Advanced

Effects of a lipid lowering fibrate and hormone replacement therapy on serum lipids and lipoproteins in overweight postmenopausal women with elevated triglycerides.

Nerbrand, Christina LU ; Nyberg, Per LU ; Nordström, Lennart and Samsioe, Göran LU (2002) In Maturitas 42(1). p.55-62
Abstract
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women after menopause. In essence major risk factors for CVD are similar in women as for men inclusive of serum lipid perturbations. The effects of estrogens and hormone replacement therapy on lipid metabolism is widely discussed and warrant further evaluation especially when combined with other lipid lowering drugs. STUDY DESIGN: Postmenopausal women were studied by an open randomised study during 9 months. Subjects were recruited from outpatient clinics in a rural area of Sweden. Major inclusive criteria comprised body mass index (BMI) >28, serum triglycerides >1.5 mmol/l. Participants were at least 12 months postmenopause with a concomitant serum Follicle... (More)
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women after menopause. In essence major risk factors for CVD are similar in women as for men inclusive of serum lipid perturbations. The effects of estrogens and hormone replacement therapy on lipid metabolism is widely discussed and warrant further evaluation especially when combined with other lipid lowering drugs. STUDY DESIGN: Postmenopausal women were studied by an open randomised study during 9 months. Subjects were recruited from outpatient clinics in a rural area of Sweden. Major inclusive criteria comprised body mass index (BMI) >28, serum triglycerides >1.5 mmol/l. Participants were at least 12 months postmenopause with a concomitant serum Follicle Stimulating Hormone (FSH) above 28 IU/l. After inclusion in the study patients were instructed to adhere to a low-fat and caloric diet for 3 months and after this period randomised into two groups of intervention; a lipidlowering fibrate (LLF) group and one hormone replacement therapy group (HRT). The LLF group was given gemfibrozil 600 mg orally twice daily and HRT group received 2 mg oestradiol in combination with 1 mg norethisterone acetate as a continuous combined therapy once daily. After 3 months, the LLF group added the HRT regimen and patients in the HRT group added gemfibrozil. Hence, all participants received the regimens combined for the last 6 months of the study. RESULTS: Serum s-cholesterol was markedly decreased in both groups during the first 3 months of single treatment (P<0.0001). This decrease reflected a reduction especially of calculated low density lipoprotein (LDL) s-cholesterol (P<0.001). High density lipoprotein (HDL) s-cholesterol was reduced in the HRT group (P<0.005) but increased (P<0.004) in the LLF group. Triglycerides were also decreased by both treatments but more marked in the LLF group (P<0.0001) than in the HRT group (P<0.02). After 9 months the reduction remained in both groups but no additive effects were encountered in any of the groups. CONCLUSION: The effects by gemfibrozil on s-cholesterol and triglycerides levels seem to be superior to continuous combined HRT in overweight women with elevated triglycerides. The combination of the two drugs did not seem to offer any additional benefit concerning the routine serum lipid or lipoprotein profile. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Female, Estrogen Replacement Therapy, Estradiol : therapeutic use, Estradiol : administration & dosage, Cholesterol : blood, Cardiovascular Diseases : prevention & control, Antilipemic Agents : therapeutic use, Antilipemic Agents : administration & dosage, Oral, Administration, Lipoproteins, HDL Cholesterol : drug effects, LDL Cholesterol : blood, Middle Age, LDL Cholesterol : drug effects, Norethindrone : administration & dosage, Norethindrone : therapeutic use, Obesity : complications, Postmenopause, Triglycerides : blood, Treatment Outcome, Support, Non-U.S. Gov't, Gemfibrozil : administration & dosage, Gemfibrozil : therapeutic use, Human, Hyperlipidemia : complications, Hyperlipidemia : prevention & control, Lipoproteins : blood, Lipoproteins : drug effects, HDL Cholesterol : blood
in
Maturitas
volume
42
issue
1
pages
55 - 62
publisher
Elsevier
external identifiers
  • pmid:12020980
  • wos:000176531000007
  • scopus:0037140679
ISSN
1873-4111
DOI
10.1016/S0378-5122(01)00302-4
language
English
LU publication?
