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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