Bjarnason N H, Haarbo J, Byrjalsen I, Kauffman R F, Christiansen C
Center for Clinical and Basic Research, Ballerup, Denmark.
Circulation. 1997 Sep 16;96(6):1964-9. doi: 10.1161/01.cir.96.6.1964.
The beneficial effect of long-term hormone replacement therapy in terms of a decreased risk of cardiovascular disease is now generally accepted. Raloxifene, a selective estrogen receptor modulator, has demonstrated hypolipidemic properties while leaving the endometrium unstimulated.
For our study of the effects of raloxifene on atherosclerosis, 75 rabbits were ovariectomized and treated with either raloxifene, 17beta-estradiol, or placebo; 25 rabbits were sham operated and treated with placebo. After 45 weeks, the raloxifene group had two thirds of the aortic atherosclerosis, as evaluated by the cholesterol content of the proximal inner part of the aorta, found in the placebo group (placebo, 577+/-55.1 nmol/mg protein; raloxifene, 397+/-53.6 nmol/mg protein; P<.05); the estrogen group had one third of the aortic atherosclerosis in the placebo group (estrogen, 177+/-32.1 nmol/mg protein; P<.001). The sham-operated group (473+/-59.6 nmol/mg protein) was not significantly different from placebo. These effects were only partly explained by the changes in serum lipids and lipoproteins, and treatment with both estrogen and raloxifene independently predicted the response in aorta cholesterol. Because plasma levels of total raloxifene were low relative to clinical values in postmenopausal women, dose-response data for raloxifene are required.
Our findings indicate that raloxifene hydrochloride has a potentially important antiatherogenic effect, analogous to that observed with estrogen in this model.
长期激素替代疗法在降低心血管疾病风险方面的有益作用现已得到普遍认可。雷洛昔芬是一种选择性雌激素受体调节剂,已显示出降血脂特性,同时不会刺激子宫内膜。
为研究雷洛昔芬对动脉粥样硬化的影响,75只兔子接受了卵巢切除术,并分别用雷洛昔芬、17β-雌二醇或安慰剂进行治疗;25只兔子进行假手术并接受安慰剂治疗。45周后,通过主动脉近端内部胆固醇含量评估,雷洛昔芬组的主动脉粥样硬化程度为安慰剂组的三分之二(安慰剂组,577±55.1纳摩尔/毫克蛋白质;雷洛昔芬组,397±53.6纳摩尔/毫克蛋白质;P<0.05);雌激素组的主动脉粥样硬化程度为安慰剂组的三分之一(雌激素组,177±32.1纳摩尔/毫克蛋白质;P<0.001)。假手术组(473±59.6纳摩尔/毫克蛋白质)与安慰剂组无显著差异。这些作用仅部分由血清脂质和脂蛋白的变化来解释,雌激素和雷洛昔芬单独治疗均可预测主动脉胆固醇的反应。由于相对于绝经后女性的临床值,雷洛昔芬的血浆总水平较低,因此需要雷洛昔芬的剂量反应数据。
我们的研究结果表明,盐酸雷洛昔芬具有潜在重要的抗动脉粥样硬化作用,类似于在该模型中观察到的雌激素的作用。