| Determinants of the effect of estrogen on the progression of subclinical atherosclerosis: Estrogen in the Prevention of Atherosclerosis Trial. | |
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MedLine Citation:
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PMID: 16037751 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the extent to which the estrogen-induced changes in lipids and markers of carbohydrate metabolism explain the beneficial effect of estrogen therapy on the progression of carotid artery intima-media thickness (IMT) in postmenopausal women. DESIGN: A randomized, double-blind, placebo-controlled, single-center trial enrolling 222 postmenopausal women 45 years and older without cardiovascular disease and with low-density lipoprotein (LDL) cholesterol levels of 3.37 mmol/L or greater (> or = 130 mg/dL). Intervention was unopposed micronized 17beta-estradiol versus placebo. Measurements were made using high-resolution B-mode ultrasonography to measure carotid artery IMT at baseline and every 6 months on-trial. RESULTS: Progression of carotid IMT was inversely related to on-trial high-density lipoprotein (HDL) cholesterol (P = 0.04) and was directly related to on-trial LDL-cholesterol (P = 0.005). Compared with placebo, women randomized to estradiol showed a higher mean on-trial HDL-cholesterol level and a lower mean on-trial LDL-cholesterol level. In contrast, fasting glucose, insulin, and hemoglobin A1C were lowered and insulin sensitivity increased with estradiol therapy, but the changes were not related to carotid IMT progression. On-trial HDL-cholesterol and LDL-cholesterol were significant independent determinants of carotid IMT progression, jointly explaining 30% of the treatment effect of unopposed estrogen on the progression of carotid IMT. CONCLUSION: Unopposed 17beta-estradiol reduced carotid IMT progression in postmenopausal women in part by increasing HDL-cholesterol and decreasing LDL-cholesterol. Although women randomized to estradiol showed improvement in all the markers of carbohydrate metabolism, these factors did not play a significant role in carotid IMT progression. |
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Authors:
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Roksana Karim; Wendy J Mack; Roger A Lobo; Juliana Hwang; Chao-ran Liu; Ci-hua Liu; Alex Sevanian; Howard N Hodis |
Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. Date: 2005-07-21 |
Journal Detail:
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Title: Menopause (New York, N.Y.) Volume: 12 ISSN: 1072-3714 ISO Abbreviation: Menopause Publication Date: 2005 Jul-Aug |
Date Detail:
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Created Date: 2005-07-29 Completed Date: 2005-12-13 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9433353 Medline TA: Menopause Country: United States |
Other Details:
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Languages: eng Pagination: 366-73 Citation Subset: IM |
Affiliation:
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Department of Preventive Medicine, Keck School of Medicine, Los Angeles, California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antilipemic Agents
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therapeutic use Arteriosclerosis / blood, pathology, prevention & control* Biological Markers / blood Blood Glucose / analysis Carotid Arteries / pathology* Cholesterol, HDL / blood Cholesterol, LDL / blood Double-Blind Method Estradiol / therapeutic use* Estrogen Replacement Therapy Female Hemoglobin A, Glycosylated / analysis Humans Insulin / blood Insulin Resistance Middle Aged Multivariate Analysis Postmenopause Tunica Intima / pathology* Tunica Media / pathology* |
| Grant Support | |
ID/Acronym/Agency:
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R01 AG-18798/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Biological Markers; 0/Blood Glucose; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hemoglobin A, Glycosylated; 11061-68-0/Insulin; 50-28-2/Estradiol |
| Comments/Corrections | |
Comment In:
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Menopause. 2005 Jul-Aug;12(4):357-8
[PMID:
16037747
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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