Relationship between apolipoprotein E polymorphism, menopausal symptoms, and serum lipids during hormone replacement therapy.

OBJECTIVE

Menopausal women receive hormone replacement therapy (HRT) to relieve symptoms and to help prevent osteoporosis or atherosclerotic disease. We investigated the association of apolipoprotein (apo) E polymorphism with menopausal symptoms, body fat mass and lipid profile in 236 women, together with the lipid changes accompanying HRT administration in 172 women from this population who were postmenopausal.

STUDY DESIGN

The subjects were divided into three groups according to apo E phenotype: group E2, apo E2/2 and 2/3; group E3, apo E3/3; group E4, apo E4/3 and 4/4. Typical menopausal symptoms were classified into four degrees of severity; body fat mass, lipid profile, and serum lipid levels were measured before and 6 months after oral HRT.

RESULTS

There were no significant differences between the symptoms of the three groups. The serum levels of apo E were the highest in group E2 and lowest in group E4. Analogous tendencies were seen in the mean levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and apo B, with group E4 having the highest levels and group E2 the lowest. Triglyceride levels (TG) were the highest in group E2, but the difference was not significant. These parameters suggest that group E4 had the highest risk of cardiovascular disease. The LDL-C/high density lipoprotein cholesterol (HDL-C) ratio was improved from 2.18 before HRT to 1.52 after HRT in group E2; from 2.26 to 1.92 in group E3; and from 2.57 to 2.10 in group E4.

CONCLUSION

The apo E phenotype was not associated with any difference in menopausal symptoms. Group E4 had the highest risk for cardiovascular disease, and group E2 the lowest. Oral HRT could be recommended for the women in group E4.