human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the efficacy of two ultra-low-dose 17β-estradiol plus norethisterone acetate ( NETA ) treatment regimens for relieving  menopausal symptoms . Design A total of 577 postmenopausal women were enrolled , in three treatment groups in a double-blind , r and omized , placebo-controlled study of 0.5 mg 17β-estradiol + 0.1 mg NETA or 0.5 mg 17β-estradiol + 0.25 mg NETA or placebo . Participants returned at weeks 4 , 8 , 12 and 24 for climacteric complaint evaluation based on a daily diary vasomotor symptom record . Patients were assessed by the Greene Climacteric Scale and urogenital symptoms were also evaluated . Results Treatment with ultra-low-dose 0.5 mg 17β-estradiol + 0.1 mg NETA ( 0.1 Group ) or 0.5 mg 17β-estradiol + 0.25 mg NETA ( 0.25 Group ) effectively reduced the severity and number of hot flushes within the initial weeks of therapy . Compared to placebo , a rapid , statistically significant decrease in the frequency and severity of hot flushes was achieved by week 3 , followed by further improvement which continued throughout the study . There were no statistically significant differences between the active treatment arms . Conclusions The data show that both ultra-low-dose regimens are effective in reducing the severity and number of hot flushes compared to placebo , with good safety profiles BACKGROUND It has been suggested that hormone therapy may help counter undesirable changes in body composition in older women . OBJECTIVE This study was design ed to test whether estrogen plus progestin ( E+P ) therapy favorably affects age-related changes in body composition in postmenopausal women . DESIGN The sub study was composed of 835 women from the estrogen plus progestin trial of the Women 's Health Initiative who were r and omly assigned to receive either  E+P therapy ( n = 437 ) or placebo ( n = 398 ) . The women had a mean age of 63.1 y and , on average , were 13.8 y past menopause . More than 17 % of the participants were from an ethnic minority . No significant differences in baseline body composition ( measured with dual-energy X-ray absorptiometry ) by intervention assignment were observed . RESULTS After 3 y of intervention , the women who received active E+P therapy lost less lean soft tissue mass ( -0.04 kg ) than did the women who received placebo ( -0.44 kg ; P = 0.001 ) . Additionally , the women in the E+P group had less upper-body fat distribution than did the women in the placebo group ( change in ratio of trunk to leg fat mass : -0.025 for the E+P group and 0.004 for the placebo group ; P = 0.003 ) . A sensitivity analysis , which was conducted on the women who took > or = 80 % of the study medication during the intervention period , corroborated the findings from the intent-to-treat analysis . CONCLUSIONS A 3-y E+P intervention significantly reduced both the loss of lean soft tissue mass and the ratio of trunk to leg fat mass  in postmenopausal women . However , the effect sizes were small , and whether these changes in body composition lead to significant health benefits remains to be confirmed BACKGROUND Menopause is associated with decreases in lean mass and increases in fat mass . Serum hormone levels and hormone replacement therapy ( HRT ) may modify the effects of exercise training on body composition in postmenopausal women . METHODS We assessed the changes in total body and regional lean soft tissue and fat mass ( using dual-energy x-ray absorptiometry ) in 94 sedentary postmenopausal women , aged 40 - 65 years , after 12 months of resistance and weight-bearing aerobic exercise training . Women currently on oral HRT ( n = 39 ) and not on HRT ( n = 55 ) were r and omized within groups to exercise and no exercise , result ing in four groups : exercise + HRT ( n = 20 ) , HRT ( n = 22 ) , exercise ( n = 24 ) , and control ( n = 28 ) . Fasting blood sample s were measured for resting serum total levels of estrone , estradiol , cortisol , and rostenedione , growth hormone , and insulin-like growth factor 1 at baseline and 12 months . RESULTS We found significant effects of exercise on increases in total body , arm , and leg lean soft tissue mass , and decreases in leg fat mass and percentage of body fat . There were no interaction effects of exercise and HRT on the changes in muscle strength and body composition . No significant changes in total hormone levels were found after 12 months . CONCLUSIONS Exercise training result ed in significant beneficial changes in lean soft tissue and fat mass in early postmenopausal women . These changes in body composition were neither influenced by prolonged HRT use nor accompanied by changes in total levels of the hormones determined in this study The aim of this study was to study the influence of hormone replacement therapy ( HRT ) on weight changes , body composition , and bone mass in early postmenopausal women in a partly r and omized comprehensive cohort study design . A total of 2016 women ages 45 - 58 years from 3 months to 2 years past