yes
id
3da4507e-9f0e-4407-b958-57059cb1446a (old id 108323)
alternative location
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12020980&dopt=Abstract
date added to LUP
2007-06-29 14:31:30
date last changed
2017-01-01 04:41:18
@article{3da4507e-9f0e-4407-b958-57059cb1446a,
  abstract     = {BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women after menopause. In essence major risk factors for CVD are similar in women as for men inclusive of serum lipid perturbations. The effects of estrogens and hormone replacement therapy on lipid metabolism is widely discussed and warrant further evaluation especially when combined with other lipid lowering drugs. STUDY DESIGN: Postmenopausal women were studied by an open randomised study during 9 months. Subjects were recruited from outpatient clinics in a rural area of Sweden. Major inclusive criteria comprised body mass index (BMI) &gt;28, serum triglycerides &gt;1.5 mmol/l. Participants were at least 12 months postmenopause with a concomitant serum Follicle Stimulating Hormone (FSH) above 28 IU/l. After inclusion in the study patients were instructed to adhere to a low-fat and caloric diet for 3 months and after this period randomised into two groups of intervention; a lipidlowering fibrate (LLF) group and one hormone replacement therapy group (HRT). The LLF group was given gemfibrozil 600 mg orally twice daily and HRT group received 2 mg oestradiol in combination with 1 mg norethisterone acetate as a continuous combined therapy once daily. After 3 months, the LLF group added the HRT regimen and patients in the HRT group added gemfibrozil. Hence, all participants received the regimens combined for the last 6 months of the study. RESULTS: Serum s-cholesterol was markedly decreased in both groups during the first 3 months of single treatment (P&lt;0.0001). This decrease reflected a reduction especially of calculated low density lipoprotein (LDL) s-cholesterol (P&lt;0.001). High density lipoprotein (HDL) s-cholesterol was reduced in the HRT group (P&lt;0.005) but increased (P&lt;0.004) in the LLF group. Triglycerides were also decreased by both treatments but more marked in the LLF group (P&lt;0.0001) than in the HRT group (P&lt;0.02). After 9 months the reduction remained in both groups but no additive effects were encountered in any of the groups. CONCLUSION: The effects by gemfibrozil on s-cholesterol and triglycerides levels seem to be superior to continuous combined HRT in overweight women with elevated triglycerides. The combination of the two drugs did not seem to offer any additional benefit concerning the routine serum lipid or lipoprotein profile.},
  author       = {Nerbrand, Christina and Nyberg, Per and Nordström, Lennart and Samsioe, Göran},
  issn         = {1873-4111},
  keyword      = {Female,Estrogen Replacement Therapy,Estradiol : therapeutic use,Estradiol : administration & dosage,Cholesterol : blood,Cardiovascular Diseases : prevention & control,Antilipemic Agents : therapeutic use,Antilipemic Agents : administration & dosage,Oral,Administration,Lipoproteins,HDL Cholesterol : drug effects,LDL Cholesterol : blood,Middle Age,LDL Cholesterol : drug effects,Norethindrone : administration & dosage,Norethindrone : therapeutic use,Obesity : complications,Postmenopause,Triglycerides : blood,Treatment Outcome,Support,Non-U.S. Gov't,Gemfibrozil : administration & dosage,Gemfibrozil : therapeutic use,Human,Hyperlipidemia : complications,Hyperlipidemia : prevention & control,Lipoproteins : blood,Lipoproteins : drug effects,HDL Cholesterol : blood},
  language     = {eng},
  number       = {1},
  pages        = {55--62},
  publisher    = {Elsevier},
  series       = {Maturitas},
  title        = {Effects of a lipid lowering fibrate and hormone replacement therapy on serum lipids and lipoproteins in overweight postmenopausal women with elevated triglycerides.},
  url          = {http://dx.doi.org/10.1016/S0378-5122(01)00302-4},
  volume       = {42},
  year         = {2002},
}