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Article: An examination of the effect of combined cyclical hormone replacement therapy on lipoprotein(a) and other lipoproteins

TitleAn examination of the effect of combined cyclical hormone replacement therapy on lipoprotein(a) and other lipoproteins
Authors
Issue Date1996
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/atherosclerosis
Citation
Atherosclerosis, 1996, v. 119 n. 2, p. 215-222 How to Cite?
AbstractLipoprotein(a) (Lp(a)) is an independent marker of cardiovascular disease which is relatively unresponsive to treatment with most of the commonly prescribed lipid lowering drugs. Concentrations of Lp(a) increase after the menopause, and the primary aim of this study was to determine whether combined hormone replacement therapy was effective in lowering levels of Lp(a) in postmenopausal women. An open longitudinal study was conducted among 42 women who had undergone a spontaneous menopause and were attending the outpatient clinic of the Prince of Wales Hospital, Hong Kong. All subjects were treated with 2 mg oral estradiol daily and 5 mg medroxyprogesterone acetate for 12 days each calendar month. Fasting blood samples for lipoprotein measurement were taken before the commencement of treatment and at 6 and 12 months. Lp(a) levels showed a skewed distribution with a median value before treatment of 9.45 mg/dl (range 1.47-95.62 mg/dl). After 6 months, there was a reduction to 7.70 mg/dl (1.12-72.59 mg/dl) (P < 0.01), and after 12 months the median concentration was 7.14 mg/dl (0.63-69.23 mg/dl) (P < 0.001 0-12 months). There were also significant reductions in the concentrations of apo B from 116.13 to 111.62 mg/dl and LDL-C from 3.02 to 2.74 mmol/l (P < 0.05), plus a lowering of TC of borderline significance. Apo A-I increased from 162.56 to 173.35 mg/dl (P < 0.01), but there were no significant changes in HDL-C or the HDL-C subfractions. TC, LDL-C, apo B and TG concentrations were higher and HDL-C and HDL2-C concentrations were lower when blood was sampled during combined treatment with estrogen and progesterone than when estrogen was being taken alone. Levels of Lp(a) were also lower during the estrogen only phase of treatment, but none of these differences were statistically significant. This study demonstrates that combined cyclical hormone replacement therapy is effective in reducing concentrations of Lp(a). The trend towards a more atherogenic lipid profile during the combined phase of treatment suggests that attention should be given to the timing of blood sampling in future studies of this nature.
Persistent Identifierhttp://hdl.handle.net/10722/210354
ISSN
2015 Impact Factor: 3.942
2015 SCImago Journal Rankings: 1.819

 

DC FieldValueLanguage
dc.contributor.authorJHaines, CJ-
dc.contributor.authorChung, TKH-
dc.contributor.authorMasarei, JRL-
dc.contributor.authorTomlinson, B-
dc.contributor.authorLau, JTF-
dc.date.accessioned2015-06-10T02:44:48Z-
dc.date.available2015-06-10T02:44:48Z-
dc.date.issued1996-
dc.identifier.citationAtherosclerosis, 1996, v. 119 n. 2, p. 215-222-
dc.identifier.issn0021-9150-
dc.identifier.urihttp://hdl.handle.net/10722/210354-
dc.description.abstractLipoprotein(a) (Lp(a)) is an independent marker of cardiovascular disease which is relatively unresponsive to treatment with most of the commonly prescribed lipid lowering drugs. Concentrations of Lp(a) increase after the menopause, and the primary aim of this study was to determine whether combined hormone replacement therapy was effective in lowering levels of Lp(a) in postmenopausal women. An open longitudinal study was conducted among 42 women who had undergone a spontaneous menopause and were attending the outpatient clinic of the Prince of Wales Hospital, Hong Kong. All subjects were treated with 2 mg oral estradiol daily and 5 mg medroxyprogesterone acetate for 12 days each calendar month. Fasting blood samples for lipoprotein measurement were taken before the commencement of treatment and at 6 and 12 months. Lp(a) levels showed a skewed distribution with a median value before treatment of 9.45 mg/dl (range 1.47-95.62 mg/dl). After 6 months, there was a reduction to 7.70 mg/dl (1.12-72.59 mg/dl) (P < 0.01), and after 12 months the median concentration was 7.14 mg/dl (0.63-69.23 mg/dl) (P < 0.001 0-12 months). There were also significant reductions in the concentrations of apo B from 116.13 to 111.62 mg/dl and LDL-C from 3.02 to 2.74 mmol/l (P < 0.05), plus a lowering of TC of borderline significance. Apo A-I increased from 162.56 to 173.35 mg/dl (P < 0.01), but there were no significant changes in HDL-C or the HDL-C subfractions. TC, LDL-C, apo B and TG concentrations were higher and HDL-C and HDL2-C concentrations were lower when blood was sampled during combined treatment with estrogen and progesterone than when estrogen was being taken alone. Levels of Lp(a) were also lower during the estrogen only phase of treatment, but none of these differences were statistically significant. This study demonstrates that combined cyclical hormone replacement therapy is effective in reducing concentrations of Lp(a). The trend towards a more atherogenic lipid profile during the combined phase of treatment suggests that attention should be given to the timing of blood sampling in future studies of this nature.-
dc.languageeng-
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/atherosclerosis-
dc.relation.ispartofAtherosclerosis-
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in [Journal title]. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in PUBLICATION, [VOL#, ISSUE#, (DATE)] DOI# -
dc.subject.meshLipoprotein(a)-
dc.subject.meshLipoproteins-
dc.subject.meshMenopause-
dc.subject.meshCoronary heart disease-
dc.titleAn examination of the effect of combined cyclical hormone replacement therapy on lipoprotein(a) and other lipoproteins-
dc.typeArticle-
dc.identifier.emailMasarei, JRL: masareij@hkucc.hku.hk-
dc.identifier.doi10.1016/0021-9150(95)05650-5-
dc.identifier.pmid8808498-
dc.identifier.hkuros25811-
dc.identifier.volume119-
dc.identifier.issue2-
dc.identifier.spage215-
dc.identifier.epage222-
dc.publisher.placeIreland-

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