INHIBITION OF CORONARY-ARTERY ATHEROSCLEROSIS BY 17-BETA ESTRADIOL IN OVARIECTOMIZED MONKEYS - LACK OF AN EFFECT OF ADDED PROGESTERONE
INHIBITION OF CORONARY-ARTERY ATHEROSCLEROSIS BY 17-BETA ESTRADIOL IN OVARIECTOMIZED MONKEYS - LACK OF AN EFFECT OF ADDED PROGESTERONE
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DOI：
10.1161/01.atv.10.6.1051
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发表时间：
1990-11-01
期刊：
影响因子：
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通讯作者：
CLARKSON, TB
中科院分区：
文献类型：
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作者：
ADAMS, MR;KAPLAN, JR;CLARKSON, TB
尽管争议仍在继续，但大量证据表明雌激素替代疗法对绝经后妇女冠心病的风险有有利影响。目前还不确定这种作用是如何介导的，以及周期性添加的雌激素是否会对雌激素相关的心脏保护作用产生不利影响。我们研究了性激素替代疗法对雌激素缺乏（卵巢切除）的成年雌性食蟹猴饮食诱导的冠状动脉粥样硬化的影响。将猴随机分配至三个治疗组之一：1）无激素替代（n = 17），2）连续给予17-β雌二醇加周期性给予塞司琼（n = 20），3）连续给予17-β雌二醇（n = 18）。血浆雌二醇和孕酮浓度的生理模式通过给予缓释皮下硅橡胶植入物中的激素来维持。实验持续了30个月。尸检时，两个激素替代组动物的冠状动脉粥样硬化受到类似的抑制（减少约一半）（p <0.05）。0.05）。激素替代治疗的抗动脉粥样硬化作用与血浆总胆固醇、脂蛋白胆固醇、载脂蛋白A-1和B浓度、高密度脂蛋白亚组分异质性和低密度脂蛋白分子量的变化无关。我们的结论是，生理性雌激素替代治疗加或不加孕酮抑制卵巢切除猴动脉粥样硬化的进展。这可能解释了为什么雌激素替代疗法可以降低绝经后妇女患冠心病的风险。
Although controversy continues, the preponderance of evidence indicates that estrogen replacement therapy favorably influences the risk of coronary heart disease in postmenopausal women. It remains uncertain how this effect is mediated and whether the cyclic addition of a progestin may influence adversely an estrogen-related cardioprotective effect. We investigated the influence of sex hormone replacement therapy on diet-induced coronary artery atherosclerosis in estrogen-deficient (ovariectomized) adult female cynomolgus monkeys. Monkeys were assigned randomly to one of three treatment groups: 1) no hormone replacement (n = 17), 2) continuously administered 17-beta estradiol plus cyclically administered progeseterone (n = 20), and 3) continuously administered 17-beta estradiol (n = 18). The physiologic patterns of plasma estradiol and progesterone concentrations were maintained by administering the hormones in sustained-release subcutaneous Silastic implants. The experiment lasted 30 months. At necropsy, coronary artery atherosclerosis was inhibited similarly (reduced by approximately one-half) in animals in animals in both hormone replacement groups (p .ltoreq. 0.05). Antiatherogenic effects of hormone replacement were independent of variation in total plasma cholesterol, lipoprotein cholesterol, apoprotein A-1 and B concentrations, high density lipoprotein subfraction heterogeneity, and low density lipoprotein molecular weight. We conclude that physiologic estrogen replacement therapy with or without added progesterone inhibits atherosclerosis progression in ovariectomized monkeys. This may explain why estrogen replacement therapy results in reduced risk of coronary heart disease in postmenopausal women.