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.
Project Ageing Women, Department of Obstetrics, Diakonessenhuis Utrecht, VU University Medical Center Amsterdam, The Netherlands.
Alyde T
AT
de Kraker
Peter
P
Kenemans
Raimond G V
RG
Smolders
Maurice V A M
MV
Kroeks
Marius J
MJ
van der Mooren
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