This meta- analysis shows that oral tibolone treatment significantly lowers circulating Lp(a ) levels in postmenopausal women .
INTRODUCTION Circulating lipoprotein ( a ) ( Lp(a ) ) is a recognized risk factor for cardiovascular disease ( CVD ) .
Tibolone , a synthetic steroid , may lower Lp(a ) levels ; however , evidence of the effects of tibolone on Lp(a ) still remain to be defined .
Therefore , we investigated the effects of tibolone treatment on circulating Lp(a ) levels in postmenopausal women .
Lipoprotein(a) concentrations, isoform size, and risk of type 2 diabetes: a Mendelian randomisation study.
BACKGROUND Low concentrations of lipoprotein(a )  in plasma are associated with increased risk of type 2 diabetes , but whether this association is causal is unclear . Variations in the LPA gene affect lipoprotein(a ) isoform size and concentrations in plasma . We therefore did a Mendelian r and omisation study to investigate whether large isoform size , low concentrations in plasma , or both , are causally associated with type 2 diabetes . METHODS We assessed data for adults from the Danish general population enrolled in the Copenhagen City Heart Study and the Copenhagen General Population Study , with and without type 2 diabetes . Eligible participants had data for  lipoprotein(a ) concentrations in plasma , LPA kringle IV type 2 ( KIV-2 ) sums of repeats ( affecting both isoform size and plasma concentrations ) , and carrier status for the LPA single-nucleotide polymorphism rs10455872 ( mainly affecting concentrations in plasma ) . FINDINGS 77,901 individuals had lipoprotein(a ) data , of whom 28,567 ( 36·7 % ) had all three measurements .  Low concentrations of lipoprotein(a ) in plasma were associated with risk of type 2 diabetes , with adjusted odds ratios of 1·26 ( 1·09 - 1·45 ) , 1·17 ( 1·01 - 1·36 ) , 1·04 ( 0·90 - 1·21 ) , and 1·05 ( 95 % CI 0·90 - 1·22 ) , respectively , for quintiles 1 - 4 , compared with quintile 5 concentrations . High KIV-2 sums of repeats were associated with risk of type 2 diabetes ( adjusted odds ratio 1·16 , 95 % CI 1·05 - 1·28 ) for KIV-2 quintile 5 versus quintiles 1 - 4 combined . Being a carrier of rs10455872 did not affect risk of type 2 diabetes . For a halving of lipoprotein(a ) concentrations , the instrumental variable estimate of the causal odds ratio for type 2 diabetes was 1·15 ( 95 % CI 1·05 - 1·27 ) for KIV-2 sum of repeats and 0·99 ( 0·95 - 1·03 ) for rs10455872 genotype . INTERPRETATION Low lipoprotein(a ) concentrations alone seem not to be causally associated with type 2 diabetes , but a causal association for large lipoprotein(a ) isoform size can not be excluded . FUNDING Danish Heart Foundation , Danish Council for Independent Research -Medical Sciences , IMK Almene Fund , and Johan and Lise Boserup 's Fund
This meta- analysis shows that oral tibolone treatment significantly lowers circulating Lp(a ) levels in postmenopausal women .
INTRODUCTION Circulating lipoprotein ( a ) ( Lp(a ) ) is a recognized risk factor for cardiovascular disease ( CVD ) .
Tibolone , a synthetic steroid , may lower Lp(a ) levels ; however , evidence of the effects of tibolone on Lp(a ) still remain to be defined .
Therefore , we investigated the effects of tibolone treatment on circulating Lp(a ) levels in postmenopausal women .