Han Rui, Wang Zhen, Prabahar Kousalya, Wan Dan
Department of Endocrinology, Chongqing Hospital of Traditional Chinese Medicine, No.6, Panxi Road Branch7, Jiangbei District, Chongqing, 400021, China.
Department of Gynecology, Chongqing Hospital of Traditional Chinese Medicine, No.6, Panxi Road Branch7, Jiangbei District, Chongqing, 400021, China.
Diabetol Metab Syndr. 2025 Jul 28;17(1):297. doi: 10.1186/s13098-025-01788-4.
The influence of medroxyprogesterone acetate plus conjugated equine estrogens (MPA/CEE) on apolipoproteins and lipoprotein(a) levels has been vastly studied with inconsistent results. These inconsistencies could be attributed to several factors, such as the characteristics of the included participants and dosage and duration of intervention, among others. This study was conducted to determine the impact of MPA/CEE on the lipoprotein(a) and apolipoprotein concentrations in the postmenopausal women through a systematic review and meta-analysis of randomized controlled trials (RCTs).
A comprehensive search was conducted across multiple databases for relevant RCTs up to April 2025, and a random-effects model was used to conduct a meta-analysis, with results presented as the weighted mean difference (WMD) along with a 95% confidence interval (CI). Subgroup and sensitivity analyses were further conducted to find potential sources of heterogeneity.
The current meta-analysis included 27 RCTs with 37 study arms. The study results revealed an increase in Apolipoprotein A1 (WMD: 12.42 mg/dL, 95%CI: 9.31, 15.52, P < 0.001), as well as a decline in Apolipoprotein B (WMD: -6.84 mg/dL, 95%CI: -8.28, -5.39, P < 0.001) and lipoprotein(a) (WMD: -5.12 mg/dL, 95%CI: -6.58, -3.65, P < 0.001) concentrations following MPA/CEE administration in postmenopausal women.
This meta-analysis indicates that MPA/CEE has a beneficial impact in the levels of atherogenic lipoproteins, which be correlated with a reduction in cardiovascular disease risk.
醋酸甲羟孕酮联合结合马雌激素（MPA/CEE）对载脂蛋白和脂蛋白(a)水平的影响已得到广泛研究，但结果并不一致。这些不一致可能归因于几个因素，如纳入参与者的特征、干预的剂量和持续时间等。本研究旨在通过对随机对照试验（RCT）进行系统评价和荟萃分析，确定MPA/CEE对绝经后女性脂蛋白(a)和载脂蛋白浓度的影响。
截至2025年4月，在多个数据库中对相关RCT进行了全面检索，并使用随机效应模型进行荟萃分析，结果以加权平均差（WMD）及95%置信区间（CI）表示。进一步进行亚组分析和敏感性分析以寻找潜在的异质性来源。
当前的荟萃分析纳入了27项RCT，共37个研究组。研究结果显示，绝经后女性服用MPA/CEE后，载脂蛋白A1升高（WMD：12.42mg/dL，95%CI：9.31，15.52，P<0.001），载脂蛋白B降低（WMD：-6.84mg/dL，95%CI：-8.28，-5.39，P<0.001），脂蛋白(a)降低（WMD：-5.12mg/dL，95%CI：-6.58，-3.65，P<0.001）。
该荟萃分析表明，MPA/CEE对致动脉粥样硬化脂蛋白水平有有益影响，这可能与心血管疾病风险降低相关。
