Anderson P W, Cox D A, Sashegyi A, Paul S, Silfen S L, Walsh B W
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Maturitas. 2001 Jul 25;39(1):71-7. doi: 10.1016/s0378-5122(00)00224-3.
To determine the effect of raloxifene (RLX) and hormone replacement therapy (HRT) on non-high density lipoprotein cholesterol (non-HDL-C) levels and the apolipoprotein-B/apolipoprotein-A1 (apo-B/apo-A1) concentration ratio, markers of serum atherogenicity, in postmenopausal women.
Three hundred and ninety healthy postmenopausal women aged 45-72 years were enrolled in a double-blind, randomized, placebo-controlled, parallel trial at eight outpatient sites in the United States. Women were randomly assigned to receive continuous combined HRT (0.625 mg/day conjugated equine estrogen and 2.5 mg/day medroxyprogesterone acetate), 60 or 120 mg/day raloxifene, or placebo for 6 months. Serum concentrations of non-HDL cholesterol and the apo-B/apo-A1 concentration ratio were measured in serum samples obtained at baseline and at 6 months of treatment.
At 6 months, non-HDL-C and apo-B/apo-A1 were significantly reduced by 60 mg/day RLX (10 and 11%, respectively), 120 mg/day RLX (9 and 12%, respectively) and HRT (10 and 12%, respectively), compared with placebo. The effect of all treatments to lower non-HDL-C and apo-B/apo-A1 was greatest in women with hypercholesterolemia (total-C>240 mg/dl) at baseline. Among women with undesirable (>160 mg/dl) non-HDL cholesterol at baseline, RLX and HRT lowered the percentage of these women remaining above this threshold after 6 months (placebo, 89%; 60 mg/day RLX, 61%; 120 mg/day RLX, 74%; HRT, 58%). Similar results were observed for women with high (>190 mg/dl) non-HDL cholesterol at baseline.
In healthy postmenopausal women, RLX and HRT lower serum non-HDL-C and apo-B/apo-A1, indicators of serum atherogenicity, to a similar extent.
确定雷洛昔芬（RLX）和激素替代疗法（HRT）对绝经后女性非高密度脂蛋白胆固醇（non-HDL-C）水平以及血清致动脉粥样硬化标志物载脂蛋白B/载脂蛋白A1（apo-B/apo-A1）浓度比值的影响。
390名年龄在45 - 72岁的健康绝经后女性在美国8个门诊地点参加了一项双盲、随机、安慰剂对照的平行试验。女性被随机分配接受连续联合HRT（0.625毫克/天结合马雌激素和2.5毫克/天醋酸甲羟孕酮）、60毫克/天或120毫克/天雷洛昔芬，或安慰剂，为期6个月。在基线和治疗6个月时采集的血清样本中测量非HDL胆固醇的血清浓度和apo-B/apo-A1浓度比值。
与安慰剂相比，在6个月时，60毫克/天雷洛昔芬（分别降低10%和11%）、120毫克/天雷洛昔芬（分别降低9%和12%）和HRT（分别降低10%和12%）使non-HDL-C和apo-B/apo-A1显著降低。所有治疗降低non-HDL-C和apo-B/apo-A1的效果在基线时患有高胆固醇血症（总胆固醇>240毫克/分升）的女性中最为显著。在基线时非HDL胆固醇不理想（>160毫克/分升）的女性中，雷洛昔芬和HRT降低了6个月后仍高于该阈值的女性百分比（安慰剂组为89%；60毫克/天雷洛昔芬组为61%；120毫克/天雷洛昔芬组为74%；HRT组为58%）。对于基线时非HDL胆固醇高（>190毫克/分升）的女性也观察到了类似结果。
在健康绝经后女性中，雷洛昔芬和HRT在降低血清non-HDL-C和apo-B/apo-A1（血清致动脉粥样硬化指标）方面程度相似。
