透皮
医学
雌激素
更年期
内科学
止血
激素
绝经后妇女
内分泌学
凝结
激素替代疗法(女性对男性)
激素疗法
药理学
乳腺癌
癌症
睾酮(贴片)
作者
Marianne Canonico,Martine Alhenc‐Gelas,Geneviève Plu‐Bureau,Valérie Olié,Pierre‐Yves Scarabin
出处
期刊:Menopause
[Ovid Technologies (Wolters Kluwer)]
日期:2010-11-01
卷期号:17 (6): 1122-1127
被引量:52
标识
DOI:10.1097/gme.0b013e3181e102eb
摘要
In Brief Objective: Although the route of estrogen administration is known to be an important determinant of the thrombotic risk among postmenopausal women using hormone therapy, recent data have shown that norpregnane derivatives but not micronized progesterone increase venous thromboembolism risk among transdermal estrogens users. However, the differential effects of progesterone and norpregnanes on hemostasis have not yet been investigated. Methods: We set up a cross-sectional study among healthy postmenopausal women aged 45 to 70 years. The impact of activated protein C (APC) on endogenous thrombin potential was investigated in the plasma samples of 108 women who did not use any hormone therapy (n = 40) or who were treated with transdermal estrogens combined with micronized progesterone (n = 30) or norpregnane derivatives (n = 38). Results: After exclusion of women with factor V Leiden and/or G20210A prothrombin gene mutations, there was no significant change in APC sensitivity among women who used transdermal estrogens combined with micronized progesterone compared with nonusers. Women using transdermal estrogens combined with norpregnanes were less sensitive to APC than were nonusers (P = 0.003) or users of transdermal estrogens combined with micronized progesterone (P = 0.004). In addition, prothrombin fragment 1 + 2 concentration was higher in users of transdermal estrogens plus norpregnanes than in nonusers (P = 0.004). Other hemostatic parameters did not vary significantly across the different subgroups. Conclusions: Transdermal estrogens combined with norpregnanes may induce APC resistance and activate blood coagulation. These results provide a biological support to epidemiological data regarding the potential thrombogenic effects of norpregnanes. However, these findings need to be confirmed in a randomized trial. The SNAC Study suggests that transdermal estrogens combined with norpregnane derivatives, but not with micronized progesterone, induce activated protein C resistance and activate blood coagulation.
科研通智能强力驱动
Strongly Powered by AbleSci AI