insulin, and leptin levels were measured in all OGTT samples.

Results: Leptin levels were related directly to body mass index (BMI), fat mass, and insulin, and inversely related to lean mass. In comparison to placebo, transdermal estradiol increased estradiol (from 77.8 ± 8.4 pmol/l to 183.1 ± 20.9 pmol/l;p < 0.0001) but did not significantly modify leptin (19.1 ± 2.4 μg/l vs. 18.6 ± 2 μg/l) or BMI. Estradiol did not modify fat mass or lean mass, significantly increased intracellular water (31.1 ± 0.7% vs. 37.2 ± 2.3%, p < 0.05), and decreased extracellular water (40.5 ± 0.7% vs. 36.3 ± 1.7%;p < 0.04). Leptin did not increase during OGTT, but a significant decrease, linearly related to BMI (r = 0.519;p = 0.0189), was observed at the end of the test.

Conclusions: Low doses of transdermal estradiol exert no influence on fasting leptin levels or BMI. The possibility that different doses of estradiol exert a more pronounced effect on circulating leptin needs to be addressed in comparative studies.

From the 1 Institute of Obstetrics and Gynecology of Modena, via del Pozzo 71, Modena, 2 Rotta Research Laboratorium, Società per Azioni, Monza, and 3 Institute of Internal Medicine II of Pisa, via Roma 67, Pisa, Italy.

Received May 10, 2001;

revised and accepted July 17, 2001.

Address reprint requests to Angelo Cagnacci, Istituto di Ginecologia e Ostetricia, Policlinico di Modena, via del Pozzo 71, 41100 Modena, Italy. E-mail:

©2002The North American Menopause Society