Hemelaar M, Kenemans P, Schalkwijk C G, Braat D D M, van der Mooren M J
Project Ageing Women and Institute for Cardiovascular Research-Vrije Universiteit, Department of Obstetrics & Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
Hum Reprod. 2006 Jun;21(6):1635-42. doi: 10.1093/humrep/del034. Epub 2006 Feb 24.
Inflammation plays an important role in the development of atherosclerotic disease. Oral post-menopausal hormone therapy increases serum C-reactive protein (CRP) levels. This study compared the effects of intranasal and oral administration of 17beta-estradiol (E2) combined with norethisterone acetate (NETA) on markers of inflammation in healthy post-menopausal women.
Ninety healthy post-menopausal women (age 56.6 +/- 4.7 years) participated in this 1-year trial. After computerized block randomization, they daily received, in a double-blind fashion, either intranasal E2/NET [175 microg/275 microg (n = 47)] or oral E2/NETA [1 mg/0.5 mg (n = 43)]. Concentrations of high sensitivity CRP and adhesion molecules were measured at baseline and after 12, 24 and 52 weeks of treatment.
CRP levels were increased (P = 0.001) in the oral but not in the intranasal group. The increase in the oral group was highest at week 12 (64.9%) and was larger (P < 0.01) compared with the non-significant increase (8.6%) found in the intranasal group. Both groups showed decreases (P < 0.001) in soluble vascular cell adhesion molecule (sVCAM), soluble intracellular adhesion molecule (sICAM) and sE-selectin. The decreases were larger (P < 0.01) in the oral than in the intranasal group.
Intranasal E2/NET therapy did not significantly increase CRP levels, in contrast to the increase observed in the oral E2/NETA treatment group. Both intranasal and oral therapy lowered plasma concentrations of adhesion molecules, however, more so in the oral group.
炎症在动脉粥样硬化疾病的发展中起重要作用。绝经后口服激素治疗会增加血清C反应蛋白（CRP）水平。本研究比较了健康绝经后女性经鼻和口服17β-雌二醇（E2）联合醋酸炔诺酮（NETA）对炎症标志物的影响。
90名健康绝经后女性（年龄56.6±4.7岁）参与了这项为期1年的试验。经过计算机分组随机化后，她们以双盲方式每日接受经鼻E2/NET[175微克/275微克（n = 47）]或口服E2/NETA[1毫克/0.5毫克（n = 43）]。在基线以及治疗12周、24周和52周后测量高敏CRP和黏附分子的浓度。
口服组CRP水平升高（P = 0.001），经鼻组则未升高。口服组在第12周时升高幅度最大（64.9%），且与经鼻组不显著的升高（8.6%）相比更大（P < 0.01）。两组可溶性血管细胞黏附分子（sVCAM）、可溶性细胞间黏附分子（sICAM）和sE-选择素均降低（P < 0.001）。口服组的降低幅度大于经鼻组（P < 0.01）。
与口服E2/NETA治疗组观察到的升高相反，经鼻E2/NET治疗未显著升高CRP水平。经鼻和口服治疗均降低了血浆黏附分子浓度，然而口服组降低得更多。
