Combined hormone replacement therapy improves endothelial function in healthy postmenopausal women
Combined hormone replacement therapy improves endothelial function in healthy postmenopausal women
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DOI：
10.1046/j.1365-2796.2001.00910.x
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发表时间：
2001-12-01
影响因子：
11.1
通讯作者：
Vrabic, L
中科院分区：
文献类型：
--
作者：
Guzic-Salobir, B;Keber, I;Vrabic, L
目标.大规模的流行病学研究表明，激素替代疗法（HRT）可以减少绝经后妇女的心血管事件。内皮功能的改善可能有助于这种保护作用。在未来。双盲研究，61名健康绝经后妇女随机接受口服连续联合HRT [雌二醇2 mg和醋酸炔诺酮（NETA）1 mg/d]或安慰剂。分别于治疗前、治疗后3个月和6个月检测肱动脉血流介导的血管舒张功能（FMD）和可溶性内皮细胞粘附分子（CAM）的表达。接受联合HRT的女性FMD显著改善（3个月后从5.97%降至10.94%，6个月后降至10.58%;与基线值相比，P均< 0.01），安慰剂组无变化（基线为6.92%，3个月后为5.86%，6个月后为6.26%）。联合HRT治疗3个月后，E-选择素和细胞间粘附分子-1（ICAM-1）分别显著降低24.6%和13.9%（均P < 0.01），并在治疗6个月后持续下降，而安慰剂组无差异。雌二醇和醋酸炔诺酮通过增强FMD和降低健康绝经后妇女可溶性E-选择素和ICAM-1水平来改善内皮功能。
Objectives. Large scale epidemiological studies suggest that hormone replacement therapy (HRT) reduces cardiovascular events in postmenopausal women. Improvement in endothelial function may contribute to this protective effect.Design. In a prospective. double blind study, 61 healthy postmenopausal women were randomized to receive either oral continuous combined HRT [oestradiol 2 mg and norethisterone acetate (NETA) 1 mg per day] or placebo. Endothelial function, assessed by flow-mediated vasodilation (FMD) of the brachial artery and expression of soluble endothelial cell adhesion molecules (CAM) were determined before, after 3 and 6 months of therapy.Results. The FMD was significantly improved in women on combined HRT (from 5.97% to 10.94% after 3 months and to 10.58% after 6 months; both P < 0.01 versus baseline values) and did not change in the placebo group (6.92% at baseline, 5.86% after 3 and 6.26% after 6 months). After 3 months of combined HRT, significant decreases of 24.6% for E-selectin and 13.9% for intercellular adhesion molecule-1 (ICAM-1) were observed (both P < 0.01 versus baseline values) and were sustained after 6 months of therapy, whilst no differences emerged in the placebo group.Conclusions. Oestradiol and norethisterone acetate improve endothelial function by both enhancing FMD and reducing the levels of soluble E-selectin and ICAM-1 in healthy postmenopausal women.