METABOLIC EFFECTS OF HORMONE REPLACEMENT/POST-MENOPAUSE

在美国女性78岁的平均寿命中， 生活在绝经后阶段的生活，时间与增加 冠状动脉疾病、骨质疏松症和子宫内膜/乳腺癌的风险 癌 目前，世界上有4000多万50岁以上的妇女， 在美国，很大一部分人口处于高风险之中， 这些医疗问题。 在过去的二十年里，绝经后妇女的益处和风险 雌激素替代品一直是相当多的辩论的主题， 科学界。 虽然雌激素治疗已经显示 明确地延缓骨质疏松和骨折，它也被 与子宫内膜癌、乳腺癌、胆结石 在某些情况下，还会增加患冠状动脉疾病的风险。 上 另一方面，冠状动脉疾病的发生频率和 绝经后的严重程度，增加可能与脂蛋白 由雌激素水平下降引起的变化。 最近的证据表明，绝经后雌激素使用者只有 三分之一的非使用者和使用者的死亡率 雌激素-孕酮联合治疗子宫内膜癌的发生率低于 非使用者或仅使用雌激素的人。 这是一项前瞻性研究2000年所产生变化的建议， 循环脂蛋白/载脂蛋白水平和选定的参数 通过给予两个剂量的结合马凝血 雌激素，单独使用和与孕激素联合使用。 使用的方案 这项研究表明，临床上既保护子宫内膜， 从增生和癌症和骨质疏松症的骨骼。 因此有 希望进一步完善最佳激素替代疗法 治疗可以实现，一个也产生最有益的 雌激素和脂蛋白水平之间的剂量反应关系，以及 作为凝血因子。

More than one-third of the average American woman's 78-year lifespan is lived in the postmenopausal stage of life, a time associated with increased risk of coronary artery disease, osteoporosis, and endometrial/breast cancer. Currently, there are over 40 million women over the age of 50 in the United States - a large segment of the population at high risk for these medical problems. During the last two decades, the benefits and risks of postmenopausal estrogen replacement have been the subject of considerable debates within the scientific community. Although estrogen therapy has been shown unequivocally to retard bone thinning and fractures, it has also been associated with an increase in endometrial and breast cancer, gallstones and, in some cases, an increased risk of coronary artery disease. On the other hand, coronary artery disease increases in both frequency and severity after menopause, an increase which may be related to lipoprotein changes induced by the decline of estrogen levels. Recent evidence indicates that postmenopausal estrogen users have only one-third the mortality of non-users and that users of estrogen-progesterone combinations have less endometrial cancer than non-users or those using estrogen alone. This is a proposal to study prospectively the changes effected in circulating lipoproteins/apoprotein levels and selected parameters of coagulation by the administration of two doses of conjugated equine estrogen, alone and in combination with a progestogen. The regimens used by this study have been shown clinically to protect both the endometrium from hyperplasia and cancer and bones from osteoporosis. Therefore, it is hoped that an even further refinement of optimal hormone replacement therapy can be achieved, one which also produces the most beneficial dose-response relationships between estrogen and lipoprotein level, as well as coagulation factors.