title: Modification of the lipidic and coagulative pattern in postmenopause women: effect of hormone replacement therapy.
abstract: OBJECTIVE
  We evaluated the changes of lipidic and coagulative pattern during menopause and the influence of hormone replacement therapy (HRT) on these parameters.
  
  
  METHODS
  We considered 158 patients divided into 2 groups: Group I consisted of 127 women in physiological/surgical menopause and Group II of 31 women with childbearing potential. Subsequently, we considered a group III formed of 34 patients from menopausal women (group I) who underwent three months of HRT. We evaluated total-cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG), lipoprotein (a) (Lpa), fibrinogen, antithrombin III (ATIII), factor VII (FVII) and tissue factor pathway inhibitor (TFPI).
  
  
  RESULTS
  We found a worse lipid profile in the post-menopausal group compared to controls (TC 243.8+/-29.7 vs 217.9+/-32.7 mg%, P=0.002; TG 121.5+/-68.4 vs 88.6+/-53.0 mg%, P=0.039; LDL-C 163.0+/-27.9 vs 136.2+/-29.6 mg%, P=0.004; HDL-C 60.9+/-14.9 vs 64.1+/-14.6 mg%, P=ns). With regard to the coagulative pattern, fibrinogen was significantly higher in the post-menopausal group (fibrinogen: 273.3+/-67.4 vs 243.8+/-39.5 mg%, P=0.013; ATIII 112.2+/-11.7 vs 117.5+/-12.7% %, P=0.059; FVII 121.6+/-11.3 vs 117.6+/-10.8 mg%, P=ns; TFPI activity 2.5+/-2.3 vs 2.1+/-1.1 U/mL, P=ns; TFPI antigen 120+/-38 vs 127+/-39 U/mL, P=ns). Comparing the same parameters, before and after three months of HRT, in patients of Group III we observed a significant improvement of TC and TG levels (TC from 232.3+/-42.7 to 215.2+/-37.6 mg%, P=0.0001; TG from 103.7+/-56.8 to 95.0+/-44.3 mg%, P=0.059; HDL-C from 62.3+/-12.9 to 63.6+/-12.6 mg%, P=ns; LDL-C from 149.3+/-38.7 to 132.6+/-34.5 mg%, P=0.0001). The following changes were observed with regard to coagulative parameters: fibrinogen from 270.9+/-69.4 to 253.2+/-56.2 mg%, P=0.07; ATIII from 113.5+/-11.4 to 110.8+/-13.2 mg%, P=0.198; FVII from 108.6+/-18.0 to 104.4+/-17.5 mg%, 0.014. TFPI activity from 2.6+/-2.3 to 2.3+/-1.4 U/ml, P=ns; TFPI antigen from 68+/-13 to 87+/-22 U/mL, P=0.001.
  
  
  CONCLUSIONS
  Our data confirm the presence of an alteration in lipidic and coagulative pattern in post menopausal women and positive changes after HRT.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine and Cardiovascular Diseases, University Hospital Paolo Giaccone, University of Palermo, Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Evola
authors.forename: G
authors.initials: G
authors.lastname: Novo
authors.forename: G
authors.initials: G
authors.lastname: Amoroso
authors.forename: D
authors.initials: D
authors.lastname: Guttilla
authors.forename: L
authors.initials: L
authors.lastname: Lo Coco
authors.forename: M
authors.initials: M
authors.lastname: Guagliardo
authors.forename: A
authors.initials: A
authors.lastname: Lupo
authors.forename: M R
authors.initials: MR
authors.lastname: Averna
authors.forename: V
authors.initials: V
authors.lastname: Giambanco
authors.forename: V
authors.initials: V
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Novo
mesh_terms: D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D002784:Cholesterol / Q000097:blood; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D020249:Hormone Replacement Therapy; D006801:Humans; D007558:Italy; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D008055:Lipids; D017270:Lipoprotein(a); D008074:Lipoproteins; D014280:Triglycerides; C051928:lipoprotein-associated coagulation inhibitor; D000990:Antithrombin III; D005169:Factor VIII; D005340:Fibrinogen; D002784:Cholesterol