Effects of estrogen, raloxifene, and hormone replacement therapy on serum C-reactive protein and homocysteine levels.
OBJECTIVE
To investigate the effects of conjugated equine estrogen (CEE), CEE plus medroxyprogesterone acetate (MPA), CEE plus Nomegestrol acetate (NA), and raloxifene on serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels in healthy postmenopausal women.


METHODS
One hundred seven healthy postmenopausal women were recruited in a prospective, randomized, and placebo-controlled 6 months study. Of these, 18 were hysterectomized and received daily oral 0.625 mg CEE. Eighty nine non-hysterectomized women were randomly allocated to one of four groups: a group (22 patients) treated with CEE, 0.625 mg/daily plus MPA 2.5 mg/daily; a group (22 patients) treated with CEE, 0.625 mg/daily plus NA 5 mg/daily; a group (23 patients) treated with raloxifene hydrochloride, 60 mg once daily; and a placebo group (22 patients). Hcy and hs-CRP were measured at baseline and at 3 and 6 months.


RESULTS
CEE (20%, P=0.03) and CEE+MPA (59%, P=0.006) increased serum hs-CRP levels significantly, whereas CEE+NA decreased serum hs-CRP by 25% (P=0.01). Raloxifene had no significant effect on serum hs-CRP levels during and after the treatment. In all active treatment groups serum Hcy levels decreased significantly compared to baseline and placebo.


CONCLUSIONS
Conjugated equine estrogen, hormone replacement therapies, and raloxifene lower serum Hcy levels to a comparable extent in postmenopausal women. Hs-CRP, as a cardiovascular risk factor, is not influenced by raloxifene, whereas CEE and CEE plus MPA significantly increase hs-CRP levels. Treatment with CEE plus NA reduces serum hs-CRP levels.
Dokuz Eylul University Faculty of Medicine, Department of Obstetrics and Gynecology, Inciralti, Izmir, Turkey. mert.gol@deu.edu.tr
Mert
M
Gol
Pinar
P
Akan
Erbil
E
Dogan
Cigdem
C
Karas
Ugur
U
Saygili
Cemal
C
Posaci
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis / Q000187:drug effects*; D004338:Drug Combinations; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006710:Homocysteine / Q000097:blood / Q000187:drug effects*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology; D008535:Megestrol / Q000008:administration & dosage / Q000494:pharmacology; D008875:Middle Aged; D009649:Norpregnadienes / Q000008:administration & dosage / Q000494:pharmacology; D017698:Postmenopause / Q000097:blood; D011446:Prospective Studies; D020849:Raloxifene Hydrochloride / Q000008:administration & dosage / Q000494:pharmacology*; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D009649:Norpregnadienes; D020845:Selective Estrogen Receptor Modulators; D006710:Homocysteine; D020849:Raloxifene Hydrochloride; C038501:nomegestrol acetate; D002097:C-Reactive Protein; D017258:Medroxyprogesterone Acetate; D008535:Megestrol