Effects of two continuous hormone therapy regimens on C-reactive protein and homocysteine.
OBJECTIVE
To compare the effects of two continuous hormone therapy (HT) regimens on the cardiovascular risk markers, C-reactive protein (CRP) and homocysteine.


METHODS
A prospective study in which 43 postmenopausal women were randomly assigned to either tibolone 2.5 mg/day (n = 20) or 0.625 mg/day conjugated equine estrogens (CEE) plus continuous medroxyprogesterone acetate (MPA) 5 mg/day (n = 23). Serum levels of CRP, homocysteine, vitamin B12, and folate were determined before and during 12 weeks of therapy.


RESULTS
C-reactive protein levels were increased by tibolone (76%; P < 0.001) and CEE+MPA (81%; P < 0.001). Neither tibolone nor CEE+MPA had any significant effect on homocysteine levels, but there was a significant difference between the effects of treatment over time (P = 0.046). Both tibolone and CEE+MPA reduced vitamin B12 levels (11%; P < 0.001, and 8%; P < 0.01, respectively), but had no statistically significant effect on folate levels. Individual changes in homocysteine levels were negatively associated with changes in vitamin B12 levels (r = -0.68; P < 0.01) after tibolone therapy.


CONCLUSIONS
Both tibolone and CEE plus MPA increased CRP levels and reduced levels of vitamin B12. Neither therapy had any significant effect on homocysteine levels. Further long-term studies into the effect of HRT on these markers, and the relationship to cardiovascular disease risk, are required.
Barnes
Judith F
JF
Department of Biochemistry, Stobhill Hospital, Glasgow G21 3UW, Scotland, UK. Beth.Farish@NorthGlasgow.Scot.NHS.UK
Farish
Elizabeth
E
Rankin
Marion
M
Hart
David M
DM
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003271:Contraceptive Agents, Female / Q000494:pharmacology; D020847:Estrogen Receptor Modulators / Q000494:pharmacology; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000494:pharmacology; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology; D008875:Middle Aged; D009652:Norpregnenes / Q000494:pharmacology; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000097:blood*
D015415:Biomarkers; D003271:Contraceptive Agents, Female; D020847:Estrogen Receptor Modulators; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D009652:Norpregnenes; D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid; D017258:Medroxyprogesterone Acetate; C027385:tibolone; D014805:Vitamin B 12