Differential effects of oral and transdermal postmenopausal estrogen replacement therapies on C-reactive protein.
C-reactive protein (CRP) is one of the main independent predictors of cardiovascular events. Oral post-menopausal estrogen replacement therapy (ERT) increases CRP levels, but the effect of transdermal ERT is not well documented. CRP, interleukine-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels were evaluated in a randomised study of 196 healthy postmenopausal women, who were allocated to receive continuous oral estradiol-1beta, (n=63) or transdermal estradiol-1beta, (n=68) both combined with micronised progesterone, or place-bo (n=65). Oral estrogen increased CRP levels compared with both placebo (p=0.010) and transdermal estrogen (p=0.004) at 6 months. There was no significant effect of transdermal estrogen on CRP levels compared with placebo (p=0.997). No significant difference was found in the median changes for IL-6 and TNF-alpha between the three treatment groups. In conclusion, transdermal estrogen has no significant effect on CRP levels at 6 months, but CRP concentrations increased significantly with oral estrogen although no changes in cytokine levels were detected. The clinical relevance of these effects remains to be determined.
Lacut
Karine
K
Département de Médecine Interne, Hôpital de la Cavale Blanche, Brest, France. karine.lacut@chu-brest.fr
Oger
Emmanuel
E
Le Gal
Grégoire
G
Blouch
Marie-Thérèse
MT
Abgrall
Jean-François
JF
Kerlan
Véronique
V
Scarabin
Pierre-Yves
PY
Mottier
Dominique
D
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis / Q000096:biosynthesis*; D003327:Coronary Disease / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control*; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D011374:Progesterone / Q000008:administration & dosage; D019851:Thrombophilia / Q000097:blood / Q000139:chemically induced; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D011374:Progesterone; D004958:Estradiol; D002097:C-Reactive Protein