METABOLIC EFFECTS OF HORMONE REPLACEMENT/POST-MENOPAUSE

超过三分之一的美国女性平均78岁的寿命是 生活在绝经后的人生阶段，这段时间与增加 冠状动脉疾病、骨质疏松症和子宫内膜/乳房的风险 癌症。目前，中国有4000多万50岁以上的妇女 美国--很大一部分人口处于高危状态 这些医疗问题。 在过去的二十年里，绝经后的好处和风险 雌激素替代一直是内部相当大的争论主题 科学界。尽管雌激素疗法已经被证明是 毫无疑问，它可以延缓骨质疏松症和骨折。 与子宫内膜癌、乳腺癌、胆结石的增加有关 在某些情况下，还会增加患冠状动脉疾病的风险。论 另一方面，冠状动脉疾病的频率和发病率都在增加 绝经后严重程度增加，可能与脂蛋白有关 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 1/3的非使用者和使用者的死亡率 雌激素和黄体酮联合用药的子宫内膜癌比 非使用者或仅使用雌激素的人。 这是一项前瞻性研究#年影响的变化的建议。 循环脂蛋白/载脂蛋白水平和选定的参数 用两种剂量的结合马进行凝血 雌激素，单独或与孕激素联合使用。所用的养生法 这项研究已经在临床上证明了对子宫内膜的保护 由增生、癌症和骨质疏松引起的骨质疏松。因此，它是 希望进一步完善最佳激素替代方案 治疗是可以实现的，一种也能产生最大益处的疗法 雌激素和脂蛋白水平之间的剂量-反应关系 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.