EFFECTS OF TRANSDERMAL 17-BETA-ESTRADIOL COMBINED WITH ORAL PROGESTOGEN ON LIPIDS AND LIPOPROTEINS IN HYPERCHOLESTEROLEMIC POSTMENOPAUSAL WOMEN

Objectives. The purpose of the study was to evaluate the effect of tra nsdermal 17 beta-oestradiol with oral progestogen on the plasma levels of lipids, lipoproteins and apolipoproteins in hypercholesterolaemic postmenopausal women. Design. During 6 months of replacement therapy w ith transdermal 17 beta-oestradiol combined with oral progestogen, pla sma lipids, lipoproteins and apolipoproteins after 3 and 6 months were measured and compared with pretreatment values by Student's t-test. S etting. From January 1992 until September 1992 patients were diagnosed and treated in an outpatient clinic of the Department of Endocrinolog y Medical Centre for Postgraduate Education, Warsaw. Subjects. The pat ients studied were 11 non-obese postmenopausal women with hypercholest erolaemia based on the World Health Organization criteria. Interventio ns. Venous blood samples were obtained before and 3 and 6 months after the beginning of cyclic replacement therapy with transdermal 17 beta- oestradiol (E2 100 mu g day(-1) combined with oral chlormadinone aceta te (2 mg day(-1) for 7 days in each cycle). Main outcome measures. The antiatherogenic effect of transdermal oestrogen replacement therapy e xerted by increased levels of high-density lipoprotein subfraction 2 c holesterol (HDL(2)-C) leading to the decrease of the total cholesterol level was anticipated. Results. After 6 months of the treatment the c oncentrations of HDL(2) cholesterol (HDL(2)-C) increased from 0.45 +/- O.07 mmol l(-1) to 0.73 +/- 0.03 mol(-1) (P< 0.05) but the levels of HDL(3) cholesterol (HDL(3)-C) decreased from 1.15 + 0.06 mmol(-1) to 0 .89 +/- 0.07 mmol(-1) (P < O.05). The concentrations of total choleste rol decreased from 6.9 +/- O.13 mmol l(-1) to 6.2 +/- 0.2 mmol(-1) (P < O.05). No changes were observed in the plasma levels of total trigly cerides, HDL cholesterol, low-density lipoprotein (LDL) cholesterol, v ery-low-density lipoprotein (VLDL) cholesterol, VLDL triglycerides, ap olipoproteins A-I and B. Conclusions. In hypercholesterolaemic postmen opausal women, transdermally administered 17 beta-oestradiol 100 mu g daily in combination with oral chlormadinone acetate has a beneficial effect through raising the level of the antiatherogenic HDL(2)-C subfr action and decreasing the level of total cholesterol.