ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveOxidized low-density lipoprotein (LDL) seems to play an important role in the etiology of atherosclerosis. To further study this, we performed two studies: (1) we determined the ability of 10 estrogen components of the drug, conjugated equine estrogen (CEE), trans-resveratrol (t-resveratrol) and quercetin (red wine components), trolox (vitamin E analog), and probucol (a serum cholesterol-lowering drug) to delay or prevent the oxidation of plasma LDL isolated from untreated postmenopausal women, and (2) we assessed the effect of long-term (>1 year) estrogen replacement therapy and hormone replacement therapy on LDL oxidation by ex vivo methods.DesignFor the in vivo study, three groups of postmenopausal women were selected based on whether they were on long-term CEE therapy (group A: 0.625 mg CEE;n= 21), on combination CEE plus progestogen therapy (group B: 0.625 mg CEE + 5.0 mg medroxyprogesterone acetate, 10 days;n= 20), or not on any hormone therapy (group C;n= 37). For the in vitro study, only LDL samples obtained from group C were used. The kinetics of LDL oxidation were measured by continuously monitoring the formation of conjugated dienes followed by determination of the lag time.ResultsAll compounds tested protected the LDL from oxidative damage. The relative antioxidant potency of estrogen components was generally greater than that of the other compounds. The minimum dose (nmoles) required to double the lag time from the control lag time of 57 ± 2 min was 0.47 for 17&bgr;-dihydroequilenin , 17&agr;-dihydroequilenin, &Dgr;8-estrone; 0.6 to 0.7 for &Dgr;8-17&bgr;-estradiol, equilenin, and quercetin; 0.9 for 17&bgr;-dihydroequilin and 17&agr;-dihydroequilin; 1.3 for equilin, estrone, 17&bgr;-estradiol, 17&agr;-estradiol; 1.4 for trolox; 1.9 for probucol; and 3.0 for t-resveratrol. The data from the in vivo study indicate that after long-term estrogen replacement therapy (group A) and hormone replacement therapy (group B), the LDL was significantly (p< 0.01) protected (higher lag time) against oxidation compared with the control (group C). There was no difference between groups A and B.ConclusionsThe oxidation of LDL isolated from postmenopausal women is inhibited differentially by various estrogens and other antioxidants. The unique ring B unsaturated estrogen components of CEE were the most potent, and t-resveratrol, the red wine component, was the least potent. Long-term CEE or CEE + medroxyprogesterone acetate administration to postmenopausal women protects the LDL against oxidation to the same extent. These combined data support the hypothesis that some of the cardioprotective benefits associated with CEE therapy and perhaps red wine consumption may be due to the ability of their components to protect LDL against oxidative modifications.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveEndometrial hyperplasia, an entity considered a precursor to endometrial carcinoma, frequently develops in women receiving unopposed estrogens. Progestins used concomitantly with estrogens can largely prevent endometrial hyperplasia and carcinoma. However, the ability of progestins to reverse endometrial hyperplasia induced by estrogens is less well recognized. The purpose of this study was to assess the medical reversal rate of endometrial hyperplasia that develops in women receiving unopposed estrogen replacement therapy (ERT).DesignReview of recent literature (1990–2000).ResultsBased on four large series, more than 90% of endometrial hyperplasia caused by ERT can be reversed by medical treatment. Discontinuation of estrogen and oral administration of 10 mg/day of medroxyprogesterone acetate continuously for 6 weeks or cyclically for 3 months (2 weeks of each month) are the two regimens most widely used. Other progestins also have been shown to be effective.ConclusionsProgestins are highly successful in reversing endometrial hyperplasia caused by ERT.