Effects of ultra-low dose hormone therapy on biochemical bone turnover markers in postmenopausal women: A randomized, placebo-controlled, double-blind trial.

OBJECTIVE: Evaluate the effects of ultra-low-dose hormone therapy (Ultra-LD HT) with 17ß-estradiol 0.5 mg and norethisterone acetate 0.1 mg (E2 0.5/NETA 0.1) versus placebo on bone turnover markers (BTM) in postmenopausal women. STUDY DESIGN: A multicenter, double-blind, randomized, placebo-controlled study was performed with 107 participants who received one tablet daily of E2 0.5/NETA 0.1 or placebo for 24-weeks. Bone formation markers-N-terminal propeptide of type I procollagen (PINP) and Bone-specific alkaline phosphatase (BSAP), and bone resorption markers-C-telopeptide of type I collagen (CTX-I) and N-telopeptide crosslinked of type I collagen (NTX) were assessed before and at 12 and 24-weeks of treatment. RESULTS: Women treated with E2 0.5/NETA 0.1 had a significant reduction in the PINP marker from baseline (58.49 ± 21.12 µg/L) to week 12 (48.31 ± 20.99 µg/L) and week 24 (39.16 ± 16.50 µg/L). Placebo group, the PINP marker did not differ significantly. The analysis of the BSAP indicated a significant increase in the placebo group (13.8 ± 5.09 µg/L and 16.29 ± 4.3 µg/L, at baseline and week 24, respectively), whereas in the treatment group the values did not change. The analysis of the NTX marker showed a significant reduction only in the treatment group (43.21 ± 15.26 nM/mM and 33.89 ± 14.9 nM/mM, at baseline and week 24, respectively). CTX-I had a significant decrease in the treatment group from baseline (0.3 ± 0.16 ng/L) to week 12 (0.21 ± 0.14 ng/L) and week 24 (0.21 ± 0.12 ng/L). CONCLUSION: Women receiving E2 0.5/NETA 0.1 experienced reductions in bone resorption and formation markers, an expected effect during the anti-resorptive therapy, suggesting a protective bone effect with the Ultra-LD HT.

Differential effect of the ultra-low dose and standard estrogen plus dydrogesterone therapy on thrombin generation and fibrinolysis in postmenopausal women.

INTRODUCTION: The objective of this study was to estimate the effects of different doses of oral hormone therapy (HT) on thrombin generation and fibrinolytic activity in postmenopausal women after 12 months of treatment. MATERIAL AND METHODS: Thrombin generation, fibrinolysis activators and inhibitors were determined before and after 12 months of treatment. Participants (180) were assigned (1:1:1) as follows: (1) standard HT group, 17ß-estradiol (1 mg/day) with dydrogesterone (5 mg/day); (2) ultra-low dose HT group, 17ß-estradiol (0.5 mg/day) with dydrogesterone (2.5 mg/day); (3) control group, no treatment. RESULTS: The standard HT led to a higher concentration of prothrombin 1 + 2 fragment (by 5.8%) with lower antithrombin activity (by 6.1%). Compared with baseline, we observed a reduction in mean antithrombin activity in the standard HT group and increases in mean levels of prothrombin 1 + 2 fragment in two HT groups. We found decreases after treatment in both standard and ultra-low dose HT groups in plasminogen activator inhibitor-1 (PAI-1) activity (-32.4% and -19.6%, respectively) and PAI-1 antigen (-9.9% and -7.8%, respectively). Intergroup analysis revealed reduction in both mean PAI-1 activities and PAI-1 antigen levels in the two treatment groups when compared with the control. CONCLUSION: Contrary to the standard estrogen plus dydrogesterone treatment, ultra-low dose HT revealed positive effects on hemostasis by intensifying fibrinolysis through a decrease in both PAI-1 activity and antigen levels, and with no impact on thrombin generation.

Effect of Xiaoyao pill combined with low-dose corticosteroid on serum estrogens in menopause syndrome and its clinical efficacy / 中国生化药物杂志

Objective To explore the effect of Xiaoyao pill combined with low-dose corticosteroid on serum estrogens levels in the treatment of patients with menopause syndrome and its clinical efficacy.Methods 96 patients with menopause syndrome from April 2013 to February 2015 in department of obstetrics and gynecology of Lishui second people’s hospital were selected and divided into 2 groups according to a random number table, the control group (48 cases) were treated with small dose of hormone therapy, the treatment group (48 cases) were treated with Xiaoyao pill combined with small dose of hormone therapy.The serum estrogens levels, Kupperman score, endometrial thickness and clinical efficacy were compared. Results The total effective rate of control group(79.17%) was lower than that of treatment group(93.75%)(P<0.05).Compared with control group post-treatment, the serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were lower, estradiol (E2) level was higher, the Kupperman score was lower, the endometrial thickness was higher than those of control group, there were significant differences ( P <0.05 ) . Conclusion Xiaoyao pill combined with small dose of hormone could improve serum E2, FSH and LH levels in the treatment of patients with menopause syndrome with high security.

