Improved fat tolerance in postmenopausal women: a possible role for hormone replacement therapy

The aim of this study was to evaluate the possible role of Hormone Replacement Therapy [HRT] in the handling of lipid stress by enhancing lipolysis and thus improving fat tolerance in women using the therapy after menopause. As a measure of the lipolytic capacity, we estimated the TG/HDL ratio, or the lipolytic index, since the lipolytic stress in the circulation, at any given time, is a function of the two parameters, triglycerides[TG] and high density lipoproteins [HDL], i.e. the lipid load and the ability to remove it. Materials and A comparative study comprising 80 postmenopausal women, who fulfilled the inclusion criteria, was carried out. Subjects were divided into four groups according to type of hormone regimen used and their respective controls. Serum total triglycerides and HDL levels were estimated and the TG/HDL ratio calculated for four groups. The difference noted in the mean values for serum HDL and TG/HDL ratios in users of oestrogen therapy and their controls prove to be statistically significant, P < 0.001 and P < 0.05 respectively. While comparison of mean values in users of a combined oestrogen and progestin regimen and their controls showed statistically significant differences in values of serum TG [P < 0.05] and serum HDL [P < 0.001]. HRT while having beneficial effects on the circulating level of cholesterol rich lipoproteins, may also play an important role in preventing atherogenesis by enhancing the removal of the triglyceride rich particles from the circulation. Raised HDL levels in hormone users appear to contribute to improved fat tolerance and this effect would perhaps be more enhanced and relevant in the non-fasting state

Biochemical assessment of small intestinal inflammation caused by NSAID utilizing hydrogen breath test analysis

A prospective, randomized study was undertaken to determine the long term effect of NSAIDs on lactose absorption. Twenty controls and 28 patients were selected from the general medical out-patients clinic of a teaching hospital, adhering to strict inclusion and exclusion criteria. Six [30%] out of the 20 controls and 21 [75%] out of 28 patients showed positive hydrogen breath test at 60, 90, or 120 minutes [H

ion >20 ppm]; p value at 60 and 120 minutes was statistically significant [p<0.01], whereas at 90 minutes it was highly significant [p<0.001]. It was concluded that patients on long term NSAIDs are more likely to develop lactose malabsorption as indicated by positive breath test. This may have predictive value in picking up early small intestinal inflammation and thus enteropathy which is now a recognized complication of this group of drugs