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Sacks FM, Walsh BW: Sex hormones and lipoprotein metabolism. Curr Opin Lipidol 1994, 5:236-240. An extensive review of the effects of estrogen and progestins on VLDL and LDL metabolism.
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3-apoA-I by 11%, whereas transdermal estradiol had no significant effect. These increased apoA-I levels resulted entirely from increased production because their fractional catabolic rates were unchanged.
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Quantitative and qualitative changes in lipids, lipoproteins, apolipoprotein A-I, and sex hormone-binding globulin due to two doses of conjugated equine estrogen with and without a progestin
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Miller VT, Muesing RA, LaRosa JC, Stoy DB, Fowler SE, Stillman RJ: Quantitative and qualitative changes in lipids, lipoproteins, apolipoprotein A-I, and sex hormone-binding globulin due to two doses of conjugated equine estrogen with and without a progestin. Obstet Gynecol 1994, 83:173-179. The authors studied 102 postmenopausal women assigned to one of two doses of CEE for 4 months, followed by the same estrogen dose and the progestin, MPA. The estrogen-induced increase in HDL was completely reversed by the progestin.
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Obstet Gynecol
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Miller, V.T.1
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Lobo RA, Pickar JH, Wild RA, Walsh BW, Hirvonen E: Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women. Obstet Gynecol 1994, 84:987-995. A group of 525 healthy postmenopausal women were randomized to receive one of five treatments for 1 year [CEE (0.625 mg) alone, CEE with MPA (2.5 or 5.0mg) given daily or CEE with MPA (5 or 10mg) given cyclically]. All regimens of MPA nearly completely reversed the HDL increase produced by estrogen alone. Lp(a), LDL, and triglycerides were not affected by MPA.
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The writing group for the PEPI trial: Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA 1995, 273:199-208. A group of 875 healthy postmenopausal women were randomized to receive one of five treatments for 3years [placebo, CEE (0.625 mg), CEE and cyclic MPA (10 mg), CEE and MPA (2.5 mg/day), CEE and cyclic micronized progesterone (2.0mg)S. MPA lowered HDL and eliminated approximately two-thirds of the HDL-raising effect of estrogen, whereas micronized progesterone had no significant effect. Progestins did not alter the LDL-lowering or triglyceride-raising effects of estrogen.
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1 cholesterol. Metabolism 1994, 43:935-939. Testosterone lowered HDL by 15% in two hypoandrogenic groups: 8 hypogonadal men and 10 women (preoperative female-to-male transsexuals), whereas LDL and triglyceride levels were unaffected. Although both groups were hypogonadic, the pretreatment HDL levels were higher in women compared with the men, which suggests that the combination of estrogenic and androgenic influences is responsible for the sex difference in HDL levels.
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Circulation
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