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Horm Metab Res 2006; 38(9): 581-586
DOI: 10.1055/s-2006-950504
Original Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Serum Lipoprotein(a) Dynamics before/after Menopause and Long-term Effects of Hormone Replacement Therapy on Lipoprotein(a) Levels in Middle-aged and Older Japanese Women

M. Ushioda 1 , K. Makita 2 , K. Takamatsu 3 , F. Horiguchi 2 , D. Aoki 2
  • 1Department of Obstetrics and Gynecology, Inagi City Hospital, Tokyo, Japan
  • 2Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan
  • 3Department of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
Further Information

Publication History

Received 15 November 2005

Accepted after revision 2 May 2006

Publication Date:
18 September 2006 (online)

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Abstract

Aim: To assess lipoprotein(a) Lp(a) dynamics before and after menopause and to examine long-term changes during hormone replacement therapy (HRT) in middle-aged and older Japanese women. Methods: (1) Serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and Lp(a) concentrations of 526 patients were compared. The patients were divided into 3 groups on the basis of menopausal status (premenopause, perimenopause, postmenopause). (2) Serum markers of lipid metabolism were measured at baseline and at 6-month intervals in 161 postmenopausal women who continuously received HRT with conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA) for 4 years. (3) Changes in serum concentrations of markers were compared among 120 women with hypercholesterolemia who were randomly assigned to receive HRT (CEE plus MPA, or transdermal estradiol plus MPA) or pravastatin. Results: (1) Lp(a) concentrations were significantly higher in the postmenopausal women than in the premenopausal or perimenopausal women. (2) The mean Lp(a) concentration after 6 months of HRT decreased by about 19%, and similar levels were maintained for 4 years (3). The mean Lp(a) concentration after 6 months of HRT decreased by 19.9% in the CEE plus MPA group, but did not change significantly in the transdermal estradiol plus MPA group or the pravastatin group. Conclusion: Our results suggest that HRT with CEE plus MPA is useful for the management of elevated serum Lp(a) concentrations in middle-aged and older women. However, follow-up studies are needed to determine whether this finding is related to the future prevention of coronary heart disease events.

Key words

Lipoprotein(a) - estrogen - menopause - hormone replacement therapy - pravastatin

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1 Individual Contribution
Mariko Ushioda and Kazuya Makita contributed equally to the manuscript

Correspondence

Kazuya MakitaM.D., Ph.D. 

Department of Obstetrics and Gynecology·School of Medicine·Keio University

35 Shinanomachi·Shinjuku-ku·Tokyo·Japan 160-8582

Phone: +81/3/33 53 12 11/62 28 3

Fax: +81/3/32 26 16 67

Email: makita@sc.itc.keio.ac.jp

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