This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Naessen, T. Articles by Lithell, H. Search for Related Content PubMed PubMed Citation Articles by Naessen, T. Articles by Lithell, H.

Serum Lipid Profile Improved by Ultra-Low Doses of 17ß-Estradiol in Elderly Women¹

Department of Women’s and Children’s Health, Section for Obstetrics and Gynecology (T.N., K.R.-M.), and Department of Geriatrics (H.L.), University Hospital, SE-751 85 Uppsala, Sweden

Address all correspondence and requests for reprints to: Tord Naessen, M.D., Ph.D., Section for Obstetrics and Gynecology, University Hospital, SE-751 85 Uppsala, Sweden. E-mail: Tord.Naessen{at}kbh.uu.se

Abstract

To determine whether ultra-low doses of estradiol (E₂) affect the serum lipid profile in elderly women, we analyzed changes in serum lipids and lipoproteins in 70 healthy women, 60 yr and older, randomly assigned to parenteral E₂ (7.5 µg per 24 h) delivered by a vaginal ring (Estring; Pharmacia-Upjohn, Malmö, Sweden) or no treatment for 12 months. Baseline serum estrone sulfate (E1S), but not E₂ or serum FSH, was negatively associated with serum total cholesterol (P = 0.026), low-density lipoprotein (LDL) cholesterol (P = 0.053), and apolipoprotein B levels (P = 0.023). Compared with no treatment, Estring treatment yielded nonsignificant increases within the normal postmenopausal range in serum E1S (+16%) and E₂ (+13%), but significantly reduced serum LDL cholesterol by 7.6% (-0.32 mmol/L; 95% confidence interval, -0.58, -0.07; P = 0.014) and LDL to high-density lipoprotein (HDL) ratio by 7.3% (-0.19 mmol/L; 95% confidence interval, -0.44, -0.06; P = 0.030). In Estring users values were significantly reduced in total cholesterol (by 4%), LDL cholesterol (by 7%), LDL to HDL ratio (by 7%), and apolipoprotein B (by 4%), and significantly increased in serum HDL triglyceride (by 25%) but not triglycerides. No significant changes were found in the untreated group. There was a significant interaction between age and both baseline serum E₂/sex hormone-binding globulin (P = 0.006) and sex hormone-binding globulin (P = 0.009) and a marginal interaction between age and E1S (P = 0.083) with regard to effects on changes in LDL cholesterol levels during Estring treatment. We conclude that ultra-low doses of E₂, which previously were considered to have only local effects, may improve serum lipid profile in elderly women with a pattern and magnitude similar to that reported after conventional estrogen doses or first-generation lipid-lowering agents. The reduction in LDL cholesterol tended to be greater with a combination of high age and low baseline levels of biologically active estrogens.

This article has been cited by other articles:

				D. F. Hayes Follow-up of Patients with Early Breast Cancer N. Engl. J. Med., June 14, 2007; 356(24): 2505 - 2513. [Full Text] [PDF]

				R. T. Chlebowski and G. L. Anderson Progestins and Recurrence in Breast Cancer Survivors J Natl Cancer Inst, April 6, 2005; 97(7): 471 - 472. [Full Text] [PDF]

				K. M. Prestwood, C. Unson, M. Kulldorff, and M. Cushman The Effect of Different Doses of Micronized 17{beta}-Estradiol on C-Reactive Protein, Interleukin-6, and Lipids in Older Women J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2004; 59(8): M827 - M832. [Abstract] [Full Text] [PDF]