Whitcroft S I, Crook D, Marsh M S, Ellerington M C, Whitehead M I, Stevenson J C
Academic Department of Obstetrics and Gynaecology, King's College School of Medicine, London, England.
Obstet Gynecol. 1994 Aug;84(2):222-6.
To see whether the short-term changes in serum lipid and lipoprotein concentrations induced by postmenopausal estrogen-progestin therapy are maintained in the long term.
Sixty-one healthy postmenopausal women were randomized to either oral therapy (continuous conjugated equine estrogens at 0.625 mg/day with sequential dl-norgestrel at 0.15 mg/day for 12 days each cycle) or transdermal therapy (patches delivering continuous 17 beta-estradiol [E2] at 0.05 mg/day with sequential norethindrone acetate at 0.25 mg/day for 14 days each cycle). Twenty-nine healthy postmenopausal women who did not request therapy served as a reference group. Fasting serum lipid and lipoprotein concentrations were monitored for 3 years.
Studied in the estrogen-progestin phase, oral and transdermal therapies reduced serum total cholesterol concentrations by 12.1% (P < .001) and 8.4% (P < .001), respectively, and those of low-density lipoprotein (LDL) by 14.2% (P < .001) and 6.6% (P < .01), respectively. These changes, apparent at 3 months, were maintained over 3 years. Serum triglyceride concentrations fell by 2.5% (P < .05) and 16.4% (P < .01), respectively. These decreases were evident after 6 months in both groups but were maintained over 3 years only in the transdermal group. High-density lipoprotein (HDL) concentrations fell in women given oral therapy (7.8%, P < .05) and transdermal therapy (10.7%, P < .001), as well as in untreated women (7.0%, P < .05).
The potentially beneficial effects of estrogen-progestin therapy on serum total and LDL cholesterol and on triglycerides were maintained over 3 years. Interpretation of the potentially detrimental effects on HDL concentrations was hindered by the changes seen in untreated women.
观察绝经后雌激素 - 孕激素治疗引起的血清脂质和脂蛋白浓度的短期变化是否能长期维持。
61名健康的绝经后女性被随机分为口服治疗组（每天服用0.625毫克连续结合马雌激素，每个周期连续12天每天服用0.15毫克序贯dl - 炔诺孕酮）或经皮治疗组（每天释放0.05毫克连续17β - 雌二醇[E2]的贴片，每个周期连续14天每天服用0.25毫克序贯醋酸炔诺酮）。29名未要求治疗的健康绝经后女性作为参照组。对空腹血清脂质和脂蛋白浓度进行了3年的监测。
在雌激素 - 孕激素治疗阶段进行研究时，口服和经皮治疗分别使血清总胆固醇浓度降低了12.1%（P <.001）和8.4%（P <.001），低密度脂蛋白（LDL）浓度分别降低了14.2%（P <.001）和6.6%（P <.01）。这些变化在3个月时明显，并在3年中持续存在。血清甘油三酯浓度分别下降了2.5%（P <.05）和16.4%（P <.01）。两组在6个月后这些下降都很明显，但仅在经皮治疗组中在3年中持续存在。接受口服治疗（7.8%，P <.05）和经皮治疗（10.7%，P <.001）的女性以及未接受治疗的女性（7.0%，P <.05）的高密度脂蛋白（HDL）浓度均下降。
雌激素 - 孕激素治疗对血清总胆固醇、LDL胆固醇和甘油三酯的潜在有益作用在3年中持续存在。未接受治疗女性中出现的变化妨碍了对HDL浓度潜在有害作用的解读。
