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Effect of medroxyprogesterone on arterial blood gases, leptin and neuropeptide Y in postmenopausal females

Depts of ¹ Pulmonary Diseases, ² Physiology and ³ Clinical Chemistry, Turku University Central Hospital and University of Turku, Turku, Finland

CORRESPONDENCE: T. Saaresranta, Dept of Pulmonary Diseases, Turku University Central Hospital, Kiinamyllynkatu 4–8, FIN-20520, Turku, Finland. Fax: 358 23133328. E-mail: tarja.saaresranta@tyks.fi

Keywords: breathing, chronic obstructive pulmonary disease, hypercapnia, leptin, neuropeptide Y, progesterone

Received: September 20, 2001
Accepted July 7, 2002

This work was supported by grants from the Finnish Medical Foundation, the Finnish Anti-Tuberculosis Association Foundation, the Väinö and Laina Kivi Foundation and the Turku University Foundation.

Natural progesterone, a potent respiratory stimulant, stimulates leptin production in premenopausal females. Leptin and its counterpart neuropeptide Y (NPY) have recently been linked with respiration. The effect of medroxyprogesterone acetate (MPA) on arterial blood gases, serum leptin and NPY was evaluated in this study.

Fourteen postmenopausal females with respiratory impairment, due mostly to chronic obstructive pulmonary disease, were recruited for a randomised, double-blind, placebo-controlled crossover trial. Arterial blood gases, serum leptin and NPY concentrations were measured at baseline and after 14 days of treatment with placebo and MPA, separated by a 6-week washout period.

Thirteen patients completed the trial. The mean±sd carbon dioxide tension in arterial blood (P_a,CO2) was 5.4±0.6 kPa at baseline, and decreased by 0.8±0.3 kPa during treatment with MPA. The oxygen tension in arterial blood (P_a,O2) and pH did not change. At baseline, the mean base excess was 0.6±1.9 mmol·L^–1 and the mean bicarbonate (HCO₃^–) concentration was 25.1±1.6 mmol·L^–1. With MPA, base excess decreased by 2.2±1.2 mmol·L^–1 and HCO₃^– by 1.9±1.0 mmol·L^–1 from baseline. The mean concentrations of serum leptin (19.8±9.9 µg·L^–1 at baseline, 19.7±9.8 µg·L^–1 with MPA) or NPY (94.0±18.3 pmol·L^–1 at baseline, 85.1±41.2 pmol·L^–1 with MPA) did not change. However, the reduction in P_a,CO2 correlated with the reduction of serum leptin concentration.

Medroxyprogesterone acetate effectively decreased the carbon dioxide tension in postmenopausal females with chronic respiratory impairment. The results suggest that a decrease in the carbon dioxide tension of 0.9 kPa is necessary for a reduction in serum leptin concentration.