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Hormone replacement therapy and lipid-lipoprotein concentrations
1Dr. Zekai Tahir Burak Women's Hospital, Talatpaşa Bulvari, Ankara, Turkey. seyi@rorqual.cc.metu.edu.tr
Insights
Hormone replacement therapy, including estrogen-only and combined formulations, improved lipid profiles in postmenopausal women. Estrogen therapy positively impacted cholesterol and triglyceride levels, enhancing overall cardiovascular health markers.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Health
- Women's Health
Background:
- Menopause is associated with changes in lipid profiles, increasing cardiovascular risk.
- Hormone replacement therapy (HRT) is a common intervention for menopausal symptoms.
- Understanding HRT's impact on lipids is crucial for cardiovascular disease prevention.
Purpose of the Study:
- To investigate the association between HRT and lipid-lipoprotein concentrations in postmenopausal women.
- To compare the effects of different HRT formulations on lipid profiles.
- To evaluate long-term lipid changes over seven years of HRT.
Main Methods:
- An open prospective longitudinal study involving 6416 postmenopausal women.
- Participants received either estrogen-only therapy (conjugated equine estrogen [CEE] or transdermal estradiol [TDE2]) or combined estrogen-progestin therapy.
- Lipid-lipoprotein concentrations (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C) were measured annually and cumulatively.
Main Results:
- Estrogen-only therapy significantly decreased total cholesterol, LDL-C, and VLDL-C, while increasing HDL-C.
- Transdermal estradiol (TDE2) showed a less pronounced increase in HDL-C and triglycerides compared to CEE.
- Combined estrogen-progestin therapy generally improved lipid profiles, with some formulations showing decreased triglycerides and VLDL.
Conclusions:
- Both estrogen-only and combined HRT formulations lead to more favorable lipid profiles in postmenopausal women.
- HRT can be an effective strategy for managing dyslipidemia in menopausal women.
- The choice of HRT formulation may influence the extent of lipid profile modification.
Objective:
To evaluate the links between hormone replacement therapy and lipid-lipoprotein concentrations (total cholesterol [T.Ch] triglycerids, high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C] and very low density lipoprotein cholesterol [VLDL-C]) in a total of 6416 postmenopausal women.
Study Design:
Open prospective longitudinal study. Of the 2184 surgical postmenopausal women, 1102 received conjugated equine estrogen (CEE), and 1082 transdermal estradiol (TDE2). Of the 4232 natural postmenopausal women: 1073 received CEE+medroxyprogesterone acetate (MPA), 1068 CEE+dydrogesterone (DD), 1044 TDE2+MPA, 1047 TDE2+DD. Lipid-lipoprotein concentrations were evaluated by using a SPSS program at 1,2,3,4,5,6,7 years of therapy and cumulatively.
Results:
Cumulative evaluation of the data on estrogen only replacement therapy revealed a significant decrease in T.Ch, LDL-C and VLDL-C, and an increase in HDL-C; however, the increase in HDL-C and triglycerids was significantly higher in CEE than TDE2 (P<0.01). Cumulative evaluation of the data on estrogen progestin hormone replacement therapy revealed a significant decrease in T.Ch, LDL-C and an increase in HDL-C for all; however, triglycerides and VLDL levels decreased in TDE2+MPA and TDE2+DD groups (P<0.05).
Conclusion:
Both the natural and surgical menopause patients were found to have more favorable lipid profiles after treatment with estrogen progesterone combined formulations and estrogen only replacement.