Paganini-Hill A, Dworsky R, Krauss R M
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90031, USA.
Am J Obstet Gynecol. 1996 Mar;174(3):897-902. doi: 10.1016/s0002-9378(96)70322-8.
Our purpose was to assess the relationships of lipid and lipoprotein cholesterol levels to hormone replacement therapy and hormone levels in elderly women.
A sample of 292 postmenopausal women 55 to 99 years old (mean 76 years) was drawn from Leisure World Laguna Hills, California, an upper-middle-class, white independent-living population. We compared 84 women receiving unopposed estrogen replacement therapy and 38 women taking combination hormone replacement therapy with 170 women who had never used hormone replacement therapy. Nonparametric tests for differences in lipid and lipoprotein cholesterol levels among groups and multiple stepwise regression models were used.
Estrogen users (with and without progestin) had lower total and low-density lipoprotein cholesterol and higher high-density lipoprotein and high-density lipoprotein subfraction types 2, 2a, and 2b cholesterol levels. High density lipoprotein type 3 subfractions were lower in combination hormone replacement therapy users but higher in unopposed estrogen users relative to nonusers. The conjugated equine estrogen dose was negatively correlated with total (p = 0.0009) and low-density lipoprotein cholesterol (p <0.0001) levels and positively correlated to high-density lipoprotein cholesterol (p = 0.002) and its subfractions. The medroxyprogesterone acetate dose showed no consistent effect on cholesterol levels.
The associations found here reaffirm the significant role of estrogen replacement therapy on lipid and lipoprotein cholesterol levels and provide no evidence of a reduction in the beneficial effect of estrogen with the addition of a progestational agent to the replacement regimen.
我们的目的是评估老年女性脂质和脂蛋白胆固醇水平与激素替代疗法及激素水平之间的关系。
从加利福尼亚州拉古纳希尔斯休闲世界选取了292名55至99岁（平均76岁）的绝经后女性作为样本，该群体为中上层阶级、白人独立生活人群。我们将84名接受单纯雌激素替代疗法的女性和38名接受联合激素替代疗法的女性与170名从未使用过激素替代疗法的女性进行了比较。采用非参数检验来比较各组间脂质和脂蛋白胆固醇水平的差异，并使用了多元逐步回归模型。
使用雌激素的女性（无论是否使用孕激素）总胆固醇和低密度脂蛋白胆固醇水平较低，高密度脂蛋白以及高密度脂蛋白亚组分2、2a和2b胆固醇水平较高。相对于未使用者，联合激素替代疗法使用者的高密度脂蛋白3亚组分较低，而单纯雌激素使用者的较高。结合马雌激素剂量与总胆固醇（p = 0.0009）和低密度脂蛋白胆固醇（p <0.0001）水平呈负相关，与高密度脂蛋白胆固醇（p = 0.002）及其亚组分呈正相关。醋酸甲羟孕酮剂量对胆固醇水平未显示出一致的影响。
此处发现的关联再次证实了雌激素替代疗法对脂质和脂蛋白胆固醇水平的重要作用，并且没有证据表明在替代方案中添加孕激素会降低雌激素的有益效果。
