ISSN:
1471-0528
Quelle:
Blackwell Publishing Journal Backfiles 1879-2005
Thema:
Medizin
Notizen:
Objective To assess the influence of three different postmenopausal hormone replacement therapies on levels of serum lipids and lipoprotein(a) [Lp(a)].Design Open, randomised, controlled study.Participants One hundred and forty healthy, early postmenopausal women.Interventions The women were randomised to receive continuous 17β-oestradiol, either orally (2 mg daily; n= 35) or transdermally (50 μg daily; n= 35), plus 10 mg dydrogesterone daily for 14 days of each 28-day cycle; or 2.5 mg tibolone daily (n= 35). Thirty-five untreated women acted as controls.Main outcome measures Fasting blood samples were analysed at baseline, 6,12 and 24 months for low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, very low density lipoprotein (VLDL), total cholesterol, triglycerides, lipoprotein(a) [Lp(a)], apolipoproteins A-l, A-2 and B, fibrinogen, and antithrombin factor III.Results At 24 months oral oestradiol increased mean HDL cholesterol (7%; 95% CI 1–14), compared with no change in the transdermal group and a decrease of 26.8% in the tibolone group (95% CI 22.9–30.5); oral oestradiol decreased mean LDL cholesterol (11.8%; 95% CI 6.3–19), compared with no change in the tibolone group. Changes in apolipoprotein A-1 and B showed a similar pattern to HDL and LDL cholesterol, respectively. Oral oestradiol increased serum triglycerides (30%; 95% CI 18–42) after 24 months, compared with no change in the tibolone and transdermal oestradiol groups. Tibolone decreased serum Lp(a) by 36.6% after 24 months (95% CI 8.3–56.2), oral oestradiol decreased levels by 29.4% (95% CI 2–51.1), compared with no change in the transdermal oestradiol group.Conclusions Oral and to a lesser extent transdermal oestradiol when sequentially combined with dydrogesterone, showed a beneficial influence on serum lipids regarding the cardiovascular disease risk, which was not seen with tibolone. The significance of Lp(a) levels on cardiovascular disease risk remains to be determined.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1111/j.1471-0528.1997.tb11982.x
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