폐경후 여성에서 호르몬 대치요법의 투여기간이 지질과 Lipoprotein ( a ) 에 대한 효과에 미치는 영향

• Published in: The Korean journal of medicine Vol. 52; no. 6; pp. 858 - 864
• Main Authors: 김치정, Chee Jeong Kim, 곽미향, Mi Hyang Kwak, 김경만, Kyung Man Kim, 이광제, Kwang Je Lee, 정유석, Yoo Suk Chung, 민용기, Young Ki Min, 유왕성, Wang Seong Ryu, 유언호, Un Ho Ryoo
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.09.1997
• Subjects: Hormone; Lipid; Lipoprotein
• ISSN: 1738-9364

Objectievs: Hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a) [Lp(a)]. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. However, previous studies had variable duration of therapy, and there was no report evaluating the effect of the duration of medication. Methods: A total 246 postmenopausal women were divided into 4 groups: group A; 0.625mg conjugated equine estrogen(CEE)(n=90), group B; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(n=35), group C; 0.625mg CEE plus 10mg MPA(n=43), and group D; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=76). Lp(a) and lipids levels were measured before, 2, 6 and 12 months after HRT. Results: In total subjects, Lp(a) was decreased with medication for 2 months by 20.7%(p<0,0001). Compared with levels at 2 months after medication, levels at 6 and 12 months revealed further reduction(p<0.001) by 5.3% and 9.0% respectively. Medication for 2 months increased HDL-C in group A, not changed in group B and C, and decreased in group D. After 12 months, HDL-C levels were increased in Group A, B, and C, and not changed in group D, In total subjects, low density lipoprotein- cholesterol(LDL-C) was decreased by 12.2% after 2 months(p<0.001). Compared with levels at 2 months after medication, LDL-C level was decreased by 3.4% after 6 months(p<0.001) and there was no further reduction after 12 months. Conclusion: The effect of hormone replacement therapy on Lp(a) and lipids were dependent upon the duration of medication. Inconsistent results in previous studies can be partially explained by the difference in this parameter.