title: The effect of hormone replacement therapy on serum homocysteine levels in perimenopausal women: a randomized controlled trial.
abstract: Serum homocysteine levels may be lowered by hormone replacement therapy, but randomized controlled trial data are scarce. We performed a single center randomized placebo-controlled trial to assess the 6 months effect of hormone replacement therapy compared with placebo on fasting serum homocysteine levels in 121 perimenopausal women free of cardiovascular disease, and recruited from the general population. The trial was double-blind with respect to a sequential combined regimen of oral 17 beta-estradiol and desogestrel (17 beta E(2)-D) and the placebo group and open with respect to a combination of conjugated equine estrogens and norgestrel (CEE-N). At baseline and after 6 months, fasting serum homocysteine levels were measured. Differences in 6 months serum homocysteine levels from baseline between treatment and placebo groups were calculated, and expressed as a percentage of the 6 months placebo level. After 6 months, the difference in serum homocysteine levels between women receiving 17 beta E(2)-D and placebo was -6.3% (95% CI, -12.4%; 0.0%, P=0.06). The difference between women receiving CEE-N and placebo was -10.1% (95% CI, -16.7%; -2.9%, P<0.01). The difference between the combined group of both types of hormone replacement therapy users and placebo was -7.8% (95% CI, -13.2%; -2.0%, P=0.01). No significant difference was observed between the two active regimens. Our results indicate that hormone replacement therapy decreases homocysteine levels in perimenopausal women.
authors.affiliation: Department of Epidemiology & Biostatistics, Erasmus University Medical School, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: A E
authors.initials: AE
authors.lastname: Hak
authors.forename: A A
authors.initials: AA
authors.lastname: Bak
authors.forename: J
authors.initials: J
authors.lastname: Lindemans
authors.forename: J
authors.initials: J
authors.lastname: Planellas
authors.forename: H J
authors.initials: HJ
authors.lastname: Coelingh Bennink
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: J C
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D000328:Adult; D002979:Climacteric; D017135:Desogestrel / Q000008:administration & dosage; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009644:Norgestrel / Q000008:administration & dosage; D045167:Progesterone Congeners / Q000008:administration & dosage
chemical_list: D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D006710:Homocysteine; D009644:Norgestrel; D004958:Estradiol; D017135:Desogestrel