The effects of 17 beta-oestradiol plus dydrogesterone compared with conjugated equine oestrogens plus medroxyprogesterone acetate on lipids, apolipoproteins and lipoprotein(a).
OBJECTIVE
To compare the effects of 17 beta-oestradiol plus dydrogesterone with conjugated equine oestrogens plus medroxyprogesterone acetate on serum lipids, apolipoproteins and lipoprotein(a) in postmenopausal women.


METHODS
A multi-centre, prospective, randomised, double-blind, comparative one-year study in 362 healthy postmenopausal women aged 39-74 years with an intact uterus. Fasting blood samples were taken at baseline and after 28 and 52 weeks of treatment. Participants received daily oral treatment with continuous combined 1 mg micronised 17 beta-oestradiol/5 mg dydrogesterone (E/D: n=180) or 0.625 mg conjugated equine oestrogens/5 mg medroxyprogesterone acetate (CEE/MPA: n=182).


RESULTS
Significant differences between the two groups after 52 weeks were observed for total cholesterol (E/D: -1.7%; CEE/MPA: -7.3%), LDL-cholesterol (E/D: -4.5%; CEE/MPA: -11.3%), HDL-cholesterol (E/D: +15.3%; CEE/MPA: +7.5%), triglycerides (E/D: +9.8%; CEE/MPA: +16.6%), VLDL-triglycerides (E/D: -3.3%; CEE/MPA: +10.0%), lipoprotein(a) (E/D: 0.0%; CEE/MPA: -25.2%) and for the ratio apolipoprotein B/LDL-cholesterol (E/D: +0.9%; CEE/MPA +5.9%).


CONCLUSIONS
E/D and CEE/MPA differ in their anti-atherogenic effects on lipids and lipoproteins. This however can not easily be translated to differences in clinical cardiovascular outcomes.
de Kraker
Alyde T
AT
Project Ageing Women, Department of Obstetrics, Diakonessenhuis Utrecht, VU University Medical Center Amsterdam, The Netherlands.
Kenemans
Peter
P
Smolders
Raimond G V
RG
Kroeks
Maurice V A M
MV
van der Mooren
Marius J
MJ
D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000097:blood / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D004311:Double-Blind Method; D004394:Dydrogesterone / Q000008:administration & dosage; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood / Q000187:drug effects; D008525:Medroxyprogesterone / Q000008:administration & dosage; D008875:Middle Aged; D009426:Netherlands; D017698:Postmenopause; D011446:Prospective Studies; D016896:Treatment Outcome; D006113:United Kingdom
D001053:Apolipoproteins; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D017270:Lipoprotein(a); D004958:Estradiol; D004394:Dydrogesterone; D008525:Medroxyprogesterone