title: A prospective, case-control study on the lipid profile and the cardiovascular risk of menopausal women on oestrogen plus progestogen therapy in a northern Italy province.
abstract: OBJECTIVE
  To evaluate the effects of oestrogen plus progestogen therapy (EPT) on the lipid metabolism of menopausal patients.
  
  
  METHODS
  We conducted a prospective study on 223 patients with clinical and blood chemistry diagnosis of menopause, who were eligible for hormone therapy and a follow-up period lasting at least 5 years. We selected a control group. Patients attended annual or 6-monthly visits for the duration of the 5-year follow-up period. For each patient, total-cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride values were considered at the first visit and after 5 years. We compared these values of the above parameters in relation to time and EPT and the repercussions that the presence/absence of replacement therapy had in terms of lipid profile alteration between the groups studied.
  
  
  RESULTS
  Of the 223 patients eligible for enrolment, 178 made up the study group (EPT Group) and 45 made up the control cohort (N-EPT-Group). At the first visit, median value was (EPT-Group vs. N-EPT-Group): cholesterol was 240 versus 226 mg/dL, LDL-cholesterol 169 versus 174 mg/dL, HDL-cholesterol 60 mg/dL in both groups, triglyceride 125 versus 92 mg/dL (p:n.s). Five years later, median value was (EPT-Group versus N-EPT-Group): cholesterol 225 versus 236 mg/dL (p < 0.001), LDL-cholesterol 125 versus 184 mg/dL (p < 0.001), HDL-cholesterol 64 versus 68 mg/dL (p:n.s.), triglyceride 72 versus 94 mg/dL (p:n.s.). No adverse effects of EPT were observed.
  
  
  CONCLUSIONS
  Thorough risk/benefit assessment, associated with initially low doses and without rigid cutoffs, particularly when started early, EPT can be made a valid means of cardiovascular prevention, specifically because it positively alters the lipid profile of menopausal women.
authors.affiliation: Department of Gynecology, Obstetrics and Neonatology Sciences, University of Parma, Parma, Italy. titosilvio.patrelli@gmail.com
authors.forename: Tito Silvio
authors.initials: TS
authors.lastname: Patrelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.forename: Laura
authors.initials: L
authors.lastname: Franchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Berretta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedrazzi
authors.forename: Lavinia
authors.initials: L
authors.lastname: Volpi
authors.forename: Adolf
authors.initials: A
authors.lastname: Lukanovic
authors.forename: Giuliano Carlo
authors.initials: GC
authors.lastname: Zanni
authors.forename: Alberto Bacchi
authors.initials: AB
authors.lastname: Modena
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007558:Italy; D050356:Lipid Metabolism / Q000187:drug effects*; D008137:Longitudinal Studies; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D011374:Progesterone / Q000494:pharmacology*; D011372:Progestins / Q000494:pharmacology*; D011446:Prospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004967:Estrogens; D011372:Progestins; D014280:Triglycerides; D011374:Progesterone; D002784:Cholesterol