For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .
Insulin-like growth factor binding protein-1 (IGFBP-1) and IGF-I during oral and transdermal estrogen replacement therapy: relation to lipoprotein(a) levels.
Low levels of insulin-like growth factor binding protein-1 ( IGFBP-1 ) have recently been associated with several risk factors for cardiovascular disease . The effects of estrogen replacement therapy ( ERT ) on plasma IGFBP-1 levels are , however , unclear . A double-blind , placebo-controlled study for 6 months was conducted in 73 hysterectomized postmenopausal women r and omized into two groups : oral estradiol ( E2 ) valerate , 2 mg/day ( n = 35 ) and transdermal E2 gel , 1 mg/day ( n=38 ) . Plasma IGFBP-1 , insulin-like growth factor-I ( IGF-I ) and lipoprotein(a ) ( Lp(a ) ) were determined at baseline , 3 and 6 months . The groups were similar for age and BMI . The baseline levels of estrone ( E1 ) , E2 , IGFBP-1 , IGF-I and Lp(a ) did not differ between the groups . During treatment , serum estradiol concentrations increased in both groups . During oral ERT , IGFBP-1 levels increased by 104 % ( P<0.001 ) , whereas IGF-I levels decreased by 13 % ( mean , P<0.05 ) . IGF-I and IGFBP-1 levels remained unchanged in the transdermal group . Lp(a ) levels decreased by 23 % ( median , P<0.001 ) in the oral group , but were unaffected by transdermal therapy . The change in IGFBP-1 concentrations during oral ERT showed an inverse correlation to that in Lp(a ) ( r = -0.40 , P<0.05 , Spearman correlation ) . In conclusion , oral ERT seems to enhance plasma levels of IGFBP-1 , which may be one reason for the reduced Lp(a ) levels
For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .