Zhou Fan, Prabahar Kousalya, Shu Jiao
Laboratory of Molecular Medicine, Puren Hospital, No. 1 Benxi St, Qingshan Dist, Wuhan City, 430080, China.
Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia.
Diabetol Metab Syndr. 2025 Apr 1;17(1):111. doi: 10.1186/s13098-025-01664-1.
To date, no meta-analysis has reported on the role of transdermal estrogens combined with Medroxyprogesterone Acetate (MPA) in relation to cardiovascular disease (CVD) risk factors in postmenopausal women. To fill this knowledge gap, a meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effects of transdermal estrogens and MPA on CVD risk factors in postmenopausal women.
A systematic literature search was conducted in major databases including PubMed/Medline, Web of Science, SCOPUS, and Embase, from inception to 12 February 2025. The combination of Medical Subject Headings (MeSH) and non-MeSH keywords was used.
A total of 14 trials were included in the meta-analysis. The combined eligible trials found that transdermal estrogens combined with MPA significantly decreased total cholesterol (TC) (WMD: -13.37 mg/dL, 95% CI: -21.54 to -5.21, p = 0.001), low density lipoprotein cholesterol (LDL-C) (WMD: -12.17 mg/dL, 95% CI: -23.26 to -1.08, p = 0.031), and apolipoprotein B (ApoB) (WMD: -7.26 mg/dL, 95% CI: -11.48 to -3.03, p = 0.001) compared to the control. No statistically significant associations were observed between transdermal estrogens combined with MPA on triglyceride (TG), high density lipoprotein cholesterol (HDL-C), lipoprotein(a) (Lp(a)), and apolipoprotein A1 (ApoAI).
Based on the results of the current meta-analysis, transdermal estrogens combined with oral MPA administration had a beneficial effect on certain CVD risk factors in postmenopausal women, as evidenced by the significant reductions in TC, LDL-C, and ApoB.
迄今为止，尚无荟萃分析报告经皮雌激素联合醋酸甲羟孕酮（MPA）对绝经后女性心血管疾病（CVD）危险因素的作用。为填补这一知识空白，开展了一项随机对照试验（RCT）的荟萃分析，以评估经皮雌激素和MPA对绝经后女性CVD危险因素的影响。
在包括PubMed/Medline、Web of Science、SCOPUS和Embase在内的主要数据库中进行了系统的文献检索，检索时间从数据库建立至2025年2月12日。使用了医学主题词（MeSH）和非MeSH关键词的组合。
荟萃分析共纳入14项试验。综合符合条件的试验发现，与对照组相比，经皮雌激素联合MPA可显著降低总胆固醇（TC）（加权均数差：-13.37mg/dL，95%置信区间：-21.54至-5.21，p = 0.001）、低密度脂蛋白胆固醇（LDL-C）（加权均数差：-12.17mg/dL，95%置信区间：-23.26至-1.08，p = 0.031）和载脂蛋白B（ApoB）（加权均数差：-7.26mg/dL，95%置信区间：-11.48至-3.03，p = 0.001）。经皮雌激素联合MPA与甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、脂蛋白（a）（Lp（a））和载脂蛋白A1（ApoAI）之间未观察到统计学上的显著关联。
基于当前荟萃分析的结果，经皮雌激素联合口服MPA对绝经后女性的某些CVD危险因素具有有益作用，TC、LDL-C和ApoB的显著降低证明了这一点。