Study on the clinical effect and immunologic function of Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder / 中国生化药物杂志

Objective To investigate the clinical effect and immunologic function of Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder.Methods 64 cases of Ventilator pneumonia in our hospital were collected and randomly divided into experiment group and control group, 32 cases each.Two groups were given conventional treatment, the control group received Methylprednisolone Sodium Succinate 1 mg/kg qd, the experiment group was given Methylprednisolone Sodium Succinate 1 mg/kg qd, and Moxifloxacin Hydrochloride and Sodium Chloride Injection 400 mg qd.Two groups of patients were continuous treated for 10 days.After treatment,T lymphocyte subsets, NK cells, white blood cell count, C reactive protein, clinical symptoms disappeared time, mechanical ventilation time, ICU length of stay and mortality rate were compared. Results After treatment, the total effective rate in the experiment group 75% was higher than the control group 50%( P <0.05 ).The levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in two groups increased(P<0.05), levels of CD8 +decreased(P<0.05),levels of WBC, CPR and PCT decreased in the two groups(P<0.05), and compared with the control group, the levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in the experiment group were higher(P<0.05), levels of CD8 + were lower(P<0.05),levels of WBC,CPR and PCT were lower(P <0.05), the rales disappeared time, cough disappeared time, fever disappeared time were significantly shorter than the control group(P <0.05), the duration of mechanical ventilation and the length of hospital stay were significantly shorter(P<0.05).Conclusion Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder was significantly effective, and it can relieve inflammation, prevention of infection control, enhance immune function.

Low-dose Hormone Therapy in Postmenopausal Women / 대한폐경학회지

The importance of the results of some large, randomized controlled trials on hormone therapy (HT) has changed the perceived risk or benefit of HT. It is now recommended that the dose and regimen of HT should be individualized based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and age of menopause. The effectiveness of low and ultra-low dose HT has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss with fewer side-effects than the standard dose HT. Although accumulating evidence demonstrates the efficacy and tolerability of low-dose HT, data about the use are limited by a lack of long-term, randomized studies. Further research is needed to determine the effect on fractures, as well as cardiovascular and breast disease.

Low-dose Hormone Therapy in Postmenopausal Women / 대한폐경학회지

The importance of the results of some large, randomized controlled trials on hormone therapy (HT) has changed the perceived risk or benefit of HT. It is now recommended that the dose and regimen of HT should be individualized based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and age of menopause. The effectiveness of low and ultra-low dose HT has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss with fewer side-effects than the standard dose HT. Although accumulating evidence demonstrates the efficacy and tolerability of low-dose HT, data about the use are limited by a lack of long-term, randomized studies. Further research is needed to determine the effect on fractures, as well as cardiovascular and breast disease.

Effect of low dose estrogen menopausal hormone therapy on nitric oxide and antioxidant activity / 대한산부인과학회지

OBJECTIVE: To evaluate the effects of low dose estrogen menopausal hormone therapy on cardiovascular system METHODS: This study categorized 95 postmenopausal women between March 2004 and August 2004. Thirty patients of estrogen therapy group, fifteen patients of estrogen-progestin therapy group, fifteen patients of low-dose estrogen therapy group, and fifteen patients of low-dose estrogen-progestin therapy group were divided. Remaining 20 patients served as control group which did not receive the hormone treatment. The blood pressure, pulse rate, lipid profile, and NO metabolites and antioxidant activity of plasma and urine were measured. RESULTS: Diastolic blood pressure was lower in hormone treatment group than control group's. Although it was not significant, the total cholestrol and LDL-cholestrol in the plasma of treatment group were lower than those of the control group while HDL-cholestrol were higher. Triglyceride in the plasma of treatment group was higher. Changes of blood pressure, pulse rate and lipid profile in low-dose group were similar to those of conventional standard dose. The plasma concentration of NO metabolites in treatment group was higher. Also, the plasma concentration of NO metabolites in low-dose group was similar to that of conventional dose. CONCLUSION: A low-dose hormone therapy was expected to bring about the improvement of endothelial cell dependent vascular reactivity like conventional dose, resulting in the reduction of diastolic blood pressure, the improvement of lipid profile, and an increase in plasma concentration of the NO metabolites. A low-dose hormone therapy may thus presumably provide beneficial effects on cardiovascular system.