title: Comparison of the effect of oral and transdermal hormone therapy on fasting and postmethionine homocysteine levels.
abstract: OBJECTIVE
  To compare the modifications on basal and post-methionine homocysteine (Hcy) levels induced by transdermal vs. oral continuous combined hormone therapy (HT).
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Outpatient service at university hospital.
  
  
  METHODS
  Twenty-four healthy postmenopausal women.
  
  
  METHODS
  Six-month administration of transdermal (50 microg/d of E(2) and 140-170 microg/d of norethisterone [NET] acetate; n = 12) or oral (2 mg of E(2) and 1 mg of NET acetate; n = 12) HT.
  
  
  METHODS
  Fasting levels of Hcy, cysteine (Cys), folate, and vitamin B12. Post-methionine Hcy concentrations.
  
  
  RESULTS
  During HT, a slight decrease of fasting Hcy (8.9 [6.7; 15.2] micromol/L vs. 8.3 [4.9; 12.0] micromol/L) and fasting Hcy/Cys, a possible index of Hcy trans-sulfuration (0.061 [0.039; 0.107] micromol/L vs. 0.048 [0.032; 0.093] micromol/L) was observed. Modifications were similar in the transdermal and oral group. Net decreases of Hcy and Hcy/Cys observed during HT were related linearly to pretreatment values (r = 0.821 and r = 0.775, respectively), and were significant for Hcy above, but not below, 9 micromol/L. Transdermal (33.5 [27.5; 75.9] micromol/L vs. 28.4 [17.4; 48.9] micromol/L) or oral HT (36.1 [17.7; 74.8] micromol/L vs. 29.9 [17.5; 50.3] micromol/L), decreased, similarly, post-methionine Hcy levels.
  
  
  CONCLUSIONS
  Similarly to oral, transdermal HT reduces post-methionine Hcy and fasting Hcy when it is elevated.
authors.affiliation: Institute of Obstetrics and Gynecology, Policlinico of Modena, Modena, Italy. cagnacci@unimore.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Cagnacci
authors.forename: Stefania
authors.initials: S
authors.lastname: Malmusi
authors.forename: Anna Lisa
authors.initials: AL
authors.lastname: Zanni
authors.forename: Chiara
authors.initials: C
authors.lastname: Alessandrini
authors.forename: Simona
authors.initials: S
authors.lastname: Caretto
authors.forename: Annibale
authors.initials: A
authors.lastname: Volpe
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005215:Fasting; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008715:Methionine / Q000378:metabolism; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage; D011446:Prospective Studies
chemical_list: D006710:Homocysteine; D004958:Estradiol; D008715:Methionine; D009640:Norethindrone