This prospective study aims to evaluate the effects of menopausal hormone therapy (MHT) on liver function, lipid profiles, and hepatic steatosis in postmenopausal women. A total of 44 participants will be divided into two groups: 22 received MHT and 22 were monitored without treatment. Biochemical parameters, FIB-4 scores, and attenuation imaging (ATI) measurements are assessed at baseline and after six months. The study investigates whether MHT is associated with favorable changes in liver enzymes, hepatic fat accumulation, and noninvasive fibrosis markers.

This prospective, controlled cohort study is designed to evaluate the effects of menopausal hormone therapy (MHT) on liver function and non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. A total of 44 participants are included and divided into two groups: 22 women will receive MHT and 22 will be monitored without treatment due to the absence of menopausal symptoms.

Biochemical parameters including liver enzymes and lipid profiles are measured at baseline and after six months. In addition, hepatic steatosis is quantitatively assessed using attenuation imaging (ATI), a novel ultrasound-based technique, and FIB-4 scores are calculated as noninvasive indicators of liver fibrosis.

The MHT regimens included both oral and transdermal estrogen, selected based on clinical indications. ATI measurements are performed using standardized protocols by radiologists blinded to clinical data.

The primary aim of the study is to investigate whether MHT is associated with favorable changes in hepatic steatosis and liver-related biomarkers.

Inclusion Criteria:

• Female participants aged 40 years or older
• Postmenopausal status (defined as ≥12 months of amenorrhea)
• No prior use of menopausal hormone therapy in the last 6 months
• Willingness to participate and provide informed consent

Exclusion Criteria:

• History of liver disease, liver malignancy, or liver transplantation
• Current or past alcohol consumption exceeding 20g/day
• Premature ovarian failure
• History of any active malignancy
• Use of medications known to affect liver enzymes or fat metabolism
• Current participation in another clinical trial

Postmenopausal women aged 40 years and older were eligible for inclusion. Only biologically female participants were considered, as the study focused on the effects of estrogen deficiency and menopausal hormone therapy.

De-identified individual data will be made available upon reasonable request from the corresponding author for academic and non-commercial use.