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Is there evidence that estrogen therapy promotes weight maintenance via effects on leptin?

Springer, Alyse M. BS1; Foster-Schubert, Karen MD2; Morton, Gregory J. PhD3; Schur, Ellen A. MD, MS1,4

doi: 10.1097/GME.0000000000000117
Review Article

Objective: Leptin, a hormone secreted by adipocytes, plays a crucial role in regulating energy balance. Estrogen, like leptin, reduces food intake and adiposity while increasing energy expenditure in animals and humans of both sexes through its actions on the central nervous system. We reviewed the literature for studies of the effects of exogenously administered estrogen on serum leptin concentrations and adiposity in women.

Methods: Using PubMed/Medline, we searched for studies of hormone therapy that enrolled healthy postmenopausal women. Studies were further evaluated to determine if leptin and adiposity were monitored both at baseline and throughout a treatment period of at least 2 months.

Results: Twenty articles met inclusion criteria. We found no consistent effects of exogenous estrogen on serum leptin concentrations, adiposity, or weight gain.

Conclusions: Despite suggestive data from animal studies, the current literature does not provide compelling evidence that estrogen therapy attenuates weight gain, alters circulating leptin levels, or improves leptin action in postmenopausal women.

From the 1University of Washington School of Medicine, Seattle, WA; 2Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine and VA Puget Sound Health Care System, Seattle, WA; 3Diabetes and Obesity Center of Excellence and 4Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA.

Received May 22, 2013; revised and accepted August 27, 2013.

Funding/support: E.A.S. was supported by National Institutes of Health grant DK083502 and a Diabetes and Endocrinology Research Center Pilot and Feasibility Award (P30DK017047).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Ellen A. Schur, MD, MS, Harborview Medical Center, 325 Ninth Avenue, Box 359780, Seattle, WA 98104. E-mail: ellschur@uw.edu

© 2014 by The North American Menopause Society.