Impact of menopause on lipid and bone metabolism and effect of hormone replacement therapy.

BACKGROUND

Hyperlipidemia and osteoporosis are the medical targets to improve the quality of life of increasing elderly women.

OBJECTIVE

To elucidate the effect of menopause and hormone replacement therapy (HRT) on lipid and bone metabolism.

SUBJECTS

With their written informed consent, studied were 89 postmenopausal with 30 premenopausal women, and postmenopausal 35 were assigned into HRT (n = 18) or control group (n = 17); the former received conjugated equine estrogen (0.625 mg/day) and medroxyprogesterone acetate (2.5 mg/day), the latter calcium aspartate (800 mg/day).

OUTCOME MEASURED

Parameters were measured for lipids; total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), triglycerides (TG), lipoproteins, and apolipoproteins as well as for bone metabolism; parathyroid hormone (PTH), 1,25(OH)2D3, bone type of alkaline phosphatase (b-ALP), intact bone gla protein (I-BGP), tartrate-resistant acid phosphatase (TRAP) in serum. Bone mineral density (BMD) of lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). Two atherogenic indices (AIs) were calculated: AIc equals [TC - HDLC]/HDLC, and AIap equals (apolipoprotein B)/(apolipoprotein A1).

RESULTS

TC increased in approximately 10% within 2 years after menopause with increased LDLC (approximately 20%) and decreased HDLC (approximately 10%), and atherogenic indices were both elevated. In HRT, HDLC increased, while TC and LDLC and TG showed no significant change; lumbar BMD increased by 3% after 12 month, while bone formation markers decreased; PTH increased and 1,25(OH)2D3 decreased.

CONCLUSION

We provided the natural changes of lipid and bone metabolism after menopause and how extent an estrogen replacement can reset these changes.