Effect of hormone replacement therapy on lipids in perimenopausal and early postmenopausal women.
OBJECTIVE
To determine the effects of oral sequential hormone replacement therapy (HRT) on lipid-profile in perimenopausal and early postmenopausal women.


METHODS
We performed a single-center, randomized, placebo-controlled trial. The trial was double blind with respect to 17beta-estradiol/desogestrel (17beta-E-D) and placebo and open with respect to conjugated estrogens/norgestrel (CEE-N). A total of 125 healthy perimenopausal and early postmenopausal women, aged 43-58 years, were recruited from the general population in Zoetermeer, the Netherlands. The intervention consisted of 6 months treatment with 1.5 mg 17beta-estradiol/0.15 mg desogestrel (n=53), 0.625 mg conjugated estrogens/0.15 mg norgestrel (n=36) or placebo (n=36). At baseline, cycle 1, 3 and 6, overnight fasting blood samples were obtained in which lipids were determined. We used linear regression analysis to calculate differences in mean change from baseline in lipids in the active treatment groups compared to placebo.


RESULTS
In both treatment groups significant (P<0.05) falls in low-density-lipoprotein (LDL)-cholesterol (17beta-E-D: -7.8% and CEE-N: -8.4%) and lipoprotein(a) (17beta-E-D: -11.7% and CEE-N: -28.3%) were found compared to placebo. Apolipoprotein A1 (17beta-E-D: 6.8% and CEE-N: 7.3%) and HDL-cholesterol (17beta-E-D: 6.4% and CEE-N: 8.0%) significantly increased compared to placebo. No significant changes were found in the other lipids. Mean changes from baseline in total cholesterol, LDL-cholesterol and apolipoprotein B were significantly more pronounced in postmenopausal women compared to perimenopausal women, adjustment for age-differences did not change the results.


CONCLUSIONS
Treatment of perimenopausal and early postmenopausal women with 17beta-E-D or CEE-N changes their lipid-profile in a potentially anti-atherogenic direction. Changes appear to be more pronounced in postmenopausal women compared to perimenopausal women.
Ossewaarde
M E
ME
Julius Center for Patient Oriented Research, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Bots
M L
ML
Bak
A A
AA
Van Der Schouw
Y T
YT
Witteman
J C
JC
Planellas
J
J
Bennink
H J
HJ
Grobbee
D E
DE
D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood* / Q000187:drug effects; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D002979:Climacteric; D017135:Desogestrel / Q000494:pharmacology; D004311:Double-Blind Method; D004958:Estradiol / Q000494:pharmacology; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D016014:Linear Models; D017270:Lipoprotein(a) / Q000097:blood / Q000187:drug effects; D008074:Lipoproteins / Q000097:blood* / Q000187:drug effects; D008875:Middle Aged; D009644:Norgestrel / Q000494:pharmacology; D017698:Postmenopause; D016896:Treatment Outcome
D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004966:Estrogens, Conjugated (USP); D017270:Lipoprotein(a); D008074:Lipoproteins; D009644:Norgestrel; D004958:Estradiol; D017135:Desogestrel