Effect of different preparations of hormone therapy on lipid and glucose metabolism, coagulation factors, and bone mineral density in overweight and obese postmenopausal women

Osmanagaoglu M., Osmanagaoglu S., Osmanagaoglu T., Okumus B., Bozkaya H.

FERTILITY AND STERILITY, sa.2, ss.384-393, 2005 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2005
  • Doi Numarası: 10.1016/j.fertnstert.2005.01.131
  • Dergi Adı: FERTILITY AND STERILITY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.384-393
  • Anahtar Kelimeler: hormone therapy, lipid profile, glucose metabolism, coagulation factors, bone mineral density, body mass index, postmenopause, INSULIN-RESISTANCE SYNDROME, REPLACEMENT THERAPY, LIPOPROTEIN CHOLESTEROL, MYOCARDIAL-INFARCTION, ESTROGEN REPLACEMENT, TIBOLONE, DISEASE, ACETATE, RISK, APOLIPOPROTEIN
  • Karadeniz Teknik Üniversitesi Adresli: Evet

Özet

Objective: To determine the effects of different preparations of hormone therapy (HT) on lipid and glucose metabolism, coagulation factors, and bone mineral density (BMD) in overweight and obese postmenopausal women. Design: A randomized, nonblinded, controlled study. Setting: Karadeniz Technical University, Department of Obstetrics and Gynecology. Patient(s): A total of 352 overweight and obese (body mass index > 25 kg/m(2)) postmenopausal women. Intervention(s): Ninety women received 2.5 mg of tibolone; 84 received 2 mg of E-2 plus 1 mg of norethisterone acetate (E-2/NETA); 90 received 0.625 mg of conjugated equine estrogen plus 2.5 mg of medroxyprogesterone acetate (CEE/MPA); and 88 did not receive any menopausal therapy (control). Main Outcome Measure(s): At baseline and after 6 months of treatment, we measured total cholesterol, triglyceride, high-density lipoprotein cholesterol (LDL), insulin, glucose, factor VII, factor VIII, von Willebrand factor, antithrombin III, protein S, protein C, fibrinogen, and BMD at the lumbar spine L-1-L-4. Result(s): There were no statistically significant differences among the groups for any variables at baseline. After 6 months of treatment, the three regimens decreased total cholesterol, triglyceride, LDL, and fibrinogen; E-2/NETA and CEE/MPA increased HDL, and tibolone increased HDL, higher insulin concentrations were found in the control and tibolone groups. Body mass index, HDL, fibrinogen levels, and L-1-L-4 BMD were independent factors in the prediction of HT use. Conclusion(s): Body mass index, HDL, fibrinogen levels and L-1-L-4 BMD were independent factors in the prediction of HT use. Treatment with tibolone, E-2/NETA, and CEE/MPA resulted in minimal improvement in lumbar spine BMD but had a beneficial effect on the procoagulation system, with minimal changes in glucose metabolism after 6 months of therapy.