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Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000.
Fertil Steril. 2001 May; 75(5):898-915.FS

Abstract

OBJECTIVE

To establish reference estimates of the effects of different hormone replacement therapy (HRT) regimens on lipid and lipoprotein levels.

DESIGN

Review and pooled analysis of prospective studies published up until the year 2000.

SETTING

Clinical trials centers, hospitals, menopause clinics.

PATIENT(S)

Healthy postmenopausal women.

INTERVENTION(S)

Estrogen alone, estrogen plus progestogen, tibolone, or raloxifene in the treatment of menopausal symptoms.

MAIN OUTCOME MEASURE(S)

Serum high- and low-density lipoprotein (HDL and LDL) cholesterol, total cholesterol, triglycerides, and lipoprotein (a).

RESULT(S)

Two-hundred forty-eight studies provided information on the effects of 42 different HRT regimens. All estrogen alone regimens raised HDL cholesterol and lowered LDL and total cholesterol. Oral estrogens raised triglycerides. Transdermal estradiol 17-beta lowered triglycerides. Progestogens had little effect on estrogen-induced reductions in LDL and total cholesterol. Estrogen-induced increases in HDL and triglycerides were opposed according to type of progestogen, in the order from least to greatest effect: dydrogesterone and medrogestone, progesterone, cyproterone acetate, medroxyprogesterone acetate, transdermal norethindrone acetate, norgestrel, and oral norethindrone acetate. Tibolone decreased HDL cholesterol and triglyceride levels. Raloxifene reduced LDL cholesterol levels. In 41 studies of 20 different formulations, HRT generally lowered lipoprotein (a).

CONCLUSION(S)

Route of estrogen administration and type of progestogen determined differential effects of HRT on lipid and lipoprotein levels. Future work will focus on the interpretation of the clinical significance of these changes.

Authors+Show Affiliations

Endocrinology and Metabolic Medicine, Division of Medicine, Imperial College School of Medicine, London, United Kingdom. i.godsland@ic.ac.uk

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11334901

Citation

Godsland, I F.. "Effects of Postmenopausal Hormone Replacement Therapy On Lipid, Lipoprotein, and Apolipoprotein (a) Concentrations: Analysis of Studies Published From 1974-2000." Fertility and Sterility, vol. 75, no. 5, 2001, pp. 898-915.
Godsland IF. Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000. Fertil Steril. 2001;75(5):898-915.
Godsland, I. F. (2001). Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000. Fertility and Sterility, 75(5), 898-915.
Godsland IF. Effects of Postmenopausal Hormone Replacement Therapy On Lipid, Lipoprotein, and Apolipoprotein (a) Concentrations: Analysis of Studies Published From 1974-2000. Fertil Steril. 2001;75(5):898-915. PubMed PMID: 11334901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000. A1 - Godsland,I F, PY - 2001/5/4/pubmed PY - 2001/6/8/medline PY - 2001/5/4/entrez SP - 898 EP - 915 JF - Fertility and sterility JO - Fertil Steril VL - 75 IS - 5 N2 - OBJECTIVE: To establish reference estimates of the effects of different hormone replacement therapy (HRT) regimens on lipid and lipoprotein levels. DESIGN: Review and pooled analysis of prospective studies published up until the year 2000. SETTING: Clinical trials centers, hospitals, menopause clinics. PATIENT(S): Healthy postmenopausal women. INTERVENTION(S): Estrogen alone, estrogen plus progestogen, tibolone, or raloxifene in the treatment of menopausal symptoms. MAIN OUTCOME MEASURE(S): Serum high- and low-density lipoprotein (HDL and LDL) cholesterol, total cholesterol, triglycerides, and lipoprotein (a). RESULT(S): Two-hundred forty-eight studies provided information on the effects of 42 different HRT regimens. All estrogen alone regimens raised HDL cholesterol and lowered LDL and total cholesterol. Oral estrogens raised triglycerides. Transdermal estradiol 17-beta lowered triglycerides. Progestogens had little effect on estrogen-induced reductions in LDL and total cholesterol. Estrogen-induced increases in HDL and triglycerides were opposed according to type of progestogen, in the order from least to greatest effect: dydrogesterone and medrogestone, progesterone, cyproterone acetate, medroxyprogesterone acetate, transdermal norethindrone acetate, norgestrel, and oral norethindrone acetate. Tibolone decreased HDL cholesterol and triglyceride levels. Raloxifene reduced LDL cholesterol levels. In 41 studies of 20 different formulations, HRT generally lowered lipoprotein (a). CONCLUSION(S): Route of estrogen administration and type of progestogen determined differential effects of HRT on lipid and lipoprotein levels. Future work will focus on the interpretation of the clinical significance of these changes. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/11334901/Effects_of_postmenopausal_hormone_replacement_therapy_on_lipid_lipoprotein_and_apolipoprotein__a__concentrations:_analysis_of_studies_published_from_1974_2000_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(01)01699-5 DB - PRIME DP - Unbound Medicine ER -