title: Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins, coagulation factors, and carbohydrate metabolism.
abstract: OBJECTIVE
  To determine the effects of lower doses of conjugated equine estrogens (CEE) alone or CEE and medroxyprogesterone acetate (MPA) on lipoproteins, carbohydrate metabolism, and coagulation/fibrinolytic factors.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Multicenter substudy of the Women's HOPE trial.
  
  
  METHODS
  Seven hundred and forty-nine healthy, postmenopausal women.
  
  
  METHODS
  Women were randomized to receive the following doses in milligrams per day: 0.625 CEE; 0.625 CEE/2.5 MPA; 0.45 CEE; 0.45 CEE/2.5 MPA; 0.45 CEE/1.5 MPA; 0.3 CEE; 0.3 CEE/1.5 MPA; or placebo.
  
  
  METHODS
  Assessment of lipids, lipoproteins, glucose tolerance, and coagulation/fibrinolytic factors at baseline, cycle 6, and year 1.
  
  
  RESULTS
  One year of treatment with any of the CEE or CEE/MPA regimens studied increased high-density lipoprotein cholesterol (HDL-C); the 10% increase in HDL-C for the CEE 0.45/MPA 1.5 group was similar to the CEE 0.625/MPA 2.5 group. Low-density lipoprotein cholesterol was significantly reduced in all of the active treatment groups except the CEE 0.3/MPA 1.5 group at cycle 13. Apolipoprotein A-I and triglyceride levels increased and apolipoprotein B levels decreased in all groups. The lipoprotein (a) level was reduced in the CEE 0.45/MPA 2.5, CEE 0.45/MPA 1.5, and CEE 0.625/MPA 2.5 groups. Minimal changes were observed in carbohydrate metabolism for all groups. Fibrinogen and PAI-1 activity decreased and plasminogen activity increased in all groups. Decreases in antithrombin III and protein S activities were significant for all active treatment groups except the CEE 0.3/MPA 1.5 group.
  
  
  CONCLUSIONS
  Lower doses of CEE and CEE/MPA induce favorable changes in lipids, lipoproteins, and hemostatic factors with minimal changes in carbohydrate metabolism.
authors: Department of Obstetrics and Gynecology, Columbia-Presbyterian Medical Center, New York, New York 10032-3784, USA. ral35@columbia.edu
authors: R A
authors: RA
authors: Lobo
authors: T
authors: T
authors: Bush
authors: B R
authors: BR
authors: Carr
authors: J H
authors: JH
authors: Pickar
mesh_terms: D000328:Adult; D000818:Animals; D001779:Blood Coagulation Factors / Q000032:analysis*; D050260:Carbohydrate Metabolism; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006736:Horses; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood
chemical_list: D001779:Blood Coagulation Factors; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D008074:Lipoproteins; D017258:Medroxyprogesterone Acetate