Effects of transdermal 17β-oestradiol combined with oral progestogen on lipids and lipoproteins in hypercholesterolaemic postmenopausal women

Abstract

Objectives. The purpose of the study was to evaluate the effect of transdermal 17β‐oestradiol with oral progestogen on the plasma levels of lipids, lipoproteins and apolipoproteins in hypercholesterolaemic postmenopausal women. Design. During 6 months of replacement therapy with transdermal 17β‐oestradiol combined with oral progestogen, plasma lipids, lipoproteins and apolipoproteins after 3 and 6 months were measured and compared with pretreatment values by Student's t‐test. Setting. From January 1992 until September 1992 patients were diagnosed and treated in an outpatient clinic of the Department of Endocrinology Medical Centre for Postgraduate Education, Warsaw. Subjects. The patients studied were 11 non‐obese postmenopausal women with hypercholesterolaemia based on the World Health Organization criteria. Interventions. Venous blood samples were obtained before and 3 and 6 months after the beginning of cyclic replacement therapy with transdermal 17β‐oestradiol (E2 100 μg day⁻¹ combined with oral chlormadinone acetate (2 mg day⁻¹ for 7 days in each cycle). Main outcome measures. The antiatherogenic effect of transdermal oestrogen replacement therapy exerted by increased levels of high‐density lipoprotein sub‐fraction 2 cholesterol (HDL₂‐C) leading to the decrease of the total cholesterol level was anticipated. Results. After 6 months of the treatment the concentrations of HDL₂ cholesterol (HDL₂‐C) increased from 0.45 ± 0.07 mmol l⁻¹ to 0.73 ± 0.03 mol l⁻¹ (P < 0.05) but the levels of HDL₃ cholesterol (HDL₃‐C) decreased from 1.15 ± 0.06 mmol l⁻¹ to 0.89 ± 0.07 mmol l⁻¹ (P < 0.05). The concentrations of total cholesterol decreased from 6.9 ± 0.13 mmol l⁻¹ to 6.2 ± 0.2 mmol l⁻¹ (P < 0.05). No changes were observed in the plasma levels of total triglycerides, HDL cholesterol, low‐density lipoprotein (LDL) cholesterol, very‐low‐density lipoprotein (VLDL) cholesterol, VLDL triglycerides, apolipoproteins A‐I and B. Conclusions. In hypercholesterolaemic postmenopausal women, transdermally administered 17β‐oestradiol 100 μg daily in combination with oral chlormadinone acetate has a beneficial effect through raising the level of the antiatherogenic HDL₂‐C subfraction and decreasing the level of total cholesterol.