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Objectives <p>To investigate the association between hormone replacement therapy (HRT) and change in body composition in post-menopausal women in the Baltimore Longitudinal Study of Aging (BLSA).</p> Materials and methods <p>We included postmenopausal women with repeated dual-energy X-ray absorptiometry measurements and documented HRT status. HRT users were propensity score–matched to non-users based on baseline characteristics including age, height, weight, race, smoking, alcohol use, physical activity, education, age at menopause, age at first pregnancy, oral contraceptive use, and oophorectomy. Linear mixed-effects models assessed associations between current HRT use and longitudinal changes in fat and lean mass. Age was modeled as a time-varying continuous variable using piecewise linear splines at 60, 70, and 80&#xa0;years. Interaction terms between HRT use and age were included to evaluate differences in age-related trajectories.</p> Results <p>HRT users (<i>n</i> = 91) and matched non-users (<i>n</i> = 220) had similar baseline characteristics. No significant interactions were found between HRT use and age for lean mass (all <i>p</i> &gt; 0.05), and the likelihood ratio test (LRT) showed no improvement in model fit with interaction terms (<i>p</i> = 0.20). In contrast, fat mass trajectories differed by HRT status. Before age 60, HRT users experienced significantly greater fat mass gain (<i>β</i> = 596&#xa0;g/year; 95% CI 75, 1117). After age 60, this reversed, with HRT users gaining 869&#xa0;g/year less fat than non-users (<i>β</i> = –869&#xa0;g/year; 95% CI − 1583, − 155), indicating a protective association of HRT after age 60. No significant differences were observed at ages 70 or 80. The LRT supported including interaction terms (<i>p</i> = 0.04).</p> Conclusion <p>HRT use is associated with less fat accumulation beyond the age of 60, although this association attenuates with advancing age. No differential association with lean mass was observed.</p>

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Hormone replacement therapy and muscle loss: repeated measures analysis from the Baltimore Longitudinal Study of Aging using DXA

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Elena Ghotbi,
  • John McGready,
  • Roham Hadidchi,
  • Hamza Ahmed Ibad,
  • Eleanor M. Simonsick,
  • Qian-Li Xue,
  • Jennifer S. R. Mammen,
  • Shadpour Demehri

摘要

Objectives

To investigate the association between hormone replacement therapy (HRT) and change in body composition in post-menopausal women in the Baltimore Longitudinal Study of Aging (BLSA).

Materials and methods

We included postmenopausal women with repeated dual-energy X-ray absorptiometry measurements and documented HRT status. HRT users were propensity score–matched to non-users based on baseline characteristics including age, height, weight, race, smoking, alcohol use, physical activity, education, age at menopause, age at first pregnancy, oral contraceptive use, and oophorectomy. Linear mixed-effects models assessed associations between current HRT use and longitudinal changes in fat and lean mass. Age was modeled as a time-varying continuous variable using piecewise linear splines at 60, 70, and 80 years. Interaction terms between HRT use and age were included to evaluate differences in age-related trajectories.

Results

HRT users (n = 91) and matched non-users (n = 220) had similar baseline characteristics. No significant interactions were found between HRT use and age for lean mass (all p > 0.05), and the likelihood ratio test (LRT) showed no improvement in model fit with interaction terms (p = 0.20). In contrast, fat mass trajectories differed by HRT status. Before age 60, HRT users experienced significantly greater fat mass gain (β = 596 g/year; 95% CI 75, 1117). After age 60, this reversed, with HRT users gaining 869 g/year less fat than non-users (β = –869 g/year; 95% CI − 1583, − 155), indicating a protective association of HRT after age 60. No significant differences were observed at ages 70 or 80. The LRT supported including interaction terms (p = 0.04).

Conclusion

HRT use is associated with less fat accumulation beyond the age of 60, although this association attenuates with advancing age. No differential association with lean mass was observed.