Substitution of transdermal estradiol during oral estrogen-progestin therapy in postmenopausal women: effects on hypertriglyceridemia.
OBJECTIVE
We investigated effects of changing from oral estrogen to transdermal estradiol on the lipid and lipoprotein profile of postmenopausal women who developed hypertriglyceridemia (serum concentrations exceeding 150 mg/dL) during estrogen-progestin therapy.


METHODS
Sixty-one postmenopausal Japanese women receiving 0.625 mg of conjugated equine estrogen plus 2.5 mg of medroxyprogesterone acetate daily for 12 months had developed serum triglyceride concentrations exceeding 150 mg/dL after 12 months of treatment. Thirty-six of them, chosen randomly for study, were assigned at random to either a group that continued this oral regimen or another that changed to transdermal estradiol while continuing 2.5 mg of oral medroxyprogesterone acetate for the next 3 months (n = 18 for each). Blood lipids were compared between groups.


RESULTS
Serum concentrations of triglyceride and very-low-density lipoprotein triglyceride decreased significantly after changing to transdermal estradiol (triglyceride, from 226.0 +/- 43.9 to 110.5 +/- 44.1 mg/dL, P < 0.01). No changes were seen in concentrations of low-density lipoprotein cholesterol or high-density lipoprotein cholesterol.


CONCLUSIONS
Changing to transdermal estradiol may improve triglyceride metabolism in women who developed hypertriglyceridemia during oral estrogen-progestin therapy, with minimal effect on cholesterol profiles.
Sanada
Mitsuhiro
M
Department of Obstetrics and Gynecology, Faculty of Medicine, Hiroshima University, Hiroshima, Japan. msanada64@hotmail.com
Tsuda
Mikio
M
Kodama
Ichiro
I
Sakashita
Tomohisa
T
Nakagawa
Hitoshi
H
Ohama
Koso
K
D000279:Administration, Cutaneous; D000284:Administration, Oral; D001053:Apolipoproteins / Q000097:blood / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000517:prevention & control*; D008055:Lipids / Q000097:blood*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D017698:Postmenopause; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D004958:Estradiol; D002784:Cholesterol; D017258:Medroxyprogesterone Acetate