Effect of hormone replacement therapy on lipids in perimenopausal and early postmenopausal women

Objective: To determine the effects of oral sequential hormone replacement therapy (HRT) on lipid-profile in perimenopausal and early postmenopausal w omen. Methods: We performed a single-center. randomized, placebo-controlled trial. The trial was double blind with respect to 17 beta -estradiol/desog estrel (17 beta -E-D) and placebo and open with respect to conjugated estro gens/norgestrel (CEE-N). A total of 125 healthy perimenopausal and early po stmenopausal women. aged 43-58 years, were recruited from the general popul ation in Zoetermeer, the Netherlands. The intervention consisted of 6 month s treatment with 1.5 mg 17 beta -estradiol/0.15 mg desogestrel (n = 53). 0. 625 mg conjugated estrogens/0.15 mg norgestrel (n = 36) or placebo (n = 36) . At baseline, cycle 1, 3 and 6, overnight fasting blood samples were obtai ned in which lipids were determined. We used linear regression analysis to calculate differences in mean change from baseline in lipids in the active treatment groups compared to placebo. Results: In both treatment groups sig nificant (P < 0.05) falls in low-density-lipoprotein (LDL)-cholesterol (17 beta -E-D: - 7.8% and CEE-N: - 8.4%) and lipoprotein(a) (17 beta -E-D: - 11 .7% and CEE-N: - 28.3%) were found compared to placebo. Apolipoprotein Al ( 17 beta -E-D: 6.8% and CEE-N: 7.3%) and HDL-cholesterol (17 beta -E-D: 6.4% and CEE-N: 8.0%) significantly increased compared to placebo. No significa nt changes were found in the other lipids. Mean changes from baseline in to tal cholesterol, LDL-cholesterol and apolipoprotein B were significantly mo re pronounced in postmenopausal women compared to perimenopausal women, adj ustment for age-differences did not change the results. Conclusion: Treatme nt of perimenopausal and early postmenopausal women with 17 beta -E-D or CE E-N changes their lipid-profile in a potentially anti-atherogenic direction . Changes appear to be more pronounced in postmenopausal women compared to perimenopausal women. (C) 2001 Elsevier Science Ireland Ltd. All rights res erved.