Endocrinology and Metabolism

The Korean Endocrine Society (대한내분비학회)
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The Effect of Hormone Replacement Therapy on Carotid Intima-Media Thickness in Healthy Postmenopausal Women

건강한 폐경기 여성에서 호르몬 대체요법이 경동맥 내중막두께에 미치는 영향

Shin, Jang-Yel;Cha, Bong-Soo;Chung, Choon-Hee;Shim, Won-Heum;Lee, Hyun-Chul
신장열;차봉수;정춘희;심원흠;이현철

  • Published : 2006.02.28
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Abstract

Background: Cardiovascular disease is the leading cause of death in postmenopausal women. The use of hormone replacement therapy (HRT) preventing for cardiovascular disease in postmenopausal women remains controversial. We investigated the effect of HRT on carotid intima-media thickness (IMT) according to the HRT duration in healthy postmenopausal women. Methods: One hundred and twenty postmenopausal women (mean age: 55.4 ${\pm}$ 3.3 years) were classified into never users, short-term, and long-term users according to the HRT duration. Carotid IMT was measured, and the clinical and biochemical cardiovascular risk factors were examined. Results: The mean IMT was significantly thinner in the long-term users than that in the never users (0.62 ${\pm}$ 0.11 vs. 0.71 ${\pm}$ 0.14 mm, P < 0.01). Also, the maximal IMT was significantly thinner in the short-term and the long-term users. However, there is no significant difference in the mean and maximal IMTs between the estrogen alone and estrogen plus progestins used group. The period exposed to menopause was significantly shorter in the long-term users than that in the never users (1.8 ${\pm}$ 2.3 vs. 4.3 ${\pm}$ 3.3 years, P < 0.001). Conclusion: Our findings suggest that if HRT is initiated during early postmenopausal period before the onset of atherosclerosis, HRT may have a beneficial effect on the prevention of carotid atherosclerosis.

연구배경: 관상동맥질환은 폐경기 여성의 주된 사망 원인으로 알려져 있다. 현재 폐경기 여성에서 심혈관질환 예방을 위한 호르몬 대체요법의 사용은 논란의 여지가 많다. 이에 저자 등은 건강한 폐경기 여성에서 초음파를 이용하여 경동맥 내중막두께를 측정하여 투여기간에 따라 호르몬 대체요법이 경동맥 죽상경화증에 미치는 영향을 고찰하였다. 방법: 심혈관질환의 과거력이 없는 50세에서 60세까지의 폐경기 여성 120명을 호르몬 대체요법 투여기간에 따라 투여 받지 않은 대조군 (52명), 3년 미만 투여군 (40명), 및 3년 이상 투여군 (28명)으로 분류하였다. 심혈관질환의 위험 인자로 알려진 임상적 특성과 생화학적 인자를 측정하였으며, 경동맥 죽상경화증의 정도를 평가하기 위해 초음파를 이용하여 경동맥 내중막두께를 측정하였다. 결과: 경동맥 내중막두께의 평균값은 대조군에 비해 3년 이상 투여군에서 유의하게 낮았다 (0.62 ${\pm}$ 0.11 vs. 0.71 ${\pm}$ 0.14 mm, P < 0.01). 또한, 경동맥 내중막두께의 최대값도 대조군에 비해 3년 미만 투여군 및 3년 이상 투여군에서 각 각 유의하게 낮았다. 그러나 에스트로겐 단독투여군과 프로게스테론 병용투여군 간에 경동맥 내중막두께의 평균값 및 최대값은 유의한 차이를 보이지 않았다. 폐경에 노출된 기간은 3년 이상 투여군에서 대조군에 비해 유의하게 짧았다 (1.8 ${\pm}$ 2.3 vs. 4.3 ${\pm}$ 3.3 years, P < 0.001). 결론: 이상의 결과로 죽상경화증이 진행되기 전인 폐경초기에 호르몬 대체요법을 시행한다면 경동맥 죽상경화증의 진행을 예방하는데 호르몬 대체요법이 도움이 될 수 있을것으로 생각된다.

Keywords

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