The effect of 17β-estradiol plus norethisterone acetate treatment on lipoprotein (a), atherogenic and anti-atherogenic apolipoproteins levels in postmenopausal women: A meta-analysis of randomized controlled trials

Tang, Zengyao; Găman, Mihnea‐Alexandru; Prabahar, Kousalya; Mei, HanYing

doi:10.1016/j.exger.2022.112055

Cited by 3 publications

(5 citation statements)

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“…A meta-analysis of 14 randomized controlled trials assessed the effect of HRT in the form of 17β-estradiol plus norethisterone acetate on serum lipoprotein (a) and apolipoproteins. The meta-analysis showed that such treatment causes a mean decrease of 67.59 mg/L in lipoprotein (a), of 3.71 mg/dl in Apo B, and has no effect on apolipoprotein A1 and A2 levels ( 44 ). A study on nearly 90,000 postmenopausal women recruited from the UK biobank has shown that increased lipoprotein (a) was associated with an increased risk of coronary heart disease.…”

Section: Menopausementioning

confidence: 99%

Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field

Olejarz,

Szczepanek-Parulska,

Ruchala

2024

Front. Endocrinol.

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Dyslipidemia is one of the most common disorders worldwide, which, if left untreated, results in a multitude of complications. Thus proper diagnostics, which includes identifying of secondary causes of dyslipidemia is crucial. Endocrine disorders are an important cause of secondary dyslipidemia. This paper aims to review the publications on lipoprotein alterations in endocrine disorders from the past two years and provide an overview of the recent discoveries in this dynamically developing and large field. Significant changes in lipoprotein serum concentrations are present in most endocrinological diseases and can be modified with proper treatment. Some lipoproteins have also been proposed as markers in some endocrine diseases, e.g., thyroid carcinoma. From the scope of endocrine disorders, the largest number of studies explored the lipoprotein changes in polycystic ovary syndrome and in women during the menopausal and peri-menopausal period. Even though the association of thyroid disorders with dyslipidemia is already well studied, new research has delivered some exciting findings about lipoprotein alterations in euthyroid patients with either positive antithyroid peroxidase antibodies or reduced sensitivity to thyroid hormones. The problem of the adverse metabolic profile, including dyslipidemia in hypoprolactinemia has been recognized. Moreover, this review describes other significant discoveries encompassing lipoprotein alterations in disorders of the adrenals, thyroid, parathyroid glands, pituitary, and gonads. The up-to-date knowledge of the influence of endocrine disorders and hormonal changes on serum lipoproteins is prudent as it can significantly impact therapeutic decisions.

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Section: Menopausementioning

confidence: 99%

Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field

Olejarz,

Szczepanek-Parulska,

Ruchala

2024

Front. Endocrinol.

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“…A great deal of evidence suggests that this period in a woman's life is linked with increased serum concentrations of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), lipoprotein (a) and other atherogenic lipoproteins, as well as with decreased high-density lipoprotein cholesterol (HDL-C) levels. 5,6 Moreover, hormone replacement therapy (HRT) which is prescribed in postmenopausal females to alleviate menopausal symptoms and correct hormonal imbalances can also influence serum lipids' concentrations. For example, the co-administration of transdermal 17β-oestradiol and norethisterone acetate reduces TC, TG, LDL-C, lipoprotein (a) and apolipoprotein B values, whereas tibolone prescription decreases HDL-C levels.…”

Section: Introductionmentioning

confidence: 99%

“…For example, the co-administration of transdermal 17β-oestradiol and norethisterone acetate reduces TC, TG, LDL-C, lipoprotein (a) and apolipoprotein B values, whereas tibolone prescription decreases HDL-C levels. 2,6,7 However, little is known regarding the impact of oral medroxyprogesterone acetate plus conjugated equine oestrogens (MPACEE) on serum lipids' concentration in women as previously published investigations have led to inconclusive and contradicting results. Therefore, the aim of the present dose-response meta-analysis of randomized controlled trials (RCTs) was to examine the effect of MPACEE administration on the lipid profile in females.…”

