OVARIECTOMY, HORMONE REPLACEMENT AND ATHEROSCLEROSIS

文献表明，口服雌激素替代疗法有 有益于血脂和脂蛋白(降低低密度脂蛋白， 高密度脂蛋白)，而非肠道给药的雌激素几乎没有或几乎没有 而且醋酸甲羟孕酮可能有额外的 有益的影响。然而，雌激素-孕激素的影响 替代疗法对绝经后女性动脉硬化程度的影响 是未知的。这项研究的一个目标是评估 绝经后激素替代治疗对动脉粥样硬化危险因素的影响：血浆 脂类、载脂蛋白、脂蛋白、血压、糖耐量和 某些行为和心理社会因素。其他目标是 评估激素替代对：1)肝素后脂肪酶的影响 活性；2)性激素结合球蛋白的结合能力 是处理的相对雌激素活性的指标；以及3) 胰岛素和胰升糖素对静脉注射葡萄糖的反应。这个 这项研究的主要目标是评估两个 常用处方类型的雌激素替代疗法，口服 马结合雌激素(倍美力)或非肠道给药 雌二醇，单独或与经常开出的 孕激素，醋酸甲羟孕酮(普罗维拉)在主动脉范围内， 冠状动脉、股动脉、颅外动脉和颅内动脉粥样硬化 绝经期(去卵巢)食蟹猴饲喂致动脉粥样硬化饲料 三年了。动脉粥样硬化的形态计量学将在 验尸报告。 这项研究的结果应该为关于 两种雌激素替代疗法单独或联合用药对患者的影响 联合应用醋酸甲羟孕酮对动脉粥样硬化程度的影响。 此外，还将获得有关血浆脂类作用的证据。 以及脂蛋白和其他危险因素在调节这种影响。 长期目标是确定损害或损害的机制 卵巢功能丧失会影响动脉粥样硬化的形成及其危险因素 确定绝经后激素的类型和剂量水平 替换与最佳收益和最小风险相关。

The literature suggests that orally-administered estrogen replacement has a beneficient influence on plasma lipids and lipoproteins (decreased LDL, increased HDL) while parenterally-administered estrogen has little or no effect; and that medroxyprogesterone acetate may have an additional beneficient influence. However, the influence of estrogen-progestogen replacement therapy on extent of atherosclerosis in postmenopausal females is unknown. One objective of this study is to assess the effects of postmenopausal hormone replacement on atherosclerosis risk factors: plasma lipids, apoproteins, lipoproteins, blood pressure, glucose tolerance, and certain behavioral and psychosocial factors. Additional objectives are to assess the effects of hormone replacement on: 1) postheparin lipase activities; 2) the binding capacity of sex hormone binding globulin, which is an indicator of the relative estrogenicity of the treatments; and 3) insulin and glucagon responses to an intravenous glucose challenge. The principal objective of this study is to assess the effects of two commonly-prescribed types of estrogen replacement, orally administered conjugated equine estrogens (Premarin) or parenterally-administered estradiol, alone or in combination with a frequently prescribed progestogen, medroxyprogesterone acetate (Provera) on extent of aortic, coronary, femoral, extra- and intracranial artery atherosclerosis in menopausal (ovariectomized) cynomolgus monkeys fed an atherogenic diet for three years. Atherosclerosis will be quantitated morphometrically at necropsy. The results of this study should provide valuable evidence regarding the influence of these two types of estrogen replacement alone or in combination with medroxyprogesterone acetate on extent of atherosclerosis. Additionally, evidence will be obtained regarding the role of plasm lipids and lipoproteins and other risk factors in mediating such an influence. Long term objectives are to determine mechanisms by which impairment or loss of ovarian function influence atherogenesis and its risk factors, and to determine what types and dosage levels of postmenopausal hormonal replacement are associated with optimal benefit and minimal risk.