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Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

NOGUEIRA-DE-SOUZA, N.C.; GUERREIRO DA SILVA, I.D.C.; DE CARVALHO, C.V.; PULCHINELLI, A.; HAIDAR, M.A.; BARACAT, E.C.; MASSAD-COSTA, A.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
79.149473%
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results...

Efeitos da terapia de reposição estrogênica nas respostas hemodinâmicas e neurais ao exercício físico agudo em mulheres no período pós-menopausa; Effects of estrogen replacement therapy in hemodinamic and neural responses to acute aerobic exercise in post-menopausal women

Oneda, Bruna
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 17/04/2006 Português
Relevância na Pesquisa
98.92036%
A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior)...

Efeitos isolados e associados da terapia de reposição oral estrogênica e do exercício físico aeróbico nas respostas hemodinâmicas e neurais em mulheres no período pós-menopausa; Effects of estrogen replacement therapy in hemodinamic and neural responses to acute aerobic exercise in post-menopausal women

Oneda, Bruna
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/02/2010 Português
Relevância na Pesquisa
98.92036%
A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior)...

Adjunctive antimicrobial photodynamic treatment of experimentally induced periodontitis in rats with ovariectomy

Garcia, Valdir Gouveia; Gualberto Júnior, Erivan Clementino; Fernandes, Leandro Araújo; Bosco, Alvaro Francisco; Nagata, Maria José Hitomi; Casatti, Cláudio Aparecido; Ervolino, Edilson; Theodoro, Letícia Helena
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 556-565
Português
Relevância na Pesquisa
69.26527%
Background: The aim of this study is to compare antimicrobial photodynamic therapy (aPDT) as an adjunctive therapy to scaling and root planing (SRP) for the treatment of experimentally induced periodontitis in rats with ovariectomy (OVX) that are or are not treated with estrogen replacement. Methods: A total of 270 female rats were divided into three groups: 1) normal rats; 2) rats with OVX; and 3) rats with OVX with estrogen replacement. Periodontal disease was induced through the introduction of a cotton thread around the mandibular left first molar. After 7 days, the ligature was removed, and the rats were randomly divided into the following treatment groups: 1) SRP plus saline solution; 2) SRP plus low-level laser therapy (LLLT); and 3) SRP plus toluidine blue O irrigation followed by LLLT. Ten rats from each group were euthanized at days 7, 15, and 30 after dental treatment. Bone loss (BL) in the furcation region was evaluated using histometric and immunohistochemical analyses. Results: aPDT treatment resulted in reduced BL compared with SRP treatment at all time points. Additionally, rats treated with aPDT exhibited reduced numbers of tartrate-resistant acid-phosphatase-positive cells and more proliferating cell nuclear antigen-positive cells in all treatment groups regardless of estrogen status. Whereas rats treated with aPDT showed weak immunoreactivity to the receptor activator of nuclear factor-k B ligand at day 7 post-treatment...

Percutaneous 17ß-estradiol replacement therapy in hypertensive postmenopausal women

Osório-Wender,M.C.; Vitola,D.; Spritzer,P.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1997 Português
Relevância na Pesquisa
68.842393%
The present study evaluated the short-term effects of percutaneous 17ß-estradiol on blood pressure, metabolic profile and hormonal levels in postmenopausal women with systemic arterial hypertension. After a wash-out period of 15 days, 10 hypertensive patients were treated with guanabenz acetate to control blood pressure, followed by 17ß-estradiol in the form of hydroalcoholic gel administered for 21 of 28 days of each cycle, for 3 cycles. Patients were evaluated before, during and 2 months after estrogen administration. Systolic and diastolic blood pressure or heart rate did not present any significant change in any patient when compared to those periods with the antihypertensive drug only (pretreatment period and 60 days after estrogen therapy was discontinued). Plasma biological markers of hepatic estrogenic action (plasma renin activity, antithrombin III, triglycerides, total cholesterol and lipoproteins) also remained unchanged during the study. Hormone treatment was effective, as indicated by the relief of menopausal symptoms, a decrease in FSH levels (73.48 ± 27.21 to 35.09 ± 20.44 IU/l, P<0.05), and an increase in estradiol levels (15.06 ± 8.76 to 78.7 ± 44.6 pg/ml, P<0.05). There was no effect on LH (18.0 ± 9.5 to 14.05 ± 8.28 IU/l). Hormone levels returned to previous values after estrogen treatment was discontinued. The data indicate that short-term percutaneous 17ß-estradiol replacement therapy...

Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

Nogueira-de-Souza,N.C.; Guerreiro da Silva,I.D.C.; de Carvalho,C.V.; Pulchinelli,A.; Haidar,M.A.; Baracat,E.C.; Massad-Costa,A.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2009 Português
Relevância na Pesquisa
79.149473%
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results...

Postmenopausal estrogen replacement therapy and increased rates of cholecystectomy and appendectomy

Mamdani, M M; Tu, K; van Walraven, C; Austin, P C; Naylor, C D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 16/05/2000 Português
Relevância na Pesquisa
68.838916%
BACKGROUND: Several studies have indicated that estrogen may prime inflammatory and nociceptive pathways, leading to symptoms that mimic cholecystitis. We set out to confirm the relation between recent estrogen use and cholecystectomy in postmenopausal women and to test the novel hypothesis that a similar relation exists for appendectomy. METHODS: We developed a retrospective cohort using prescribing and surgical procedure information from health administrative databases for approximately 800,000 female residents of Ontario who were over 65 years of age between July 1, 1993, and Mar. 31, 1998. We compared the incidence of cholecystectomy and appendectomy among women recently prescribed estrogen replacement therapy, levothyroxine and dihydropyridine calcium-channel antagonists (DCCA) using age-adjusted Cox proportional hazards models. Patients were followed for a mean of 540 (standard deviation [SD] 449) days. RESULTS: Compared with women taking DCCA, those who had recently begun taking estrogen were significantly more likely to undergo cholecystectomy (age-adjusted risk ratio [aRR] 1.9, 95% confidence interval [CI] 1.6-2.2) and appendectomy (aRR 1.8, 95% CI 1.1-3.0). No significant difference in either outcome measure was found between the levothyroxine users and the DCCA users. INTERPRETATION: This study identifies an increased risk of cholecystectomy and appendectomy among postmenopausal women who have recently begun estrogen replacement therapy.

The risks and benefits of long-term estrogen replacement therapy.

Barrett-Connor, E L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1989 Português
Relevância na Pesquisa
68.91252%
Estrogen replacement therapy (ERT) for postmenopausal women greatly reduces the risk of osteoporotic fractures, but carries an increased risk of endometrial cancer. This risk can be reduced by the addition of progestin, which does not interfere with the osteoporotic benefit of estrogen. Although long-term use data are few, there is presently little evidence for an increase or decrease in breast cancer risk associated with estrogen by itself (unopposed estrogen), or estrogen plus progestin. In contrast, a large body of evidence suggests that unopposed estrogen significantly reduces the risk of cardiovascular disease; there is no evidence that this benefit will persist when a progestin is added. The preferred method of estrogen replacement therapy, to prevent osteoporosis in a postmenopausal woman with an intact uterus, should be chosen with these different risks and benefits in mind.

Brain endogenous estrogen levels determine responses to estrogen replacement therapy via regulation of BACE1 and NEP in female Alzheimer’s transgenic mice

