Double blind, randomized study of estradiol replacement therapy on markers of inflammation, coagulation and fibrinolysis

Žegura, Branka; Keber, Irena; Šebeštjen, Miran; Köenig, Wolfgang

doi:10.1016/s0021-9150(03)00088-1

Cited by 65 publications

(42 citation statements)

References 41 publications

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“…These and the neutral effects on TNFa levels are consistent with studies of transdermal estrogen in women (42,43,(49)(50)(51). Interestingly, we were also unable to detect significant effects of parenteral estrogen on leptin levels in these men.…”

Section: Discussionsupporting

confidence: 89%

Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer

Purnell

Bland

Garzotto

et al. 2006

Journal of Lipid Research

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Androgen deprivation therapy (ADT) for prostate cancer is now used in earlier disease stages and as adjuvant treatment. Recognizing and reducing the toxicity of this therapy, including worsened lipid levels and cardiovascular disease (CVD) risks, has become an important clinical concern. Oral estrogen therapy induces hypogonadism and mitigates many side effects of ADT, but has a high thrombosis risk. Transdermal estrogen therapy (TDE) has a lower thrombosis risk than oral estrogen and may improve CVD risk compared with ADT. This prospective pilot study of 18 men with androgen-independent prostate cancer receiving ADT measured effects of TDE on lipid and inflammatory CVD risk factors before and after 8 weeks of TDE (estradiol 0.6 mg/day). During treatment, estradiol levels rose 17-fold; total cholesterol, LDL cholesterol, and apolipoprotein B levels decreased. HDL 2 cholesterol increased, with no changes in triglyceride or VLDL cholesterol levels. Dense LDL cholesterol decreased and LDL buoyancy increased in association with a decrease in HL activity. Highly sensitive C-reactive protein levels and other inflammatory markers did not worsen. Compared with ADT, short-term TDE therapy of prostate cancer improves lipid levels without deterioration of CVD-associated inflammatory markers and may, on longer-term follow-up, improve CVD and mortality

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Section: Discussionsupporting

confidence: 89%

Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer

Purnell

Bland

Garzotto

et al. 2006

Journal of Lipid Research

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“…No significant difference by progesterone treatment group was seen. Smaller studies examining glucose and insulin levels after short-term use of CEO [15], oestradiol [15,16] or in cross-sectional analysis [17,18] have shown similar effects.…”

Section: Discussionmentioning

confidence: 91%

The effect of conjugated equine oestrogen on diabetes incidence: the Women’s Health Initiative randomised trial

et al. 2006

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“…37 An increase in plasma fibrinolytic activity primarily related to a significant increase in tissue-type plasminogen activator and a decrease in plasminogen activator inhibitor Type 1 has been observed in women receiving HRT. 9,32,36 Cerebral vasodilation 4 and transient elevation in systemic blood pressure 31 associated with HRT may additionally contribute to risk of SAH in postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Hormone replacement therapy and the risk of subarachnoid hemorrhage in postmenopausal women

Qureshi¹,

Malik²,

Saeed³

et al. 2016

JNS

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T he risk of intracranial aneurysm formation and subarachnoid hemorrhage (SAH) is higher in postmenopausal women compared with premenopausal women. 8,13,18,19,28 Reduced levels of estrogen in postmenopausal women may increase the risk of aneurysm formation and rupture by reduction in collagen and elastin content and reduced elasticity of arterial walls. 3 In an experimental intracranial aneurysm mouse model, estrogen prevented aneurysmal rupture in ovariectomized mice. 30The protective effect of estrogen seemed to occur through activation of estrogen receptor-b, a predominant subtype of estrogen receptor in human intracranial aneurysms and cerebral arteries. Hormone replacement therapy (HRT) was associated with reduced risk of spontaneous SAH in postmenopausal women in most 19,22 but not all case control studies. 25 The Women's Health Initiative (WHI) randomized trial 33 assessed the effect of estrogen plus progestin on ischemic and hemorrhagic stroke in 608 women 50-79 years of age with an average follow-up of 5.6 years. There was a nonsignificant protective effect on hemorrhagic stroke (HR 0.82, 95% CI 0.43-1.56). However, the study was underpowered because there were only 10 SAH events among the randomized patients. A meta-analysis 24 found a small nonsignificant protective effect of HRT on risk of SAH (HR 0.8, 95% CI 0.57-1.04).We performed this study to determine the effect of abbreviatioNs HRT = hormone replacement therapy; RR = relative risk; SAH = subarachnoid hemorrhage; SE = standard error; WHI = Women's Health Initiative. obJective The incidence of subarachnoid hemorrhage (SAH) increases after menopause. Anecdotal data suggest that hormone replacement therapy (HRT) may reduce the rate of SAH and aneurysm formation in women. The goal of this study was to determine the effect of HRT on occurrence of SAH in a large prospective cohort of postmenopausal women. methods The data were analyzed for 93,676 women 50-79 years of age who were enrolled in the observational arm of the Women's Health Initiative Study. The effect of HRT on risk of SAH was determined over a period of 12 ± 1 years (mean ± SD) using Cox proportional hazards analysis after adjusting for potential confounders. Additional analysis was performed to identify the risk associated with "estrogen only" and "estrogen and progesterone" HRT among women. results Of the 93,676 participants, 114 (0.1%) developed SAH during the follow-up period. The rate of SAH was higher among women on active HRT compared with those without HRT used (0.14% vs 0.11%, absolute difference 0.03%, p < 0.0001). In unadjusted analysis, participants who reported active use of HRT were 60% more likely to suffer an SAH (RR 1.6, 95% CI 1.1-2.3). Compared with women without HRT use, the risk of SAH continued to be higher among women reporting active use of HRT (RR 1.5, 95% CI 1.0-2.2) after adjusting for age, systolic blood pressure, cigarette smoking, alcohol consumption, body mass index, race/ethnicity, diabetes, and cardiovascular disease. The risk of SAH was nonsignificantly h...

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Double blind, randomized study of estradiol replacement therapy on markers of inflammation, coagulation and fibrinolysis

Cited by 65 publications

References 41 publications

Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer

Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer

The effect of conjugated equine oestrogen on diabetes incidence: the Women’s Health Initiative randomised trial

Hormone replacement therapy and the risk of subarachnoid hemorrhage in postmenopausal women

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