Changes in the lipoprotein profile in postmenopausal women receiving hormone replacement therapy. Effects of natural and synthetic progesterone.
OBJECTIVE
To compare the effects of medroxyprogesterone acetate and micronized progesterone on the lipid profile of postmenopausal women receiving conjugated equine estrogen.


METHODS
A prospective, clinical study of the changes in lipoprotein profile evaluated in 123 postmenopausal women receiving conjugated estrogen alone (group I), conjugated estrogen combined with medroxyprogesterone acetate (group II) or micronized progesterone (group III) before treatment and six months after.


RESULTS
Group I had significantly increased high-density lipoprotein cholesterol (HDL-C) levels (14.4%) after six months as well as decreased low-density lipoprotein cholesterol (LDL-C) concentrations (-6.61%), LDL/HDL and total cholesterol/HDL-C ratios (P < .05). In groups II and III, HDL-C concentrations increased 4.58% and 5.44%, respectively, after six months. LDL-C levels were markedly decreased in group II (8.98%). There was no significant reduction in LDL-C levels in group III. Total cholesterol levels were significantly decreased only in group II (-4.93%). Triglyceride levels were increased with statistical significance only in group III (21.2%, P < .05). LDL/HDL and total cholesterol/ HDL-C ratios were significantly decreased in group II, and this effect was more pronounced in group I. There was no change in the ratios in group III.


CONCLUSIONS
Conjugated estrogen replacement therapy had a persistent cardioprotective effect in postmenopausal women, based on the positive effect on lipoprotein metabolism. Both natural and synthetic progesterones blunt the beneficial effects of estrogen on the lipoprotein profile, and micronized progesterone is not superior to medroxyprogesterone acetate.
Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Taiwan, R.O.C.
F P
FP
Chen
N
N
Lee
Y K
YK
Soong
D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects*; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D017698:Postmenopause; D011374:Progesterone / Q000494:pharmacology / Q000627:therapeutic use*; D045167:Progesterone Congeners / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies
D008074:Lipoproteins; D045167:Progesterone Congeners; D011374:Progesterone; D017258:Medroxyprogesterone Acetate