期刊
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
卷 26, 期 2, 页码 385-391出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/01.ATV.0000199248.53590.e1
关键词
apolipoprotein A-I; estrogen; progestin; kinetics stable isotopes
资金
- NCRR NIH HHS [M01 RR00054, M01 RR000054] Funding Source: Medline
- NHLBI NIH HHS [R01 HL056895-04, K08 HL03209, R01 HL056895] Funding Source: Medline
- NIA NIH HHS [AG08812, P60 AG008812] Funding Source: Medline
- NIBIB NIH HHS [P41 EB001975, P41 EB-001975] Funding Source: Medline
- NIDDK NIH HHS [P30 DK040561-11, P30 DK040561] Funding Source: Medline
Objective - Plasma high-density lipoprotein (HDL) cholesterol levels are inversely correlated with the risk of developing coronary heart disease. Hormonal replacement therapy (HRT) affects plasma HDL cholesterol levels, with estrogen increasing HDL cholesterol levels and progestins blunting this effect. This study was designed to assess the mechanism responsible for these effects. Materials and Methods - HDL apolipoprotein A-I (apoA-I) kinetics were studied in 8 healthy postmenopausal women participating in a double-blind, randomized, crossover study comprising 3 phases: placebo, conjugated equine estrogen (CEE) (0.625 mg/d), and CEE plus medroxyprogesterone acetate (MPA) (2.5 mg/d). Compared with placebo, treatment with CEE resulted in an increase in apoA-I pool size ( + 20%, P < 0.01) because of a significant increase in apoA-I production rate ( + 47%, P < 0.05) and no significant changes in apoA-I fractional catabolic rate. Compared with the CEE alone phase, treatment with the CEE plus MPA resulted in an 8% (P < 0.02) reduction in apoA-I pool size and a significant reduction in apoA-I production rate ( - 13%, P < 0.04), without changes in apoA-I fractional catabolic rate. Conclusion - Postmenopausal estrogen replacement increases apoA-I levels and production rate. When progestin is added to estrogen, it opposes these effects by reducing the production of apoA-I.
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