Effect of different preparations of hormone therapy on lipid and glucose metabolism, coagulation factors, and bone mineral density in overweight and obese postmenopausal women.
OBJECTIVE
To determine the effects of different preparations of hormone therapy (HT) on lipid and glucose metabolism, coagulation factors, and bone mineral density (BMD) in overweight and obese postmenopausal women.


METHODS
A randomized, nonblinded, controlled study.


METHODS
Karadeniz Technical University, Department of Obstetrics and Gynecology.


METHODS
A total of 352 overweight and obese (body mass index >25 kg/m2) postmenopausal women.


METHODS
Ninety women received 2.5 mg of tibolone; 84 received 2 mg of E2 plus 1 mg of norethisterone acetate (E2/NETA); 90 received 0.625 mg of conjugated equine estrogen plus 2.5 mg of medroxyprogesterone acetate (CEE/MPA); and 88 did not receive any menopausal therapy (control).


METHODS
At baseline and after 6 months of treatment, we measured total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), insulin, glucose, factor VII, factor VIII, von Willebrand factor, antithrombin III, protein S, protein C, fibrinogen, and BMD at the lumbar spine L1-L4.


RESULTS
There were no statistically significant differences among the groups for any variables at baseline. After 6 months of treatment, the three regimens decreased total cholesterol, triglyceride, LDL, and fibrinogen; E2/NETA and CEE/MPA increased HDL, and tibolone decreased HDL; higher insulin concentrations were found in the control and tibolone groups. Body mass index, HDL, fibrinogen levels, and L1-L4 BMD were independent factors in the prediction of HT use.


CONCLUSIONS
Body mass index, HDL, fibrinogen levels and L1-L4 BMD were independent factors in the prediction of HT use. Treatment with tibolone, E2/NETA, and CEE/MPA resulted in minimal improvement in lumbar spine BMD but had a beneficial effect on the procoagulation system, with minimal changes in glucose metabolism after 6 months of therapy.
Osmanağaoğlu
Mehmet A
MA
Department of Obstetrics and Gynecology, Karadeniz Technical University, Trabzon, Turkey. osmanaga@meds.ktu.edu.tr
Osmanağaoğlu
Selen
S
Osmanağaoğlu
Tayfun
T
Okumuş
Bakiye
B
Bozkaya
Hasan
H
D000328:Adult; D000368:Aged; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008525:Medroxyprogesterone / Q000008:administration & dosage; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077563:Norethindrone Acetate; D009652:Norpregnenes / Q000008:administration & dosage; D009765:Obesity / Q000097:blood; D050177:Overweight / Q000187:drug effects* / Q000502:physiology; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D017698:Postmenopause / Q000097:blood / Q000187:drug effects*
D001779:Blood Coagulation Factors; D001786:Blood Glucose; D003280:Contraceptives, Oral, Synthetic; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D009652:Norpregnenes; D004364:Pharmaceutical Preparations; D000077563:Norethindrone Acetate; C027385:tibolone; D008525:Medroxyprogesterone; D009640:Norethindrone