The effect of hormone replacement therapy on the levels of serum lipids, apolipoprotein AI, apolipoprotein B and lipoprotein (a) in Turkish postmenopausal women

被引：19

作者：

Bayrak A. ^{[1
,5
]}

Aldemir D. ^{[2
]}

Bayrak T. ^{[1
]}

Çorakçi A. ^{[3
]}

Dursun P. ^{[4
]}

机构：

[1] Biochemistry Dept., Faculty of Medicine, Hacettepe University, Ankara

[2] Biochemistry Dept., Faculty of Medicine, Başkent University, Ankara

[3] Obstetrics and Gynecology Dept., Faculty of Medicine, Kocaeli University, Kocaeli

[4] Obstetrics and Gynecology Dept., Faculty of Medicine, Hacettepe University

[5] Cebeci, 06700 Ankara, Gecim sokak

来源：

Archives of Gynecology and Obstetrics | 2006年 / 274卷 / 5期

关键词：

Atherosclerotic diseases; Cardioprotective effect of estrogen; Coronary heart disease; ERT; HRT; Lipids; Lipoproteins;

D O I：

10.1007/s00404-006-0187-2

中图分类号：

学科分类号：

摘要：

Objectives: Estrogen replacement therapy alters the lipid profiles favorably for delaying atherosclerosis in postmenopausal women. The effects of estrogen plus progesterone combination therapy on lipids are controversial. This study was designed to evaluate the effect of female sex hormones on lipids and lipoproteins and to clarify the influence of progesterone on the effect of estrogen in postmenopausal women. Methods: Of the 60 postmenopausal women admitted to our menopause clinic, 40 had intact uterus and received continuous 0.625 mg conjugated equine estrogen (CEE) plus 2.5 mg medroxyprogesterone acetate (MPA), whereas the remaining 20 were hysterectomized and received 0.625 mg CEE daily. To assess the alterations in lipids and lipoproteins during menopause, 45 healthy premenopausal women were investigated. Lipid and lipoprotein levels were assessed in each subject at baseline and at the 6th and 18th months of therapy. Results: In menopause, a shift towards more atherogenic lipid and lipoprotein profiles than those of the premenopausal state was found. Following 18 months of treatment, both regimens reduced total cholesterol (TC) levels as compared with the baseline (6.4 vs. 6.9% in the CEE/MPA and CEE groups, respectively). The CEE group had a more pronounced increase in high-density lipoprotein (HDL) cholesterol than the CEE/MPA group (10.3 vs. 8.8%, respectively). Both groups displayed reduced TC, low-density lipoprotein (LDL) cholesterol and apolipoprotein-B (ApoB) concentrations, whereas triglycerides increased, with a greater tendency to increase in the CEE/MPA group at the end of the trial. Also, the lipoprotein (a) [Lp(a)] levels decreased significantly (27.6 vs. 24.5% in the CEE/MPA and CEE groups, respectively). This decrease was more pronounced in subjects with a relatively higher basal Lp(a) concentration. Conclusion: Both treatment regimens caused positive alterations in the lipid and lipoprotein profiles. This association might play a pivotal role in the postmenopausal increases in atherosclerotic diseases and cardioprotective effect of estrogen in postmenopausal women. © Springer-Verlag 2006.

引用

页码：289 / 296

页数：7

共 57 条

[1]

Nathan L., Chaudhuri G., Estrogens and atherosclerosis, Annu Rev Pharmacol Toxicol, 137, pp. 477-515, (1997)

[2]

Chang T.C., Lien Y.R., Chen M., Cheng S.P., Et al., Effect of conjugated eguine estrogen in combination with two different progestogens on the risk factors of coronary heart disease in postmenopausal Chinese women in Taiwan: A randomized one-year study, Acta Obstet Gynecol Scand, 83, pp. 661-666, (2004)

[3]

Christodoulakos G.E., Lambrinoudaki I.V., Panoulis C.P., Papadias C.A., Kouskouni E.E., Et al., Effect of hormone replacement therapy, tibolone and raloxifene on serum lipids and lipoprotein in Greek postmenopausal women, Gynecol Endocrinol, 18, pp. 244-257, (2004)

[4]

Solomon C.G., Dluhy, Rethinking postmenopausal hormone therapy, N Engl J Med, 348, pp. 579-580, (2003)

[5]

Risk and benefits of estrogen plus progestin in healthy postmenopausal women, JAMA, 288, pp. 321-333, (2002)

[6]

Grady D., Yaffe K., Kristof M., Lin F., Richards C., Barrettconnor E., Effect of postmenopausal hormone therapy on cognatitive function: The Heart and Estrogen/Progestin Replacement Study, Am J Med, 113, pp. 543-548, (2002)

[7]

Ettinger B., Friedman G.D., Bush T., Quesenberry C.P., Reduced mortality associated with long-term postmenopausal estrogen therapy, Obstet Gynecol, 87, pp. 6-12, (1996)

[8]

Wiklund I., Karlberg J., Mattsson L.A., Quality of life of postmenopausal women on a regimen of transdermal estradiol therapy: A double-blind placebo-controlled study, Am J Obstet Gynecol, 168, pp. 824-830, (1993)

[9]

Grady D., Postmenopausal hormones - Therapy for symptoms only, N Engl J Med, 348, pp. 1835-1837, (2003)

[10]

Grambrell Jr. R.D., The menopause: Benefits and risk of estrogen-progestogen replacement therapy, Fertil Steril, 37, pp. 457-474, (1982)

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