Plasma leptin and adiponectin levels in hormone replacement therapy and contraception: effects of different progestogens

ObjectiveTo evaluate the impact of hormone replacement therapy and oral contraceptives containing different progestogens on adiponectin and leptin serum levels.DesignProspective, longitudinal, semi-randomized study.SettingGeneral gynecology clinic of a university hospital.Patient(s)Forty-five healthy postmenopausal and 45 healthy premenopausal women.Intervention(s)Thirty postmenopausal women were randomized to receive either drospirenone (DRSP) 2 mg + E2 1 mg (n = 15) or norethisterone acetate (NETA) 0.5 mg + E2 1 mg (n = 15). Thirty premenopausal women were randomized to receive either ethinilestradiol (EE) 0.020 mg + DRSP 3 mg (n = 15) or EE 0.020 mg + desogestrel 0.15 mg (n = 15). Furthermore, 15 postmenopausal and 15 premenopausal untreated women served as controls.Main Outcome Measure(s)Adiponectin and leptin serum levels before and after 6 months of hormonal therapy.Result(s)No significant differences in leptin levels were detected in any group after 6 months. Adiponectin levels were significantly reduced in the NETA + E2 group and increased in the EE + DRSP group, while remaining unmodified in all other groups.Conclusion(s)Hormone replacement therapy with NETA, but not with DRSP, decreases serum adiponectin levels. Oral contraceptives containing DRSP increase serum adiponectin levels.