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

[11]

Wolf P.H., Madans J.H., Finucane F.F., Higgins M., Kleinman J.C., Reduction of cardiovascular disease-related mortality among postmenopausal women who use hormones: Evidence from a national cohort, Am J Obstet Gynecol, 164, pp. 489-494, (1991)

[12]

Gibbons W.F., Judd H.L., Luciano A.A., Et al., Comparison Sequential Versus Continious Estrogen/progestin Replacement Therapy on Serum Lipid Patterns: Multiuniversity National Upjohn Study Collaborative, (1991)

[13]

Odmark I.S., Backstrom T., Haeger M., Jonsson B., Bixo M., Effects of continous combined conjugated estrogen/medroxyprogesterone acetate on lipids and lipoproteins, Maturitas, 48, pp. 137-146, (2004)

[14]

Hirvonen E., Malkonen M., Mannihen V., Effects of different progestogens on lipoproteins during postmenopausal replacement therapy, N Engl J Med, 304, pp. 560-563, (1981)

[15]

Lobo R.A., Pickar J.H., Wild R.A., Wash B., Et al., Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women, Obstet Gynecol, 84, pp. 987-995, (1994)

[16]

Kim C.J., Jang H.C., Cho D.H., Min Y.K., Effects of hormone replacement therapy on lipoprotein(a) and lipids in postmenopausal women, Arterioscler Thromb Vasc Biol, 14, pp. 275-281, (1994)

[17]

Gurakar A., Hoeg J.M., Kostner G., Papadopoulos N.M., Et al., Levels of lipoprotein Lp(a) decline with neomycin and niacin treatment, Atherosclerosis, 57, pp. 293-301, (1985)

[18]

Meilahn E.N., Kuller L.H., Matthews K.A., Stein E.A., Lp(a) concentrations among pre-and postmenopausal women over time: The Healthy Women Study, Circulation, 84, 2 SUPPL., (1991)

[19]

Nabulsi A.A., Folsom A.R., White A., Patsch W., Heiss G., Et al., Association of hormone-replacement theraby with various cardiovascular risk factors in postmenopausal women, N Engl J Med, 15, pp. 1069-1075, (1993)

[20]

Wahl P., Walden C.W., Knopp R., Hoover J., Et al., Effect of estrogen progestin potency on lipid/lipoprotein cholesterol, N Engl J Med, 308, pp. 862-867, (1983)

← 1 2 3 4 5 6 →