last menstrual bleeding were included . One thous and were r and omly assigned to HRT or no HRT in an open trial , whereas the others were allocated according to their preferences . All were followed for 5 years for body weight , bone mass , and body composition measurements . Body weight increased less over the 5 years in women r and omized to HRT ( 1.94 + /- 4.86 kg ) than in women r and omized to no HRT ( 2.57 + /- 4.63 , p = 0.046 ) . A similar pattern was seen in the group receiving HRT or not by their own choice . The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat . The main determinant of the weight gain was a decline in physical fitness . Women opting for HRT had a significantly lower body weight at inclusion than the other participants , but the results in the self-selected part of the study followed the pattern found in the r and omized part . The change in fat mass was the strongest predictor of bone changes in untreated women , whereas the change in lean body mass was the strongest predictor when HRT was given . Body weight increases after the menopause . The gain in weight is related to a decrease in working capacity . HRT is associated with a smaller increase in fat mass after menopause . Fat gain protects against bone loss in untreated women but not in HRT-treated women . The data suggest that women 's attitudes to HRT are more positive if they have low body weight , but there is no evidence that the conclusions in this study are skewed by selection bias Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The independent and combined effects of exercise training and hormone replacement therapy ( HRT ) on body composition , fat distribution , glucose tolerance , and insulin action were studied in postmenopausal women , aged 68 + /- 5 yr , assigned to control ( n = 19 ) , exercise ( n = 18 ) , HRT ( n = 15 ) , and exercise + HRT ( n = 16 ) groups . The exercise consisted of 2 mo of flexibility exercises followed by 9 mo of endurance exercise . HRT was conjugated estrogens 0.625 mg/day and trimonthly medroxyprogesterone acetate 5 mg/day for 13 days . Total and regional body composition were measured by dual-energy X-ray absorptiometry . Serum glucose and insulin responses were measured during a 2-h oral glucose tolerance test . There were significant main effects of exercise on reductions in total and regional ( trunk , arms , legs ) fat mass , increase in leg fat-free mass , and improvements in glucose tolerance and insulin action . There were significant main effects of HRT on the reduction of total fat mass ( HRT , -3.0 + /- 4.0 kg ; no HRT , -1.3 + /- 2.6 kg ) , with a strong trend for reductions in trunk and leg fat mass ( both P = 0.07 ) . There was also a significant improvement in insulin action in response to HRT . These results suggest that there are independent and additive effects of exercise training and HRT on the reduction in fat mass and improvement in insulin action in postmenopausal women ; the effect of HRT on insulin action may be mediated , in part , through changes in central adiposity OBJECTIVE Our purpose was to determine the efficacy of dietary calcium augmentation in the prevention of early postmenopausal bone density loss in comparison with hormonal replacement therapy and placebo . STUDY DESIGN A three-arm parallel r and omized trial comparing the influence of placebo , dietary calcium augmentation , and estrogen-progesterone-calcium in 118 women who were within 6 years of menopause was conducted .  Dual photon absorptiometry was performed annually to measure lean and fat mass . In addition , the ratio of fat in the trunk/extremities was measured . RESULTS Body weight increased in each group . The increase was statistically significant in the hormone replacement group ( 0.8 kg/year ) . The percent of body fat increased in each group from baseline measurements , with the greatest increase in the hormonal replacement group . There was a decline in the extremity/trunk ratio in the hormonal replacement group as a result of a relatively greater increase in the trunk fat mass . There was a rapid rate of loss in lean body mass that was equal among groups . CONCLUSIONS Menopause is associated with a gain in fat mass and a loss of lean body mass , but these changes in body composition are not prevented by hormone replacement therapy Summary Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function . This prospect i ve , population -based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults . Introduction The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions . Methods N = 681 volunteers ( 48 % female ; mean ± SD age 61.4 ± 7.0 years ) participated in baseline and follow-up assessment s ( mean 5.1 ± 0.5 years later ) . Appendicular lean mass ( ALM ) was assessed by dual-energy X-ray absorptiometry , h and grip ( HGS ) and lower-limb ( LLS ) strength were assessed by dynamometry , and falls risk was determined using the physiological profile assessment . Anthropometric definitions ( ALM/height squared [ ALM – H ] , ALM/weight × 100 and a residuals method [ ALM – R ] ) and performance-based definitions ( HGS , LLS and upper- and lower-limb muscle quality [ LMQ ] ) of sarcopenia were examined . The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia . Results Sarcopenia prevalence increased after 5 years for all operational definitions except ALM – H ( men : −4.0 % ; women : −5.5 % ) . Men classified with sarcopenia according to anthropometric definitions , and women classified with sarcopenia according to performance-based definitions , had significant increases in falls risk over 5 years ( all P < 0.05 ) compared to individuals without sarcopenia . Significant sex interactions were observed for ALM-R , LLS and LMQ ( all P < 0.05 ) definitions . Conclusions Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions . Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults , but sex-specific differences may exist according to different anthropometric or performance-based definitions OBJECTIVES To determine the effects of ultra-low-dose hormone therapy on muscle mass and physical function in community-dwelling women . DESIGN Double-blind , placebo-controlled trial . SETTING Clinical research center in Connecticut . PARTICIPANTS Healthy , community-dwelling women aged 65 and older ( n=167 ) . INTERVENTION Eligible women were r and omly assigned to treatment with 0.25 mg 17-beta estradiol or placebo for 36 months . All women ( estradiol or placebo ) with an intact uterus received micronized progesterone 100 mg/d for 2 weeks every 6 months . All participants received 1,300 mg elemental calcium with 1,000 IU vitamin D per day . MEASUREMENTS Appendicular skeletal muscle mass ( ASM ) , lean body mass ( LBM ) , and percentage body fat were measured using dual x-ray absorptiometry . Sarcopenia was defined as skeletal muscle mass ( ASM/height2 ) 2 st and ard deviations or less than young , healthy reference population mean . Physical activity ( Physical Activity Scale in the Elderly ( PASE ) ) and performance were measured . Serum estrone , estradiol , and sex hormone-binding globulin were measured . RESULTS The prevalence of sarcopenia at baseline was 13 % . There were no baseline differences between groups except for PASE score and chair rise time , in which the estrogen group had better performance . No changes in ASM , LBM , percentage of body fat , or physical performance were found after 3 years of est 
    Output:
    
agent
Conclusions and Relevance This systematic review and meta- analysis did not show a significant beneficial or detrimental association of HT with muscle mass .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the efficacy of two ultra-low-dose 17β-estradiol plus norethisterone acetate ( NETA ) treatment regimens for relieving  menopausal symptoms . Design A total of 577 postmenopausal women were enrolled , in three treatment groups in a double-blind , r and omized , placebo-controlled study of 0.5 mg 17β-estradiol + 0.1 mg NETA or 0.5 mg 17β-estradiol + 0.25 mg NETA or placebo . Participants returned at weeks 4 , 8 , 12 and 24 for climacteric complaint evaluation based on a daily diary vasomotor symptom record . Patients were assessed by the Greene Climacteric Scale and urogenital symptoms were also evaluated . Results Treatment with ultra-low-dose 0.5 mg 17β-estradiol + 0.1 mg NETA ( 0.1 Group ) or 0.5 mg 17β-estradiol + 0.25 mg NETA ( 0.25 Group ) effectively reduced the severity and number of hot flushes within the initial weeks of therapy . Compared to placebo , a rapid , statistically significant decrease in the frequency and severity of hot flushes was achieved by week 3 , followed by further improvement which continued throughout the study . There were no statistically significant differences between the active treatment arms . Conclusions The data show that both ultra-low-dose regimens are effective in reducing the severity and number of hot flushes compared to placebo , with good safety profiles BACKGROUND It has been suggested that hormone therapy may help counter undesirable changes in body composition in older women . OBJECTIVE This study was design ed to test whether estrogen plus progestin ( E+P ) therapy favorably affects age-related changes in body composition in postmenopausal women . DESIGN The sub study was composed of 835 women from the estrogen plus progestin trial of the Women 's Health Initiative who were r and omly assigned to receive either  E+P therapy ( n = 437 ) or placebo ( n = 398 ) . The women had a mean age of 63.1 y and , on average , were 13.8 y past menopause . More than 17 % of the participants were from an ethnic minority . No significant differences in baseline body composition ( measured with dual-energy X-ray absorptiometry ) by intervention assignment were observed . RESULTS After 3 y of intervention , the women who received active E+P therapy lost less lean soft tissue mass ( -0.04 kg ) than did the women who received placebo ( -0.44 kg ; P = 0.001 ) . Additionally , the women in the E+P group had less upper-body