Section: Introductionmentioning

confidence: 99%

“…One main reason for the boost in cardiovascular risk in females who experience menopause is related to the development of dyslipidaemia. A great deal of evidence suggests that this period in a woman's life is linked with increased serum concentrations of total cholesterol (TC), triglycerides (TG), low‐density lipoprotein cholesterol (LDL‐C), lipoprotein (a) and other atherogenic lipoproteins, as well as with decreased high‐density lipoprotein cholesterol (HDL‐C) levels 5,6 . Moreover, hormone replacement therapy (HRT) which is prescribed in postmenopausal females to alleviate menopausal symptoms and correct hormonal imbalances can also influence serum lipids' concentrations.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, hormone replacement therapy (HRT) which is prescribed in postmenopausal females to alleviate menopausal symptoms and correct hormonal imbalances can also influence serum lipids' concentrations. For example, the co‐administration of transdermal 17β‐oestradiol and norethisterone acetate reduces TC, TG, LDL‐C, lipoprotein (a) and apolipoprotein B values, whereas tibolone prescription decreases HDL‐C levels 2,6,7 …”

Section: Introductionmentioning

confidence: 99%

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Comprehensive meta‐analysis of the effects of oral medroxyprogesterone acetate plus conjugated equine oestrogens on the lipid profile in women: Insights from randomized controlled trials

Zhang,

Xie,

et al. 2024

Eur J Clin Investigation

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BackgroundMenopause is associated with elevated cardiovascular risk due to the loss of the cardioprotective effect of oestrogens. Postmenopausal women are often prescribed hormone replacement therapy (HRT) in order to control menopause symptoms and correct hormone imbalances; however, HRT can impact serum lipids' concentrations. At present, data on the effect of the administration of medroxyprogesterone acetate plus conjugated equine oestrogens (MPACEE) on the lipid profile in females are uncertain, as the investigations conducted so far have produced conflicting results. Thus, we aimed to clarify the impact of MPACEE prescription on the serum lipids' values in women by means of a systematic review and meta‐analysis of randomized controlled trials (RCTs).MethodsWe employed a random‐effects model based on the DerSimonian and Laird method to determine the combined estimates of the intervention's impact on the lipid profile. The computation of the weighted mean difference (WMD) and its corresponding 95% confidence interval (CI) relied on the mean and standard deviation values from both the MPACEE and control group, respectively.ResultsA total of 53 RCTs were included in the meta‐analysis with 68 RCT arms on total cholesterol (TC), 70 RCT arms on low‐density lipoprotein cholesterol (LDL‐C) and triglycerides (TG), and 69 RCT arms on high‐density lipoprotein cholesterol (HDL‐C). Administration of MPACEE resulted in a significant reduction of TC (WMD = −11.93 mg/dL; 95% CI: −13.42, −10.44; p < .001) and LDL‐C (WMD = −16.61 mg/dL; 95% CI: −17.97, −15.26; p < .001) levels, and a notable increase in HDL‐C (WMD = 3.40 mg/dL; 95% CI: 2.93, 3.86; p < .001) and TG (WMD = 10.28 mg/dL; 95% CI: 7.92, 12.64; p < .001) concentrations. Subgroup analysis revealed that changes in the lipid profile were influenced by several factors: body mass index (for TC, HDL‐C, TG), MPACEE dosages (for TC, LDL‐C, HDL‐C, TG), age (for TC, LDL‐C, HDL‐C, TG), durations of the intervention (for TC, LDL‐C, HDL‐C, TG), continuous/sequential administration of MPACEE (continuous for TC; sequential for LDL‐C, TG) administration of MPACEE and serum lipids' concentrations before enrolment in the RCT (for TC, LDL‐C, HDL‐C, TG).ConclusionsMPACEE administration can influence serum lipids' concentrations in females by raising HDL‐C and TG levels and reducing LDL‐C and TC values. Therefore, postmenopausal women who suffer from hypercholesterolaemia might benefit from this type of HRT.

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Hormone Replacement Therapy (And Other Options to Treat Menopausal Symptoms)

Lambrinoudaki,

Armeni,

Silionga

2024

Manual of Cardiovascular Disease in Women

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The effect of 17β-estradiol plus norethisterone acetate treatment on lipoprotein (a), atherogenic and anti-atherogenic apolipoproteins levels in postmenopausal women: A meta-analysis of randomized controlled trials

Cited by 3 publications

References 49 publications

Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field

Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field

Comprehensive meta‐analysis of the effects of oral medroxyprogesterone acetate plus conjugated equine oestrogens on the lipid profile in women: Insights from randomized controlled trials

Hormone Replacement Therapy (And Other Options to Treat Menopausal Symptoms)

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