Hemelaar Majoie, Kenemans Peter, de Bie Lut, van de Weijer Peter H M, van der Mooren Marius J
Department of Obstetrics and Gynecology, Project Aging Women, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
Fertil Steril. 2006 Apr;85(4):979-88. doi: 10.1016/j.fertnstert.2005.09.036.
To compare the effects of continuous combined 17beta-estradiol (E2) plus norethisterone (acetate) [NET(A)] therapy by either intranasal or oral administration on the lipid profile in postmenopausal women.
Randomized, double-blind, multicenter trial.
Gynecologic outpatient department.
PATIENT(S): Two-hundred thirty-three healthy postmenopausal women.
INTERVENTION(S): Women received continuous combined hormone therapy, either intranasal E2/NET (175 microg/275 microg) as a spray (n = 117) or oral E2/NETA (1 mg/0.5 mg) as a capsule (n = 116), for 1 year.
MAIN OUTCOME MEASURE(S): Fasting plasma concentrations of lipids and (apo)lipoproteins; and atherogenic indices at baseline and after 12, 24, and 52 weeks of treatment.
RESULT(S): We found a significant (P < .001) decrease from baseline in both treatment groups in total, low-density lipoprotein- (LDL), high-density lipoprotein- (HDL), and HDL2-cholesterol, in triglycerides, apolipoprotein B (apoB), and lipoprotein(a). Levels of HDL3-cholesterol and apolipoprotein A1 (apoA1) were transiently decreased in the intranasal group. In the oral group, compared with the intranasal group, the decrease was larger for ratio total and LDL-cholesterol and lipoprotein(a) and smaller for triglycerides and apoA1. In the oral group, the ratios total/HDL cholesterol and LDL/HDL cholesterol were lowered, and the ratio apoB/LDL was increased, more than in the intranasal group.
CONCLUSION(S): Both intranasal and oral E2/NET(A) therapy improved the lipid profile of healthy postmenopausal women, with some effects being more pronounced after oral administration.
比较经鼻或口服连续联合应用17β-雌二醇（E2）加炔诺酮（醋酸酯）[NET(A)]疗法对绝经后女性血脂谱的影响。
随机、双盲、多中心试验。
妇科门诊。
233名健康绝经后女性。
女性接受连续联合激素治疗，经鼻给予E2/NET（175微克/275微克）喷雾剂（n = 117）或口服E2/NETA（1毫克/0.5毫克）胶囊（n = 116），为期1年。
空腹血浆脂质和（载）脂蛋白浓度；以及治疗第12、24和52周时的致动脉粥样化指数。
我们发现，两个治疗组的总胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）和HDL2胆固醇、甘油三酯、载脂蛋白B（apoB）和脂蛋白(a)均较基线显著降低（P < .001）。经鼻给药组的HDL3胆固醇和载脂蛋白A1（apoA1）水平短暂下降。口服组与经鼻给药组相比，总胆固醇与LDL胆固醇比值和脂蛋白(a)下降幅度更大，甘油三酯和apoA1下降幅度更小。口服组的总胆固醇/HDL胆固醇比值和LDL/HDL胆固醇比值降低，apoB/LDL比值升高，且变化幅度均大于经鼻给药组。
经鼻和口服E2/NET(A)疗法均改善了健康绝经后女性的血脂谱，口服给药后的某些效果更为显著。
