Open AccessEffekty dlitel'nogo primeneniya estrogen-gestagennoy terapii u zhenshchin reproduktivnogovozrasta s izolirovannym gipogonadotropnymgipogonadizmom
Author(s) -
Irena Ilovayskaya,
Vita Zektser,
А. В. Ильин,
Н. П. Гончаров,
И И Дедов
Publication year - 2010
Publication title -
ožirenie i metabolizm
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.154
H-Index - 5
eISSN - 2306-5524
pISSN - 2071-8713
DOI - 10.14341/2071-8713-5279
Subject(s) - medicine , endocrinology , dydrogesterone , alkaline phosphatase , cholesterol , hypogonadotropic hypogonadism , estrogen , chemistry , hormone , biochemistry , enzyme
We examined 56 normoprolactinemic women of reproductive age (18-45 y.o.) with isolated hypogonadotropic hypogonadism(group 1) initially and on treatment with 2 mg of 17beta-estradiol and 10 mg of dydrogesterone in sequenced manner (HRT), durationof HRT was from 18 to 42 (median 36) months; 45 healthy women (20-38 y.o.) were included in control group 2. Initially hypercholesterolemiawas observed in 50% of cases in group 1 and 6.6% in group 2 (z=12,29, p=0,0005); nevertheless, the difference in lipid levelsbetween groups 1 and 2 was not statistically significant: total cholesterol levels 5,2 (4,3; 6,0) mmol/l and 4,63 (4,15; 5,15) mmol/l respectively(1vs2, р=0,1); triglycerides 0,8 (0,62; 1,3) mmol/l and 0,76 (0,6; 0,85) mmol/l (1vs2, р=0,08); HDL 1,89 (1,24; 2,1) mmol/land 1,79 (1,44; 2,8) mmol/l (1vs2, p=0,85); LDL 2,7 (2,2; 3,2) mmol/l and 2,75 (2,3; 3,3) mmol/l (1vs2, p=0,64). In group 1 decreaseof total cholesterol and triglycerides concentrations was found on HRT: total cholesterol 4,8 (3,95; 5,1) mmol/l (before vs on treatmentp=0,041), triglycerides 0,65 (0,6; 0,9) (before vs on treatment p=0,044) respectively, changes in HDL and LDL levels were not revealed.Initial concentrations of Ca++, P, and alkaline phosphatase (AP) were within normal range in all women. However, concentrations ofCa++ and AP were higher in group 1 compared to group 2: Ca++ 1,13 (1,08; 1,19) mmol/l and 1,05 (1,03; 1,09) mmol/l (1vs2,p=0,0016); AP 161,5 (141,8; 183) IU/l and 141,0 (119; 151) IU/l (1vs2, p=0,044). On HRT reduce in Ca++ and AP concentrationswas observed: Ca++ concentrations 1,05 (1,03; 1,10) mmol/l (before vs on treatment p=0,004), AP 139 (112; 143) IU/l (before vs ontreatment p=0,004). HRT was accompanied by improvement of clinical symptoms, had no influence on thyroid function, and provokedphysiological rise of prolactin levels.Thus, despite lacking the expressed biochemical disorders, isolated hypogonadotropic hypogonadismin women of reproductive age have hidden negative impact on lipid and mineral metabolism. Long term HRT is safe and significantlyimproved parameters of lipid and mineral homeostasis in this cohort of patients.