Li, Rena; He, Ping; Cui, Jie; Staufenbiel, Matthias; Harada, Nobuhiro; Shen, Yong
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
68.977676%
Estrogens have been found to improve memory and reduce risk of dementia, although conflicting results such as failure of estrogen replacement therapy for treatment of Alzheimer’s disease (AD) also has been reported. Only recently, our published human brain studies showed a depletion of brain estrogen in women with Alzheimer’s disease, while other studies have demonstrated cognitive impairment believed to be caused by inhibition of endogenous estrogen synthesis in females. To investigate whether the shortage of brain estrogen alters the sensitivity of response to estrogen replacement therapy, we have used genetic and surgical animal models to examine the response of estrogen treatment in AD neuropathology. Our studies have shown that early treatment with 17β-estradiol (E2) or genistein could reduce brain amyloid levels by increasing Aβ clearance in both APP23 mice with genetic deficiency of aromatase (APP/Ar+/−), in which the brains contains non-detectable levels of estrogen, and in APP23 mice with an ovariectomy (APP/OVX), in which the brains still contain certain levels of estrogen. However, only APP/Ar+/− mice showed a great reduction in brain amyloid plaque formation after E2 or genistein treatment along with downregulation of beta secretase (BACE1) mRNA and protein expression. Our results suggest that early and long-term usage of E2 and/or genistein may prevent AD pathologies in a dependent manner on endogenous brain estrogen levels in aged females.

Prediction of Pubertal Growth at Start of Estrogen Replacement Therapy in Turner Syndrome

Tanaka, Toshiaki; Horikawa, Reiko; Naiki, Yasuhiro; Yokoya, Susumu; Satoh, Mari
Fonte: The Japanese Society for Pediatric Endocrinology Publicador: The Japanese Society for Pediatric Endocrinology
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
69.106885%
In estrogen replacement therapy in Turner syndrome, there is no report which recommends the timing of the start of estrogen therapy in relation to height or adult height prediction. We have established a prediction model for pubertal growth (height difference from the start of estrogen therapy until adult height) at the start of estrogen replacement therapy. Twenty-seven Turner girls without spontaneous puberty were divided into two groups according to birth years; Group I consisted of 16 patients born from 1980–1989 and Group II consisted of 11 patients born before 1980. Using clinical characteristics from Group I, stepwise multiple regression analysis taking pubertal growth as an independent factor, and chronological age, bone age (TW2 RUS method standardized for Japanese children), height and height SDS as dependent factors revealed following formula (p<0.001, R2=0.737): (pubertal growth) = – 1.01x (Chronological age at start of E) – 0.326x (height at start of E) – 1.779x (bone age at start of E) + 90.997. Predicted adult height was obtained by adding predicted pubertal growth to height at the start of estrogen therapy. The mean absolute difference between real adult height (tallest height after height velocity less than 1 cm/yr) and predicted adult height was 1.6 ± 0.9 cm (0.3–2.8 cm) in Group I. When this prediction model was applied to Group II...

Health status of hormone replacement therapy users and non-users as determined by the SF-36 quality-of-life dimension

Wilson, D.; Taylor, A.; MacLennan, A.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Artigo de Revista Científica
Publicado em //1998 Português
Relevância na Pesquisa
78.069424%
BACKGROUND: The objective of this study was to compare the health status of women who use and do not use hormone replacement therapy (HRT). METHOD: The 1994 South Australian Health Omnibus Survey (a population health interview survey) was used to administer the short form-36 health survey questionnaire (SF-36) to users and non-users of HRT. A representative sample of 813 women aged 40 years and older were interviewed. The response rate of the survey was 72.4%. Eight health dimensions of the SF-36 were measured: physical functioning, social functioning, role limitations owing to emotional problems, role limitations owing to physical problems, mental health, vitality, pain and general health. RESULTS: The mean score for all eight health dimensions was in the bottom 50% of the population for HRT users while non-users were in the upper 50%. Users of HRT had significantly poorer scores for physical limitations, body pain, general health, vitality, social functioning and mental health. CONCLUSION: Women who use HRT are less healthy than non-users when measured by a generic health status measure.

