低剂量激素替代疗法对有冠状动脉疾病风险的绝经后妇女血脂谱和内皮功能的影响：一项随机试验。

Lipid profiles and endothelial function with low-dose hormone replacement therapy in postmenopausal women at risk for coronary artery disease: a randomized trial.

作者信息

Mercuro Giuseppe, Vitale Cristiana, Fini Massimo, Zoncu Sandra, Leonardo Filippo, Rosano Giuseppe M C

机构信息

Cardiovascular Research Unit, Department of Internal Medicine, San Raffaele Hospital, Rome, Italy.

出版信息

Int J Cardiol. 2003 Jun;89(2-3):257-65. doi: 10.1016/s0167-5273(02)00505-3.

DOI:10.1016/s0167-5273(02)00505-3

PMID:12767550

Abstract

AIMS

To compare the effect of low (0.3 mg) and commonly prescribed (0.625 mg) doses of conjugated equine estrogens (CEE) on brachial artery flow-mediated dilation and lipid profiles.

METHODS AND RESULTS

Twenty-five postmenopausal women (mean age, 65+/-6 years) at risk for coronary artery disease (CAD) (> or =2 established risk factors) entered a double-blind crossover study. Brachial artery endothelial function was evaluated by means of high-resolution vascular echography. Both CEE doses significantly decreased total cholesterol (-13%, 0.3 mg; -15%, 0.625 mg), low-density lipoprotein-cholesterol (LDL-C) (-15%, 0.3 mg; -16%, 0.625 mg), and lipoprotein(a) (-28%, 0.3 mg; -39%, 0.625 mg) values from baseline levels. Both treatments increased high-density lipoprotein-cholesterol (HDL-C) (5%, 0.3 mg; 7%, 0.625 mg) and triglycerides (3%, 0.3 mg; 8%, 0.625 mg). There was no dose effect for changes in the LDL-C/HDL-C ratio (-21%, 0.3 mg; -23%, 0.625 mg). Both doses improved brachial artery dilation during reactive hyperemia by 63% over baseline.

CONCLUSION

In women at risk for CAD, low-dose hormone replacement treatment (HRT) improves lipid profiles and brachial artery endothelial function comparably to the most commonly prescribed dose. The benefit:risk ratio of low-dose HRT provides an attractive option for postmenopausal women at risk for CAD.

摘要

目的

比较低剂量（0.3毫克）和常用剂量（0.625毫克）的结合马雌激素（CEE）对肱动脉血流介导的血管舒张和血脂谱的影响。

方法与结果

25名有冠状动脉疾病（CAD）风险（≥2个已确定的风险因素）的绝经后女性（平均年龄，65±6岁）进入一项双盲交叉研究。通过高分辨率血管超声评估肱动脉内皮功能。两种CEE剂量均使总胆固醇（-13%，0.3毫克；-15%，0.625毫克）、低密度脂蛋白胆固醇（LDL-C）（-15%，0.3毫克；-16%，0.625毫克）和脂蛋白(a)（-28%，0.3毫克；-39%，0.625毫克）值从基线水平显著降低。两种治疗均使高密度脂蛋白胆固醇（HDL-C）升高（5%，0.3毫克；7%，0.625毫克）和甘油三酯升高（3%，0.3毫克；8%，0.625毫克）。LDL-C/HDL-C比值的变化没有剂量效应（-21%，0.3毫克；-23%，0.625毫克）。两种剂量均使反应性充血期间的肱动脉扩张比基线提高63%。