Circulating concentrations of hemostatic factors and two "steroid sensitive proteins" during oral hormone replacement therapy in women with coronary heart disease.
OBJECTIVE
To study a possible use of sex hormone-binding globulin (SHBG) and corticosteroid-binding globulin (CBG) as markers for changes in hemostatic factors during oral postmenopausal hormone replacement therapy (HRT).


METHODS
Twenty-eight postmenopausal women were treated with oral conjugated equine estrogens+oral medroxyprogesterone acetate (CEE + MPA, n = 15) or with placebo (n = 13). Serum SHBG, CBG, testosterone, cortisol and plasma coagulation factors, coagulation inhibitors and markers of coagulation activation were measured before and after 6 and 12 months of treatment.


RESULTS
Pretreatment plasminogen activator inhibitor 1 (PAI-1) levels correlated negatively to SHBG and antithrombin III (AT III) negatively to total and free cortisol. In the CEE + MPA group, CBG, SHBG and Factor VII increased, and PAI-1, AT III and free testosterone decreased during treatment. No significant changes were found in plasma von Willebrand factor antigen, thrombin-antithrombin complex, fibrin D-dimer and fibrinogen. A significant, negative correlation was found between changes in SHBG and PAI-1. No changes were found in the placebo group.


CONCLUSIONS
The only correlation found between changes in "steroid sensitive" proteins and hemostatic factors was between increased SHBG and a possibly beneficial effect of estrogens, i.e. decreased PAI-1 values. SHBG or CBG could not be used as predictors of increased cardiovascular risk during postmenopausal oral HRT.
Pripp
U
U
Department of Cardiology, Karolinska Institute, Karolinska University Hospital Solna, Stockholm, Sweden.
Schenck-Gustafsson
K
K
Landgren
B-M
BM
Carlström
K
K
D000284:Administration, Oral; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis*; D003327:Coronary Disease / Q000097:blood* / Q000150:complications; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012738:Sex Hormone-Binding Globulin / Q000032:analysis* / Q000378:metabolism; D014156:Transcortin / Q000032:analysis* / Q000378:metabolism
D015415:Biomarkers; D001779:Blood Coagulation Factors; D012738:Sex Hormone-Binding Globulin; D014156:Transcortin