Evaluation of neuroprotective effects of long-term low dose hormone replacement therapy on postmenopausal women brain hippocampus using magnetic resonance scanner / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopausal women in hormone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters.</p><p><b>METHODS</b>A total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [estradiol (E2) 0.5-1.0 mg and progesterone 0.5-2.0 mg, once a day] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay (ELISA). The gene types of apolipoprotein E (ApoE) were measured by polymerase chain reaction, and the subjects with susceptible genes (ApoE epsilon3/epsilon4) of Alzheimer's disease (AD) were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging (MRI), and results in two groups were analyzed by statistical method.</p><p><b>RESULTS</b>Compared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher (P < 0.05) except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups. The results of hippocampus MRI for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 14 cases, control group 11 cases) showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group (0.406 +/- 0.028) was significantly higher than control group (0.369 +/- 0.031, P < 0.05). The results of 1H MRS for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 12 cases, control group 11 cases) showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group (1.54 +/- 0.08) were significantly higher than control group (1.45 +/- 0.13, P < 0.05).</p><p><b>CONCLUSIONS</b>For postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE epsilon3/epsilon4 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.</p>

Effects of long-term and low-dose hormone replacement therapy on bone mineral density in postmenopausal women / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effects of long-term and low-dose hormone replacement therapy on bone mineral density (BMD), and the incidence of bone pain in postmenopausal women.</p><p><b>METHODS</b>Totally 141 postmenopausal women were selected from the medical staff of the Peking Union Medical College Hospital. Of them, 63 women treated with low-dose sex hormone for over 5 (5-32) years were divided into hormone replacement therapy (HRT) group, and 78 never receiving HRT were divided into control group. The BMD was measured by dual energy X-ray absorptiometry (DEXA) at lumbar spine, Ward's triangle, femoral neck, trochanter, and total hip, and the incidence of bone pain was inquired.</p><p><b>RESULTS</b>The BMD in the HRT group was 9.1% higher than that in the control group (P < 0.05). The incidence of bone pain was significantly lower in the HRT group (71.4%) than that in the control group (89.7%).</p><p><b>CONCLUSION</b>Long-term and low-dose hormone replacement therapy can reduce bone loss and the incidence of bone pain.</p>

Bone mineral and body composition analysis of whole body in 292 normal subjects assessed by dual X-ray absorptiometry / 中国医学科学院学报

<p><b>OBJECTIVE</b>To understand whole body bone mineral and body composition changes in normal subjects, and study the relationship between body composition and bone mineral.</p><p><b>METHODS</b>292 normal subjects aged 10-79 years old, including 140 males and 152 females, were selected to be measured bone mineral content (BMC), bone mineral density (BMD) lean and fat of whole body by dual X-ray absorptiometry (DXA). Individuals were divided into age-groups by every ten years and were analyzed by statistical methods.</p><p><b>RESULTS</b>In males, peak values of BMC, BMD, lean and fat were in the 30-39, 20-39, 30-39, 70-79 age-groups. In females, they were in the 30-39, 30-39, 30-49, 50-69 age-groups respectively. Peak values of BMC, BMD and lean were higher in males than that in females, but peak value of BMD was not significantly higher in males than that in females. Peak value of fat was higher in females than that in males. Loss of BMC and BMD for females were more pronounced than that for males. Loss of lean for males was more pronounced than that for females. There are significant positive correlation between lean, weight and bone mineral in males and females. Fat has significant effect on BMC in females only.</p><p><b>CONCLUSIONS</b>The normal bone mineral and body composition data of whole body for males and females, and the characteristic of changes with aging are provided for analyzing the relationship between bone mineral and body composition with ease.</p>

Right attitude towards the postmenopausal hormone replacement therapy / 中国医学科学院学报

We have gone through decades using hormone replacement therapy (HRT). The first problem encountered was increased endometrial cancer and solved by addition of progesterone. Now we are facing cardiovascular complications and how could we solve in the use of HRT. Research in vitro with HUAR and HUVEC and clinically seemed to show that small physiological doses might be the solution in protection of CVD.

Effects of sex hormones on serum levels of nitric oxide and plasma angiotensin II in postmenopausal women / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effect of estrogen and progestin on the blood levels of nitric oxide and angiotensin II in aid of the application of hormone replacement therapy in postmenopausal women.</p><p><b>METHODS</b>The serum nitric oxide and plasma angiotensin II levels in postmenopausal women were determined before and 3 months after oral intake of estradiol valerate 1 mg/day (n = 10) or estradiol valerate, 1 mg/d plus medroxyprogesterone acetate, 2 mg/d (n = 30).</p><p><b>RESULTS</b>The serum nitric oxide levels of postmenopausal women were significantly increased by 3 months of oral estradiol valerate 1 mg/d (P < 0.05), whereas the plasma levels of angiotensin II tended to decrease. The positive correlation between the increases of nitric oxide and the changes of estradial 3 months after oral intake of estradiol valerate 1 mg/d was significant. Compared with the baseline, no significant changes were observed in both serum nitric oxide levels and plasma angiotensin II levels 3 months after oral intake of estradiol valerate, 1 mg/d plus medroxyprogesterone acetate, 2 mg/d (P < 0.05).</p><p><b>CONCLUSIONS</b>The vascular functions can be improved through increasing the serum nitric oxide level after 3-month oral intake of estradiol valerate, 1 mg/d in postmenopausal women, and estradiol valerate plus medroxyprogesterone acetate intake may attenuate the beneficial effects.</p>