OBJECTIVE:

The aim of this study is to investigate the effects of estrogens, combined estrogen-progestin, raloxifene and tibolone on serum lipid profile and inflammation markers in postmenopausal women.

MATERIALS-METHODS:

Sixty-two postmenopausal women were included in this study. Among them, 49 women were randomely assigned to 1 of 4 treatment groups and received estrogens, combined estrogen-progestin, raloxifene and tibolone for six months. First group (n = 16) is consisted of women in surgical menopause and received only estrogen treatment (0.625 mg conjugated equine estrogen). The second group (n = 12) is consisted of women who received combined estrogen-progestin treatment (0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesteron acetate), the third (n =10) and the fourth groups (n = 11) received raloxifene (60 mg) and tibolone (2.5 mg), respectively. Thirteen women who did not receive hormone replacement therapy consisted the fifth group (control group). In all women, serum concentrations of total cholesterol (TC), HDL, LDL, triglycerid (TG), apolipoprotein A1 (apo A1), apolipoprotein B (apo B), lipoprotein a [Lp (a)], high sensitive C-reactive protein (hs-CRP) and fibrinogen were measured at baseline and after 6 months of therapy, and the effects of different replacement therapies on these parameters were compared.

RESULTS:

In all treatments groups serum TC, LDL and apo B levels decreased significantly (p < 0.05) whereas, hs-CRP remained unchanged. HDL and apo A1 levels increased significantly in all treatment groups (p < 0.05) except tibolone. Lp (a) levels decreased in all treatment groups except raloxifene (p < 0.05). TG levels decreased only in women receiving combined estrogen-progestin treatment (p < 0.05). Fibrinogen levels decreased in women receiving combined estrogen-progesteron and raloxifene treatments (p < 0.05).

DISCUSSION:

In addition to classic HRT, raloxifene and tibolone treatments have also positive effects on lipid profile and inflammation markers in postmenauposal women.

Keywords: Menopause, lipid profile, hs-CRP, fibrinogen, coronary artery disease, hormone replacement therapy