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo evaluate the effectiveness of vaginal danazol as progestin supplement to estrogen replacement therapy, and its interference with uterine and carotid artery flow compared with medroxyprogesterone-acetate (MPA), estrogen alone, and placebo.MethodsForty healthy women at least 12 months after natural menopause were randomly divided into four treatment groups: Group 1 (n=10), continuous transdermal estradiol (TE) (50 &mgr;g/day), plus a monthly 10-day course of MPA (10 mg/day); Group 2 (n=10), continuous TE plus a monthly 10-day course of vaginal danazol (200 mg/day); Group 3 (n=10), TE alone; Group 4 (n=10), placebo. At baseline and during the first, third, and sixth month of treatment, the endometrial thickness was assessed by transvaginal ultrasonography, while the pulsatility index (PI) of the carotid and uterine arteries was assessed by color Doppler. An endometrial biopsy was also performed before and after the treatment.ResultsAt baseline, no significant differences between ages and other evaluated parameters were present in the four groups. In groups 1, 2, and 3, the values of carotid and uterine PI decreased significantly and similarly during the treatment, while in group 4 they were unchanged. In group 3 only, the endometrium was significantly thicker during treatment than before. No endometrial hyperplasia was present in the four groups at the end of the treatment.ConclusionsVaginal danazol seems to be capable of counteracting the mitogenic effect of estrogen on the endometrium without reducing the effectiveness of estrogens to improve peripheral arterial perfusion.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveSince a previous study showed an inverse correlation between high density lipoproteins (HDL) and bone mineral density (BMD), we searched for a possible relationship between HDL level and the presence of postmenopausal osteoporosis.DesignWe measured HDL levels in 37 women with postmenopausal osteoporosis, and compared them with a control group of 43 healthy postmenopausal women. The HDL levels were compared between the two groups using Student’sttest and were correlated with BMD by Pearson’s coefficient. To avoid possible selection bias, we compared patients and controls for body mass index by &khgr;2test. The sensitivity and specificity of HDL level higher than 65 mg% (positive test) or lower than 45 mg% (negative test) was compared with double emission x-ray absorptiometry (considered the gold standard in the measurement of BMD).ResultsThe level of HDL was significantly higher in the osteoporotic patients than in the controls (67.7 ± 15.5 mg%vs58.3 ± 11.6 mg%,p= 0.0039). HDL was inversely correlated with BMD (r = –0.29,p= 0.0083). HDL higher than 65 mg% has a high specificity (77%) for patients with osteoporosis, while HDL lower than 45 mg% has a high sensitivity (97%) in detecting subject without osteoporosis.ConclusionsOur preliminary data suggest an interesting, as yet unexplained association between HDL and bone mineral density in postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo assess women’s beliefs about natural hormones, including what they believe the term “natural” means, and their beliefs about the risks, side effects, and efficacy of natural hormone replacement compared to standard hormone replacement.DesignEighty-two women completed a 20-item survey available at a local compounding pharmacy. Respondents were white (100%), middle-aged (mean age, 47.22 years), and college educated (95.1%); 32.9% were perimenopausal, and 50.0% were postmenopausal; 58.5% were currently using hormone replacement therapy and, of those, 77.1% were using human bio-identical hormones.ResultsNinety percent of the respondents (n= 74) reported that they had heard about natural hormones. Of those, most believed natural meant plant-derived (44.6%) and/or not synthesized or made without chemicals (50.0%). Most reported hearing about natural hormones from a healthcare provider (66.2%) and/or magazines and books (55.4%). When compared with standard hormone replacement, most respondents endorsed the beliefs that natural hormones have fewer or no risks (71.4%), have fewer or no side effects (69.0%), and are equally or more effective for managing menopause symptoms (61.8%). In addition, many endorsed the beliefs that natural hormone replacement is equally or more effective than standard hormone replacement for protection against osteoporosis (47.1%) and heart disease (40.0%), although many endorsed “don’t know” for bone (45.7%) and heart (54.3%) protection.ConclusionsAmong women responding to a survey in a compounding pharmacy, most believed that, compared with standard hormones, natural hormones are safer, cause fewer side effects, and are equally or more effective for symptom management. Many believed natural hormone replacement is equally or more effective for long-term bone and heart protection. Educating women on the nature, risks, and benefits of natural hormone therapy is recommended.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID