폐경 후 호르몬 대체요법 2년 후 총 경동맥의 혈관 내막 두께 변화로 동맥경화에 미치는 효과를 본 연구

Abstract

Objective : To assess the 2-year effects of postmenopausal hormone replacement therapy (HRT) on progression of atherosclerosis, measured as intima media thickness (IMT) in carotid arteries. Methods : This study included 102 postmenopausal women recruited from the general population. Blood pressure, biochemical charicteristics, and common carotid IMT with B mode ultrasonography were measured at baseline and 27.9±3.7 years-HRT : 36 patients; sequential regimen (0.625㎎ conjugated equine estrogens: CEE/5㎎ medroxyprogesterone acetate: MPA), 34 patients; continuous regimen (0.625㎎ CEE/2.5㎎ MPA), 12 patients; 2.5㎎ tibolone, 10 patients; oral estrogen regimen (0.625㎎ CEE), 10 patients; transdermal estrogen regimen (50㎍ estradiol). Results : After HRT, total cholesterol (210.7±34.0 vs 202.8±30.9 ㎎/㎗, p=0.029), LDL (l13.3±25.5 vs 80.5±24.7 ㎎/㎗, p=0.034), lipoprotein (a) (51.3±13.8 vs 39.7±13.2 ㎎/㎗, p=0.038), and fasting insulin (6.8±2.6 vs 4.4±2.7 μ/㎖, p=0.026) were significantly decreased. Significant changes of the other biochemical characteristics and blood pressure could not be demonstrated. Common carotid IMT (average : Lt. 0.69±0.18 vs 0.53±0.20 ㎜, p<0.001, Rt. 0.65±0.11 vs 0.48±0.17 ㎜, p<0.001; maximum : Lt. 0.73±0.20 vs 0.68±0.23 ㎜, p=0.001, Rt. 0.68±0.12 vs 0.57±0.20 ㎜, p<0.001) was significantly decreased. There were no difference between the groups according to method of HRT. Conclusion : The findings of this study show that 2-year of HRT was effective in slowing progression of subclinical atherosclerosis in postmenopausal women.