Female Sex Hormones, Insulin Resistance and Effects of Exercise in a Human Experimental Model of Menopause
Status:
Unknown status
Trial end date:
2018-08-01
Target enrollment:
Participant gender:
Summary
The main objective of this study is to investigate the role of female sex hormones in
relation to insulin resistance in a controlled human experimental model of menopause and to
explore whether exercise and/or hormone treatment (HT) can compensate for loss of endogenous
sex hormone production by maintaining insulin sensitivity and metabolic activity at a level
equivalent to what is seen in premenopausal women.
Loss of ovarian function is associated with an increased incidence of metabolic disease
including metabolic syndrome, type 2 diabetes and cardiovascular disease. This increased
disease incidence seems to be related to changes in body composition including decreased
skeletal muscle mass and increased visceral fat mass as well as decreased whole body fat
oxidation and energy expenditure. Regular physical activity decreases general mortality among
other things by increasing fat free mass and insulin sensitivity and hereby prevents
metabolic syndrome and cardiovascular disease - conditions seen with an increased incidence
after menopause and could therefore be a possible treatment.
In the present study the Investigators will assess the role of sex hormones in a model of
menopause where healthy women are undergoing planned bilateral oophorectomy due to risk of
hereditary ovary cancer. The use of this model makes it possible to control the time point
for loss of ovarian function and hereby investigate the timeframe and possible contributing
factors in a strictly controlled model. 48 premenopausal women will be included in the study.
The study is conducted in women who have already been offered surgical oophorectomy. The
first 2 months the study will be an observational cohort study. Hereafter the patients will
be allocated to one of four groups (n=12) in a randomized controlled trial, addressing the
effects of 6 months of exercise with or without HT. Type of surgery has been decided before
inclusion based on medical indications. The women will be offered HT according to national
guidelines, but the choice is up to them. Randomization applies only to the training
intervention.
Firstly the Investigators aim at investigating the role of endogenous female sex hormones and
HT in relation to insulin resistance, whole body fat oxidation and -energy expenditure,
changes in visceral fat mass and fat free mass after oophorectomy. Secondly, the
Investigators wish to study the molecular mechanisms behind the oophorectomy-induced insulin
resistance with a focus on insulin signaling in skeletal muscle and fat tissue. Lastly, the
investigators aim to explore whether exercise and/or HT can compensate for loss of endogenous
female sex hormone production by maintaining IS and metabolic activity, hereby preventing
future incidents of metabolic disease in relation to menopause.
All in all, this project will contribute with new knowledge concerning the question of how
endogenous female sex hormones affect insulin sensitivity and metabolic functioning and how
exercise may be used as a disease preventive modality for middle-aged women.