Changes in the use of hormone replacement therapy in South Australia

MacLennan, A.; Taylor, A.; Wilson, D.
Fonte: Australasian Medical Publishing Co. Publicador: Australasian Medical Publishing Co.
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
78.18479%
OBJECTIVE: To determine changes in the use of hormone replacement therapy (HRT) in South Australia between 1991 and 1993. DESIGN AND SETTING: Survey of women aged 40 years and over, as part of the 1991 and 1993 South Australian Health Omnibus Surveys (household interviews); 868 were interviewed in 1991 and 790 in 1993. OUTCOME MEASURES: Rates of HRT use. RESULTS: In 1993, 19.0% of women aged 40 years and over were taking HRT and 28.5% had ever taken it (currently or in the past). The highest rates were in the 50-54 years age group (46.2% current use and 57.8% ever use). Between 1991 and 1993 there was a 40% increase in the number of women taking HRT and a significant increase (P < 0.01) in the median duration of therapy, from 38 to 54 months. There were also significant increases in rates of use by country women and Australian-born women (P < 0.01). Premarin and Provera remained the most commonly used products in 1993. CONCLUSION: Australian perimenopausal women are increasingly using HRT. This may reflect recent educational programs on the menopause for both health professionals and the public, and also an increasing number of choices of therapy.

Colorectal cancer and oestrogen replacement therapy, a meta analysis of the epidemiological studies

MacLennan, S.; MacLennan, A.; Ryan, P.
Fonte: Australasian Medical Publishing Publicador: Australasian Medical Publishing
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
78.4271%
OBJECTIVE: To determine if non-contraceptive oestrogen replacement therapy alters the risk of colorectal cancer. DATA SOURCES: A search was made of the MEDLINE database (January 1974 to October 1993) and Current Contents (October-December 1993) and of reference lists of articles identified in the search. Sixteen studies were identified and fourteen met defined criteria for analysis. DATA SYNTHESIS: The overall relative risk of oestrogen replacement therapy use and colorectal cancer was 0.92 (95% confidence interval, 0.74-1.15), which was not significantly different from unity (P > 0.05). The separate overall relative risks of oestrogen replacement therapy use for colon or rectal cancer were also not significantly different from unity. CONCLUSION: When the results of all studies published to date are combined, there is no association between oestrogen replacement therapy and the incidence of colorectal cancer. However, long term randomised control trials are required to confirm this.

Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women

Vickers, M.; MacLennan, A.; Lawton, B.; Ford, D.; Martin, J.; Meredith, S.; De Stavola, B.; Rose, S.; Dowell, A.; Wilkes, H.; Darbyshire, J.; Meade, T.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
Relevância na Pesquisa
78.474805%
Objective To assess the long term risks and benefits of hormone replacement therapy (combined hormone therapy versus placebo, and oestrogen alone versus combined hormone therapy). Design Multicentre, randomised, placebo controlled, double blind trial. Setting General practices in UK (384), Australia (91), and New Zealand (24). Participants Postmenopausal women aged 50-69 years at randomisation. At early closure of the trial, 56 583 had been screened, 8980 entered run-in, and 5692 (26% of target of 22 300) started treatment. Interventions Oestrogen only therapy (conjugated equine oestrogens 0.625 mg orally daily) or combined hormone therapy (conjugated equine oestrogens plus medroxyprogesterone acetate 2.5/5.0 mg orally daily). Ten years of treatment planned. Main outcome measures Primary outcomes: major cardiovascular disease, osteoporotic fractures, and breast cancer. Secondary outcomes: other cancers, death from all causes, venous thromboembolism, cerebrovascular disease, dementia, and quality of life. Results The trial was prematurely closed during recruitment, after a median follow-up of 11.9 months (interquartile range 7.1-19.6, total 6498 women years) in those enrolled, after the publication of early results from the women's health initiative study. The mean age of randomised women was 62.8 (SD 4.8) years. When combined hormone therapy (n=2196) was compared with placebo (n=2189)...

Hormone replacement therapy and breast cancer: What are the facts?

