Effects of conjugated equine estrogen and medroxyprogesterone acetate on lipoprotein(a) and other lipoproteins in japanese postmenopausal women with and without dyslipidemia.
OBJECTIVE
The cardiovascular effects of postmenopausal hormone replacement are controversially discussed. We investigated the effects of 12 months of treatment with conjugated equine estrogen and medroxyprogesterone acetate on lipoprotein(a) [Lp(a)] and other lipoproteins in Japanese postmenopausal women (PMW) with and without dyslipidemia.


METHODS
Forty-three normolipidemic and 17 dyslipidemic PMW [total cholesterol (TC) >/=220 mg/dl or triglyceride (TG) >/=150 mg/dl] received conjugated equine estrogen (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) daily for 12 months, and the results were compared with those of 26 normolipidemic and 14 dyslipidemic subjects declining this treatment as controls. The fasting serum levels of Lp(a), TC, TG, high-density lipoprotein cholesterol, low- density lipoprotein cholesterol, apolipoprotein (Apo) AI, Apo AII, Apo B, Apo CII, and Apo E were measured in each subject at baseline and 12 months after this treatment initiation.


RESULTS
The treatment decreased Lp(a) similarly in normolipidemic and dyslipidemic PMW and decreased TC, low-density lipoprotein cholesterol, Apo CII, and Apo E and increased high-density lipoprotein cholesterol, Apo AI, and Apo AII in both groups. The therapy also significantly increased TG in normolipidemic but not dyslipidemic subjects. In controls, the levels of Lp(a) and other lipoproteins were unaltered.


CONCLUSIONS
In PMW with or without dyslipidemia, improvement in Lp(a) and other lipoproteins may represent cardiovascular benefits of hormone replacement therapy. However, an elevation of the TG levels seen with the therapy warrants caution, especially in PMW without dyslipidemia.
Sumino
Hiroyuki
H
2nd Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan. suminoh@med.gunma-u.ac.jp
Ichikawa
Shuichi
S
Sakamoto
Hironosuke
H
Sawada
Yoshie
Y
Kumakura
Hisao
H
Takayama
Yoshiaki
Y
Sakamaki
Tetsuo
T
Kurabayashi
Masahiko
M
D044466:Asian People; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D014280:Triglycerides / Q000097:blood
D004966:Estrogens, Conjugated (USP); D017270:Lipoprotein(a); D008074:Lipoproteins; D014280:Triglycerides; D017258:Medroxyprogesterone Acetate