fat distribution than did the women in the placebo group ( change in ratio of trunk to leg fat mass : -0.025 for the E+P group and 0.004 for the placebo group ; P = 0.003 ) . A sensitivity analysis , which was conducted on the women who took > or = 80 % of the study medication during the intervention period , corroborated the findings from the intent-to-treat analysis . CONCLUSIONS A 3-y E+P intervention significantly reduced both the loss of lean soft tissue mass and the ratio of trunk to leg fat mass  in postmenopausal women . However , the effect sizes were small , and whether these changes in body composition lead to significant health benefits remains to be confirmed BACKGROUND Menopause is associated with decreases in lean mass and increases in fat mass . Serum hormone levels and hormone replacement therapy ( HRT ) may modify the effects of exercise training on body composition in postmenopausal women . METHODS We assessed the changes in total body and regional lean soft tissue and fat mass ( using dual-energy x-ray absorptiometry ) in 94 sedentary postmenopausal women , aged 40 - 65 years , after 12 months of resistance and weight-bearing aerobic exercise training . Women currently on oral HRT ( n = 39 ) and not on HRT ( n = 55 ) were r and omized within groups to exercise and no exercise , result ing in four groups : exercise + HRT ( n = 20 ) , HRT ( n = 22 ) , exercise ( n = 24 ) , and control ( n = 28 ) . Fasting blood sample s were measured for resting serum total levels of estrone , estradiol , cortisol , and rostenedione , growth hormone , and insulin-like growth factor 1 at baseline and 12 months . RESULTS We found significant effects of exercise on increases in total body , arm , and leg lean soft tissue mass , and decreases in leg fat mass and percentage of body fat . There were no interaction effects of exercise and HRT on the changes in muscle strength and body composition . No significant changes in total hormone levels were found after 12 months . CONCLUSIONS Exercise training result ed in significant beneficial changes in lean soft tissue and fat mass in early postmenopausal women . These changes in body composition were neither influenced by prolonged HRT use nor accompanied by changes in total levels of the hormones determined in this study The aim of this study was to study the influence of hormone replacement therapy ( HRT ) on weight changes , body composition , and bone mass in early postmenopausal women in a partly r and omized comprehensive cohort study design . A total of 2016 women ages 45 - 58 years from 3 months to 2 years past last menstrual bleeding were included . One thous and were r and omly assigned to HRT or no HRT in an open trial , whereas the others were allocated according to their preferences . All were followed for 5 years for body weight , bone mass , and body composition measurements . Body weight increased less over the 5 years in women r and omized to HRT ( 1.94 + /- 4.86 kg ) than in women r and omized to no HRT ( 2.57 + /- 4.63 , p = 0.046 ) . A similar pattern was seen in the group receiving HRT or not by their own choice . The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat . The main determinant of the weight gain was a decline in physical fitness . Women opting for HRT had a significantly lower body weight at inclusion than the other participants , but the results in the self-selected part of the study followed the pattern found in the r and omized part . The change in fat mass was the strongest predictor of bone changes in untreated women , whereas the change in lean body mass was the strongest predictor when HRT was given . Body weight increases after the menopause . The gain in weight is related to a decrease in working capacity . HRT is associated with a smaller increase in fat mass after menopause . Fat gain protects against bone loss in untreated women but not in HRT-treated women . The data suggest that women 's attitudes to HRT are more positive if they have low body weight , but there is no evidence that the conclusions in this study are skewed by selection bias Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The independent and combined effects of exercise training and hormone replacement therapy ( HRT ) on body composition , fat distribution , glucose tolerance , and insulin action were studied in postmenopausal women , aged 68 + /- 5 yr , assigned to control ( n = 19 ) , exercise ( n = 18 ) , HRT ( n = 15 ) , and exercise + HRT ( n = 16 ) groups . The exercise consisted of 2 mo of flexibility exercises followed by 9 mo of endurance exercise . HRT was conjugated estrogens 0.625 mg/day and trimonthly medroxyprogesterone acetate 5 mg/day for 13 days . Total and regional body composition were measured by dual-energy X-ray absorptiometry . Serum glucose and insulin responses were measured during a 2-h oral glucose tolerance test . There were significant main effects of exercise on reductions in total and regional ( trunk , arms , legs ) fat mass , increase in leg fat-free mass , and improvements