Effects of Continuous Combined Hormone Replacement Therapy on Inflammation in Hypertensive and/or Overweight Postmenopausal Women
Effects of Continuous Combined Hormone Replacement Therapy on Inflammation in Hypertensive and/or Overweight Postmenopausal Women
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连续联合激素替代疗法对高血压和/或超重绝经后女性炎症的影响
DOI：
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
E. Shin
中科院分区：
文献类型：
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作者：
K. Koh;J. Ahn;D. Jin;B. Yoon;Hyung Sik Kim;D. Kim;M. Shin;J. Son;I. S. Choi;E. Shin
目的：我们观察到雌激素在2型糖尿病绝经后妇女中没有显示出心脏保护作用。我们假设高血压和/或超重女性可能不太可能意识到雌激素对心血管的益处。方法与结果：我们采用随机、双盲、交叉设计，对35名绝经后高血压和/或超重妇女每日给予微剂量孕酮（MP） 100 mg或醋酸甲羟孕酮（MPA） 2.5 mg，外加共轭马雌激素（CEE） 0.625 mg，持续2个月。CEE+MP或MPA可显著改善血流介导的舒张，降低血浆e-选择素、细胞间黏附分子1型、单核细胞趋化蛋白-1、肿瘤坏死因子- agr；水平（P <0.001, P <0.001, P =0.021, P <0.001, P <0.001，方差分析P <0.001），但不包括c反应蛋白和纤维蛋白原水平。值得注意的是，就这些效果而言，每种疗法之间没有显著差异。然而，在这些妇女中，血流介导的舒张改善的幅度小于健康绝经后妇女，而大于我们先前研究中报道的糖尿病绝经后妇女。CEE+MP或MPA对炎症标志物的影响与健康绝经后妇女相当，但与患有糖尿病的绝经后妇女没有可比性。结论：雌激素联合合成黄体酮可显著改善高血压和/或超重女性血流介导的肱动脉扩张反应，降低炎症标志物，与雌激素联合天然黄体酮相当。
Objective—We observed that estrogen did not show cardioprotective benefits in type 2 diabetic postmenopausal women. We hypothesized that hypertensive and/or overweight women may be less likely to realize cardiovascular benefits from estrogen. Methods and Results—We administered micronized progesterone (MP) 100 mg or medroxyprogesterone acetate (MPA) 2.5 mg with conjugated equine estrogen (CEE) 0.625 mg daily during 2 months to 35 hypertensive and/or overweight postmenopausal women with a randomized, double-blind, crossover design. With significant changes of lipoproteins, CEE+MP or MPA significantly improved flow-mediated dilation and reduced plasma E-selectin, intercellular adhesion molecule type-1, monocyte chemoattractant protein-1, and tumor necrosis factor-&agr; levels (P <0.001, P <0.001, P =0.021, P <0.001, and P <0.001 by ANOVA, respectively), but not C-reactive protein and fibrinogen levels. Of note, there were no significant differences between each therapy regarding these effects. However, the magnitude of improvement of flow-mediated dilation in these women was less than in healthy postmenopausal women and more than in diabetic postmenopausal women reported by our previous studies. The effects of CEE+MP or MPA on inflammatory markers were comparable to healthy postmenopausal women, but not comparable to diabetic postmenopausal women. Conclusions—Estrogen combined with synthetic progestin significantly improved flow-mediated brachial artery dilator response and reduced inflammation markers in hypertensive and/or overweight women, comparable to estrogen combined with natural progesterone.
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DOI：
10.1056/nejm199906173402418
发表时间：
1999-06
期刊：
The New England journal of medicine
影响因子：
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作者：
Williams Kj;I. Tabas
通讯作者：
Williams Kj;I. Tabas
雌激素/孕激素治疗和洛伐他汀对患有冠状动脉疾病的绝经后妇女的血脂和血流介导的血管舒张的单独和联合影响。
影响因子：
24
作者：
Herrington,DM;Werbel,BL;Riley,WA;Pusser,BE;Morgan,TM
通讯作者：
Morgan,TM
影响因子：
15.9
作者：
Srivastava, S;Weitzmann, MN;Pacifici, R
通讯作者：
Pacifici, R
影响因子：
15.9
作者：
CaulinGlaser, T;Watson, CA;Bender, JR
通讯作者：
Bender, JR
影响因子：
10.8
作者：
Post, WS;Goldschmidt-Clermont, PJ;Issa, JPJ
通讯作者：
Issa, JPJ