title: Effect of oral and transdermal hormone therapy on hyaluronic acid in women with and without a history of intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  Intrahepatic cholestasis of pregnancy predisposes women to liver disorders years after affected pregnancy. We compared the basal levels and responses of hyaluronic acid, a marker of liver fibrosis, and liver transaminases to postmenopausal hormone therapy in women with (n = 20) and without (n = 20) a history of intrahepatic cholestasis of pregnancy.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled, crossover trial.
  
  
  RESULTS
  Basal levels of hyaluronic acid were similar in both groups. Two weeks of oral estradiol 2.0 mg/day led to significant but similar (10.9% to 15.4%) rises in hyaluronic acid in both groups. Increasing the dose of oral estradiol to 4.0 mg/day resulted in normalization of the levels, whereas the addition of medroxyprogesterone acetate led to falls (11.0% to 10.7 %) in hyaluronic acid. Transdermal estradiol 50 microg led to a rise (3.2 %) in hyaluronic acid only in the control group. Other liver markers were normal at baseline and during hormone therapy.
  
  
  CONCLUSIONS
  Normal basal levels and/or normal responses of hyaluronic acid and other liver markers to hormone therapy in women with previous intrahepatic cholestasis suggest that this therapy does not predispose these women to liver diseases.
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Pauliina
authors.initials: P
authors.lastname: Tuomikoski
authors.forename: Kristiina
authors.initials: K
authors.lastname: Aittomäki
authors.forename: Tomi S
authors.initials: TS
authors.lastname: Mikkola
authors.forename: Anne
authors.initials: A
authors.lastname: Ropponen
authors.forename: Olavi
authors.initials: O
authors.lastname: Ylikorkala
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D056486:Chemical and Drug Induced Liver Injury; D002780:Cholestasis, Intrahepatic / Q000097:blood*; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008525:Medroxyprogesterone / Q000008:administration & dosage*; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood; D000637:Transaminases / Q000097:blood
chemical_list: D004958:Estradiol; D006820:Hyaluronic Acid; D000637:Transaminases; D008525:Medroxyprogesterone