Flaxseed dietary supplement versus hormone replacement therapy in hypercholesterolemic menopausal women
Flaxseed dietary supplement versus hormone replacement therapy in hypercholesterolemic menopausal women
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DOI：
10.1016/s0029-7844(02)02123-3
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发表时间：
2002-09-01
影响因子：
7.2
通讯作者：
Forest, JC
中科院分区：
文献类型：
--
作者：
Lemay, A;Dodin, S;Forest, JC
目的：为了评估高胆固醇血症绝经期妇女通过植物雌激素膳食补充剂与口服雌激素-孕酮替代治疗的血脂变化。25例总胆固醇大于6.2 mmol/L的绝经期患者（240 mg/dL），胆固醇/高密度脂蛋白-胆固醇比值大于4.5，甘油三酯小于3.5 mmol/L（310 mg/dL）的受试者被随机分配到他们的饮食中添加40 g/天的粉碎的亚麻籽，或者每天单独服用0.625 mg结合的马雌激素（子宫切除术，n = 10）或与100 mg微粉化孕酮（完整子宫，n = 15）组合。治疗2个月后，两组在2个月的洗脱期内继续单独饮食，然后再交叉到另一种治疗2个月。结果：激素替代疗法与亚麻籽对降低低密度脂蛋白胆固醇的作用有差异（3.8 +/- 0.2 vs 4.4 +/- 0.2 mmol/L）（148 +/- 8 vs 170 8 mg/dL）（P = 0.10），高密度脂蛋白胆固醇升高（1.6 +/- 0.04 vs 1.3 +/- 0.03 mmol/L）（62 +/- 1 vs 50 1 mg/dL）（P = .001），载脂蛋白A-1升高（1.71 +/- 0.07 vs 1.42 +/- 0.05 g/L）（P = .003）。这些变化与饮食、运动或人体测量的修改无关。两种治疗方法在绝经期症状以及葡萄糖和胰岛素水平方面产生了相似的下降。与亚麻籽相比，只有激素替代疗法引起性激素结合球蛋白升高（P = .004），纤维蛋白原降低（P = .08），纤溶酶原激活物抑制剂I型结论：虽然40克亚麻籽与口服雌激素-孕酮一样有效，可以改善轻度更年期症状，降低血糖和胰岛素水平，只有激素替代疗法能显著改善高胆固醇血症妇女的胆固醇分布，并有利地改变与心血管健康相关的标志物。(C)2002年由美国妇产科医师学会。
OBJECTIVE: To assess serum lipid changes by a phytoestrogen dietary supplement compared with oral estrogen-progesterone replacement in hypercholesterolemic menopausal women.METHODS: Twenty-five menopausal patients with total cholesterol greater than 6.2 mmol/L (240 mg/dL), a cholesterol/high-density lipoprotein-cholesterol ratio greater than 4.5 and triglycerides less than 3.5 mmol/L (310 mg/dL) after a 4-month diet, were randomized to add 40 g/day of crushed flaxseed to their diet or to take daily 0.625 mg of conjugated equine estrogens alone (hysterectomy, n = 10) or combined with 100 mg of micronized progesterone (intact uterus, n = 15). After 2 months of treatment, both groups continued the diet alone during a 2-month washout period before crossing over to the alternate treatment for 2 more months.RESULTS: Differences were found between hormone replacement therapy and flaxseed respectively for decrease of low-density lipoprotein cholesterol (3.8 +/- 0.2 versus 4.4 +/- 0.2 mmol/L) (148 +/- 8 versus 170 8 mg/dL) (P = .10), increase of high-density lipoprotein cholesterol (1.6 +/- 0.04 versus 1.3 +/- 0.03 mmol/L) (62 +/- 1 versus 50 1 mg/dL) (P = .001), and increase of apolipoprotein A-1 (1.71 +/- 0.07 versus 1.42 +/- 0.05 g/L) (P = .003). These changes were not related to modifications in diet, exercise, or anthropometric measurements evaluated in parallel. Both treatments produced similar decreases in menopausal symptoms and in glucose and insulin levels. Only hormone replacement therapy as compared with flaxseed induced an elevation of sex hormone binding globulin (P = .004), lowered fibrinogen (P = .08), and plasminogen activator inhibitor type I (P = .01).CONCLUSION: Although 40 g of flaxseed is as effective as oral estrogen-progesterone to improve mild menopausal symptoms and to lower glucose and insulin levels, only hormone replacement therapy significantly improves cholesterol profile in hypercholesterolemic women and favorably modifies markers related to cardiovascular health. (C) 2002 by The American College of Obstetricians and Gynecologists.