Levels of Sex Steroid and Cardiovascular Disease Measures in Premenopausal and Hormone-Treated Women at Midlife
Year: 2008
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The "timing hypothesis," in addressing findings from the Women's Health Initiative trial, suggests that hormone therapy (HT) should be initiated within 6 years of the menopause transition to extend a favorable estrogenic environment after menopause. METHODS: We compared sex steroid and cardiovascular profiles at the 5-year follow-up visit in a community-based, longitudinal study of the menopause transition (Study of Women's Health Across the Nation). Women aged 47 to 57 years were in 1 of 4 groups: premenopausal, women using conjugated equine estrogen with or without progestin, or postmenopausal (<5 years) without HT use. Cardiovascular assays included low-density lipoprotein cholesterol, oxidized low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoproteins A-I and B, F(2a)-isoprostanes, C-reactive protein, and lipoprotein (a)-1. Sex steroid assays were performed for estradiol, estrogen receptor ligand load, 2-hydroxyestrone, 16alpha-hydroxyestrone, total testosterone, and sex hormone-binding globulin. RESULTS: Users of HT had 50% higher levels of sex hormone-binding globulin (P < .001 for both HT groups), which limits binding of sex steroids to their receptors, and higher excreted estrone metabolites (more than 60%; P < .001 for both HT groups) than premenopausal or postmenopausal women. These findings were, in turn, associated with higher levels of F(2a)-isoprostanes, an oxidative stress measure, than in premenopausal women. The HT users had a more favorable ratio of high-density to low-density lipoprotein cholesterol than did premenopausal or postmenopausal women (P < .01), but higher triglyceride levels (P < .01). CONCLUSION: Although HT users had some more favorable lipid profiles than premenopausal and postmenopausal women, there was evidence of adverse HT effects even in women free of atherosclerosis studied within the approximate 6-year period proposed with the timing hypothesis.
Source: Archives of Internal Medicine
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1078949291, G1395245948, Study of Women's Health Across the Nation (SWAN) V: UCLA Site, Study of Women's Health Across the Nation (SWAN) V: Chicago site, G1650445419, G1716029836, MENOPAUSAL TRANSITION IN BLACK AND WHITE WOMEN, G2069832255, G240534699, SWAN Genomic Analyses and SWAN Legacy, G2701036747, G2853426343, G2886598935, G2899798242, Study of Women's Health Across the Nation (SWAN) V: Coordinating Center, G3862244033, G4002206572, G4088562605, Study of Women's Health Across the Nation (SWAN) V: Central Laboratory, GYNECOLOGIC IMPACT OF THE MENOPAUSAL TRANSITION, G4492651742, G4790394471, G4847607846, G5212787517, G5481793173, Functional Status and the Menopause Transition, G6138161980, G6356525961, G6423459859, G6454223305, Study of Women's Health Across the Nation (SWAN V): Michigan Site, G6881890559, G7076164640, G711645435, G7265740541, G8334913947, Study of Women's Health Across the Nation(SWAN) V: Pittsburgh, G8865318642, G988252460
OpenAlex ID: W2154229546