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Effects of bilateral ovariectomy and postoperative hormonal replacement therapy with 17-estradiol or raloxifene on serum leptin levels

Tommaselli, Giovanni A. MD1; Di Carlo, Costantino MD1; Nasti, Anna MD1; Giordano, Elena MD1; Pisano, Gustavo MD2; Pellicano, Massimiliano MD1; Bifulco, Giuseppe MD1; Nappi, Carmine MD1

Articles

Objective: To verify the effects of hypoestrogenism and replacement therapy on body mass index (BMI) and leptin in ovariectomized women.

Design: We conducted a longitudinal study on 56 women undergoing abdominal bilateral ovariectomy divided into three groups: 19 untreated controls, 18 scheduled to receive 17β-estradiol, and 19 on raloxifene starting 15 days after surgery. Height, weight, and BMI were recorded on the day of surgery, 5 and 15 days later, and then after 6 months. Leptin and estradiol concentrations were determined by radioimmunoassay on the day of surgery, days 1, 5, and 15, and 6 months after.

Results: Leptin levels rose significantly on the day after surgery [median (range): 18.2 (9.8–25.0), 12.5 (9.1–20.9), and 20.5 (12.9–24.5);P < 0.01 v basal] and returned to values similar to baseline on day 5 in all groups. Six months later, controls showed significantly higher leptin levels in comparison with both treated women and basal values [median (range): 19.7 (10.4–22.8), 11.0 (7.6–16.9), and 13.5 (9.1–14.8) ng/ml;P < 0.01). Estradiol levels decreased in all groups, reaching statistical significance 5 days after surgery (P < 0.01 v basal). A significant rise was observed 6 months after surgery in women treated with estrogens (P < 0.01). Six months after surgery, BMI increased in untreated controls in comparison with treated women and baseline, although not significantly.

Conclusions: The absence of modifications in leptin on days 5 and 15 after ovariectomy suggests that, in humans, estrogens may not exert an important effect on leptin secretion. After 6 months, replacement therapy maintained leptin levels and BMI was unmodified, whereas untreated controls showed a significant increase in leptin and a trend toward higher BMI, suggesting that replacement therapy may prevent changes in fat distribution and in leptin levels.

From the 1Department of Obstetrics and Gynecology, University of Naples “Federico II,” the 2Department of Endocrinology, Second University of Naples, Italy.

Received February 8, 2002; revised and accepted September 11, 2002.

Address reprint requests to Giovanni A. Tommaselli, MD, Department of Obstetrics, Gynecology and Pathophysiology of Human Reproduction, University of Naples “Federico II,” Via S. Pansini, 5 80131 Naples, Italy. E-mail: gtommaselli@yahoo.it.

©2003The North American Menopause Society