the role of estrogen in adipocyte remodeling following surgical menopause

Conditions: Menopause Surgical; Estrogen Deficiency; Adiposity

Summary: the overarching aim of this study is to assess the downstream effects of abrupt estrogen deficiency in women undergoing elective bilateral oophorectomy by studying: 1. the rate of in vivo adipogenesis in the subcutaneous abdominal (scabd) and subcutaneous femoral (scfem) adipose tissue depots following bilateral oophorectomy surgery using an innovative (and tested) 8-week incorporation of stable isotope (deuterium; 2h) administered in the form of heavy water (2h2o) to endogenously label adipose tissue dna; 2. the changes in expression of subcutaneous adipose tissue genes and proteins specific to adipocyte expansion and function; extracellular matrix remodeling and fibrosis; and inflammation in the scabd and scfem depots before and after elective bilateral oophorectomy.

this is a cross-sectional study that will enroll up to 10 women undergoing laparoscopic, elective bilateral oophorectomy at a local hospital in baton rouge, la. women will complete 7 study visits over 3 months; a single screening visit to assess eligibility, a pre-bilateral oophorectomy visit for imaging and adipose tissue biopsy collection, and 5 post-bilateral oophorectomy visits to "dose", maintain compliance and subject retention, and perform follow-up imaging and adipose tissue biopsy collection for outcome measures.

Eligibility criteria:
inclusion criteria: * healthy females * ages 18-45 y * bmi between 25 kg/m2 and 40 kg/m2 (±0.5 kg/m2 will be accepted) * are pre-menopausal (follicle-stimulating hormone, fsh\<40 miu/ml) * asymptomatic for the following menopause-related symptoms: hot flashes, insomnia (trouble sleeping), or mood swings * planning to have a laparoscopically, elective bilateral oophorectomy * no medical indication for increased cancer risk * are willing to drink heavy water (2h2o) over an 8-week period * medically cleared for participation in the study by ob/gyn and medical investigator * are willing to have blood and fat tissue stored for future use exclusion criteria: * unstable weight in the last 3 months \[gain or loss \>7 lb (or 3.2 kg)\] * significant changes in diet or physical activity level within the past month * smoking or use of tobacco products within the last 3 months * amenorrhea (or absence of regular monthly cycles) * history of clinically diagnosed diabetes or a fasting blood glucose \>126 mg/dl * average screening blood pressure \>140/90 mmhg * chronic use of systemic glucocorticoids, systemic adrenergic-stimulating agents, antipsychotic/antidepressant medications, thiazolidinediones, and other medications that cause clinically significant weight gain, weight loss or are known to make changes in fat cell number/size. * previous bariatric surgery (or other surgeries) for obesity or weight loss * use of over the counter or prescription weight loss products * history of metabolic diseases (other than diabetes) * history of neurological disease * history of cardiovascular disease (or other chronic diseases) * unable or unwilling to have an mri performed * pregnant, planning to become pregnant, or breastfeeding * use of hormone replacement therapy. * unwilling to discontinue any form or hormonal therapy (e.g., contraceptives including birth control pills, vaginal ring, injections, implant, or skin patch; hormonal supplements, etc.) upon enrollment (after the screening visit).