Postmenopausal hormone replacement and obesity

Objective: To compare the association of postmenopausal hormone replacement therapy and lipid and lipoprotein levels in obese and nonobese women.Methods: We studied 4,851 postmenopausal women participating in a population-based observational study. Using cross-sectional data, women were classified into four groups according to their hormone use: current users of estrogen only, current users of estrogen and progestin, never users of hormone replacement therapy, and former users of hormone replacement therapy. Body mass index was categorized as: normal (BMI < 27.3 kg/m(2)), overweight (27.3 kg/m(2) 32.3 kg/m(2)).Results: Hormone use was associated with lower total cholesterol and low-density lipoprotein levels and higher triglyceride levels among all categories of body mass index. However, there was an interaction between hormone use and body mass index for the outcome variable high-density lipoprotein. Among users of estrogen and progestin, high-density lipoprotein levels decreased as body mass index increased. Obese users of combination therapy had a mean high-density lipoprotein level similar to that in obese never users and obese former users of hormone replacement therapy.Conclusion: Our results suggest that, in general, hormone replacement therapy is associated with a favorable lipid profile regardless of body mass index. However, among obese women on combination estrogen and progestin therapy, hormone use was not associated with higher high-density lipoprotein concentrations compared to nonusers. This observation needs further study.