MacLennan, A.; Smith, M.
Fonte: Australasian Medical Publishing Co. Publicador: Australasian Medical Publishing Co.
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
78.069424%
Selective quotation in the popular press of studies showing a potential association between hormone replacement therapy (HRT) and breast cancer has fuelled women's concern. However, the increase in detected breast cancer among long term HRT users that was seen in some studies is compatible with surveillance bias and confounding caused by increased risk factors among HRT users (e.g., higher socioeconomic class, alcohol intake and body mass index). Until adequate data are available from randomised controlled trials, the evidence-based conclusion is that HRT has no effect on breast cancer rates. HRT may reduce mortality and morbidity from other diseases and the overall risk-benefit ratio should be considered for each woman.

Future long-term trials of postmenopausal hormone replacement therapy: what is possible and what is the optimal protocol and regimen?

Purbrick, B.; Stranks, K.; Sum, C.; MacLennan, A.
Fonte: Parthenon Publishing Group Publicador: Parthenon Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
Relevância na Pesquisa
78.824062%
The ideal long-term, randomized, placebo-controlled trial of hormone replacement therapy (HRT) from near menopause for up to 30 years to assess major morbidity and mortality is impractical because of high cost, participant retention, therapy compliance, and continuity of research staff and funding. Also the trial regimen may become outdated. It is nihilistic to demand such a long-term trial before endorsing HRT. However, medium-term trials using surrogate measures for long-term morbidity and mortality are possible and two are near completion. If these studies have been able to maintain reasonable participant retention, therapy compliance and minimal breach of protocol, they will set standards for trials of new HRT regimens. This paper discusses lessons learnt from past attempts at long-term trials and suggests the currently optimal protocol and cost of assessing new HRT regimens to optimize potential benefi ts and minimize adverse effects. A 5-7 year randomized, placebo-controlled trial of a flexible transdermal estrogen regimen ± either a selective estrogen receptor modulator, e.g. bazedoxifene, or micronized progesterone is discussed. Mild to moderately symptomatic women, 1–4 years post menopause, can be recruited via general practice and group meetings. Future trials should be funded by independent agencies and are high priority in women’s health.; B. Purbrick...

Hormone replacement therapy: prevalence, compliance and the 'healthy women' notion

MacLennan, A.; Wilson, D.; Taylor, A.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Artigo de Revista Científica
Publicado em //1998 Português
Relevância na Pesquisa
78.1382%
BACKGROUND: The objective of this study was to assess the current trends of hormone replacement therapy (HRT) use, including rates of use, length of use, continuation rates and characteristics of users and non-users and to examine the hypothesis that 'healthy women' are more likely to be users of HRT. METHODS: Analysis was carried out of three representative South Australian population studies in 1991, 1993 and 1995 comprising 3019, 3004 and 3016 personal interviews, respectively. RESULTS: Current use (and ever-use) of HRT in all women aged 50 years and over rose from 13.2% (26.7%) in 1991, to 21.2% (31.9%) in 1993 and 26.0% (40.5%) in 1995. Highest use is now in the 55-59-year age group where, in 1995, current use was 50.9% and ever use was 69.0%. Median compliance rates with HRT rose from 24 months in 1991 to 60 months in 1995 for current users aged 50 years of age or above. The pattern of increasing use of HRT is not consistent across age groups. Analyses of the 1995 data show that, in contrast with increasing rates of current use in women over 55 years, there was no overall change in rates for women below this age. There were no statistically significant differences in health indicators, e.g. blood pressure, smoking, cholesterol levels or body mass index between users and non-users of HRT. However...