in glucose tolerance and insulin action . There were significant main effects of HRT on the reduction of total fat mass ( HRT , -3.0 + /- 4.0 kg ; no HRT , -1.3 + /- 2.6 kg ) , with a strong trend for reductions in trunk and leg fat mass ( both P = 0.07 ) . There was also a significant improvement in insulin action in response to HRT . These results suggest that there are independent and additive effects of exercise training and HRT on the reduction in fat mass and improvement in insulin action in postmenopausal women ; the effect of HRT on insulin action may be mediated , in part , through changes in central adiposity OBJECTIVE Our purpose was to determine the efficacy of dietary calcium augmentation in the prevention of early postmenopausal bone density loss in comparison with hormonal replacement therapy and placebo . STUDY DESIGN A three-arm parallel r and omized trial comparing the influence of placebo , dietary calcium augmentation , and estrogen-progesterone-calcium in 118 women who were within 6 years of menopause was conducted .  Dual photon absorptiometry was performed annually to measure lean and fat mass . In addition , the ratio of fat in the trunk/extremities was measured . RESULTS Body weight increased in each group . The increase was statistically significant in the hormone replacement group ( 0.8 kg/year ) . The percent of body fat increased in each group from baseline measurements , with the greatest increase in the hormonal replacement group . There was a decline in the extremity/trunk ratio in the hormonal replacement group as a result of a relatively greater increase in the trunk fat mass . There was a rapid rate of loss in lean body mass that was equal among groups . CONCLUSIONS Menopause is associated with a gain in fat mass and a loss of lean body mass , but these changes in body composition are not prevented by hormone replacement therapy Summary Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function . This prospect i ve , population -based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults . Introduction The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions . Methods N = 681 volunteers ( 48 % female ; mean ± SD age 61.4 ± 7.0 years ) participated in baseline and follow-up assessment s ( mean 5.1 ± 0.5 years later ) . Appendicular lean mass ( ALM ) was assessed by dual-energy X-ray absorptiometry , h and grip ( HGS ) and lower-limb ( LLS ) strength were assessed by dynamometry , and falls risk was determined using the physiological profile assessment . Anthropometric definitions ( ALM/height squared [ ALM – H ] , ALM/weight × 100 and a residuals method [ ALM – R ] ) and performance-based definitions ( HGS , LLS and upper- and lower-limb muscle quality [ LMQ ] ) of sarcopenia were examined . The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia . Results Sarcopenia prevalence increased after 5 years for all operational definitions except ALM – H ( men : −4.0 % ; women : −5.5 % ) . Men classified with sarcopenia according to anthropometric definitions , and women classified with sarcopenia according to performance-based definitions , had significant increases in falls risk over 5 years ( all P < 0.05 ) compared to individuals without sarcopenia . Significant sex interactions were observed for ALM-R , LLS and LMQ ( all P < 0.05 ) definitions . Conclusions Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions . Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults , but sex-specific differences may exist according to different anthropometric or performance-based definitions OBJECTIVES To determine the effects of ultra-low-dose hormone therapy on muscle mass and physical function in community-dwelling women . DESIGN Double-blind , placebo-controlled trial . SETTING Clinical research center in Connecticut . PARTICIPANTS Healthy , community-dwelling women aged 65 and older ( n=167 ) . INTERVENTION Eligible women were r and omly assigned to treatment with 0.25 mg 17-beta estradiol or placebo for 36 months . All women ( estradiol or placebo ) with an intact uterus received micronized progesterone 100 mg/d for 2 weeks every 6 months . All participants received 1,300 mg elemental calcium with 1,000 IU vitamin D per day . MEASUREMENTS Appendicular skeletal muscle mass ( ASM ) , lean body mass ( LBM ) , and percentage body fat were measured using dual x-ray absorptiometry . Sarcopenia was defined as skeletal muscle mass ( ASM/height2 ) 2 st and ard deviations or less than young , healthy reference population mean . Physical activity ( Physical Activity Scale in the Elderly ( PASE ) ) and performance were measured . Serum estrone , estradiol , and sex hormone-binding globulin were measured . RESULTS The prevalence of sarcopenia at baseline was 13 % . There were no baseline differences between groups except for PASE score and chair rise time , in which the estrogen group had better performance . No changes in ASM , LBM , percentage of body fat , or physical performance were found after 3 years of est 
    Output:
    