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Short‐term hormone replacement therapy: reduced plasma levels of soluble adhesion molecules
Author(s) -
W.M. van Baal,
J.J. Emeis,
P. Kenemans,
H. Van Kessel,
E. R. A. Peters-Muller,
Casper G. Schalkwijk,
M.J. van der Mooren,
Coen D.A. Stehouwer
Publication year - 1999
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1999.00565.x
Subject(s) - hormone replacement therapy (female to male) , chemistry , hormone therapy , term (time) , hormone , medicine , cell adhesion molecule , endocrinology , adhesion , immunology , cancer , organic chemistry , breast cancer , testosterone (patch) , physics , quantum mechanics
Background Epidemiological data have suggested that the use of hormone replacement therapy (HRT) is associated with a decreased risk of cardiovascular disease. Vascular endothelium and adhesion molecules play an important role in the initiation and progression of atherosclerosis. Material and methods Prospective, randomized, placebo‐controlled 12‐week study. Sixty healthy, normotensive postmenopausal women received either micronised oestradiol 2 mg alone ( n = 16, E 2 group), or sequentially combined with a progestagen; E 2 + P groups trimegestone 0.5 mg (E 2 + T, n = 14) or dydrogesterone 10 mg (E 2 + D group, n = 14) or placebo ( n = 16). Data were collected at baseline and at 4 and 12 weeks. Results Twelve weeks of treatment with E 2 or E 2 + P was associated with a significant decrease in the plasma concentrations of soluble intercellular adhesion molecule‐1 (sICAM‐1), vascular cell adhesion molecule‐1 (sVCAM‐1), and thrombomodulin (sTM). The average decrease in these markers was about 9%. In women treated with trimegestone the decreases were larger than in those treated with dydrogesterone; for sICAM‐1 (−15% vs. −2%; P < 0.0001), sVCAM‐1 (−15% vs. +3%; P = 0.003) and sTM (−9% vs. −4%; P = 0.11). Plasma levels of endothelin‐1 (ET‐1) decreased (by 13%) only in women treated with E 2 + P. In the E 2 group, flow‐mediated, endothelium‐dependent vasodilatation increased by 6 percentage points after 12 weeks ( P = 0.07 vs. baseline, P = 0.02 vs. E 2 + P, and P = 0.17 vs. placebo). Conclusion Short‐term treatment with E 2 or E 2 + trimegestone reduces plasma levels of sICAM‐1, sVCAM‐1 and sTM. ET‐1 decreased only in the E 2 + P groups. Different types of progestagens may differentially affect sICAM‐1, sVCAM‐1 and sTM levels, which may be relevant for the choice of type HRT.