Effects of transdermal and oral hormone replacement therapies on monocyte chemoattractant protein-1 levels: a randomized clinical trial.

OBJECTIVES

To assess the effects of oral and transdermal hormone replacement therapies (HRT) on levels of important cardiovascular disease (CVD) markers, MCP-1 and homocyteine, in the early postmenopausal period.

STUDY DESIGN

Seventy-six healthy, early postmenopausal women were enrolled in the study. Patients were randomly assigned to receive oral or transdermal HRT for 6 months. The first group received continuous combined oral HRT containing 1mg 17β-estradiol and 0.5mg norethisterone acetate (n=39), and the second group received sequential transdermal HRT releasing 50μg/day estradiol alone given twice a week on days 1-14 and 50μg/day estradiol plus 0.25mg/day norethisterone acetate given twice a week on days 15-28 (n=37). Circulating levels of MCP-1 and homocysteine, along with other CVD markers, were assessed before and after treatment in all patients.

RESULTS

There were no significant differences between the baseline characteristics of the two groups. Baseline serum MCP-1 levels were similar between the oral and transdermal HRT groups (150.1±12.8 vs. 145.2±11.6pg/ml; P=.219). The mean MCP-1 levels did not change after 6 months of HRT in both oral (150.1±12.8 vs. 153.6±12.5pg/ml; P=.192) and transdermal HRT groups (145.2±11.6 vs. 146.1±15.1pg/ml; P=.419). Moreover, there was no significant difference between the groups in MCP-1 serum levels after 6 months of HRT. Similarly, no difference was found in serum homocyteine levels following 6 months of HRT.

CONCLUSIONS

Both oral continuous and sequential transdermal HRTs do not have significant effects on serum MCP-1 and homocyteine levels in women during the early postmenopausal period.