Hormone replacement therapy and false positive recall in the Million Women Study: patterns of use, hormonal constituents and consistency of effect

Banks, Emily; Reeves, Gillian; Beral, Valerie; Bull, Diana; Crossley, Barbara; Simmonds, Moya; Hilton, Elizabeth; Bailey, Stephen; Barrett, Nigel; Briers, Peter; English, Ruth; Jackson, Alan; Kutt, Elizabeth; Lavelle, Janet; Rockall, Linda; Wallis, Matthe
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
78.4157%
INTRODUCTION Current and recent users of hormone replacement therapy (HRT) have an increased risk of being recalled to assessment at mammography without breast cancer being diagnosed ('false positive recall'), but there is limited information on the effects of different patterns of HRT use on this. The aim of this study is to investigate in detail the relationship between patterns of use of HRT and false positive recall. METHODS A total of 87,967 postmenopausal women aged 50 to 64 years attending routine breast cancer screening at 10 UK National Health Service Breast Screening Units from 1996 to 1998 joined the Million Women Study by completing a questionnaire before screening and were followed for their screening outcome. RESULTS Overall, 399 (0.5%) participants were diagnosed with breast cancer and 2,629 (3.0%) had false positive recall. Compared to never users of HRT, the adjusted relative risk (95% CI) of false positive recall was: 1.62 (1.43-1.83), 1.80 (1.62-2.01) and 0.76 (0.52-1.10) in current users of oestrogen-only HRT, oestrogen-progestagen HRT and tibolone, respectively (p (heterogeneity) < 0.0001); 1.65 (1.43-1.91), 1.49 (1.22-1.81) and 2.11 (1.45-3.07) for current HRT used orally, transdermally or via an implant, respectively (p (heterogeneity) = 0.2); and 1.84 (1.67-2.04) and 1.75 (1.49-2.06) for sequential and continuous oestrogen-progestagen HRT...

The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women.

O'Sullivan, A J; Crampton, L J; Freund, J; Ho, K K
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 01/09/1998 Português
Relevância na Pesquisa
69.13248%
The route of estrogen replacement therapy has a major impact on the growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis. Estrogen administration by the oral, but not the transdermal route, reduces IGF-I and increases GH levels in postmenopausal women. To investigate whether these perturbations have metabolic consequences, we compared the effects of 24 wk each of oral (Premarin 1.25 mg) and transdermal (Estraderm 100TTS) estrogen on energy metabolism and body composition in 18 postmenopausal women in an open-label randomized crossover study. Energy expenditure, lipid oxidation (lipid(ox)), and carbohydrate oxidation (CHOox) were measured by indirect calorimetry in the fasted and fed state before and after 2 and 6 mon treatment. Lean body mass, fat mass, and total body bone mineral density were measured by dual X-ray absorptiometry before and after 6 mon treatment. Mean (+/-SE) Luteinizing hormone levels fell to comparable levels during oral and transdermal estrogen, and bone mineral density was significantly increased by both treatments. Mean IGF-I was significantly lower during oral estrogen (77+/-7 versus 97+/-7 microg/liter, P < 0.05) treatment. Lipid(ox) 30-60 min after a standardized meal was significantly lower (36+/-5 versus 54+/-5 mg/min...

Estrogen replacement therapy and cardioprotection: mechanisms and controversies

Subbiah,M.T.R.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2002 Português
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Epidemiological and case-controlled studies suggest that estrogen replacement therapy might be beneficial in terms of primary prevention of coronary heart disease (CHD). This beneficial effect of estrogens was initially considered to be due to the reduction of low density lipoproteins (LDL) and to increases in high density lipoproteins (HDL). Recent studies have shown that estrogens protect against oxidative stress and decrease LDL oxidation. Estrogens have direct effects on the arterial tissue and modulate vascular reactivity through nitric oxide and prostaglandin synthesis. While many of the effects of estrogen on vascular tissue are believed to be mediated by estrogen receptors alpha and ß, there is evidence for `immediate non-genomic' effects. The role of HDL in interacting with 17ß-estradiol including its esterification and transfer of esterified estrogens to LDL is beginning to be elucidated. Despite the suggested positive effects of estrogens, two recent placebo-controlled clinical trials in women with CHD did not detect any beneficial effects on overall coronary events with estrogen therapy. In fact, there was an increase in CHD events in some women. Mutations in thrombogenic genes (factor V Leiden, prothrombin mutation, etc.) in a subset of women may play a role in this unexpected finding. Thus...