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MENOPOZUN VE HORMON REPLASMAN TEDAVİSİNİN PLAZMA NİTRAT/NİTRİT VE ENDOTELİN-1 DÜZEYLERİNE ETKİSİ

EFFECTS OF MENOPAUSE AND POSTMENOPAUSALHORMONE REPLACEMENT THERAPY ON PLASMA NITRATE/NITRITE AND ENDOTHELIN-1 LEVELS

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2008

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Keywords (Original Language):

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Abstract (2. Language): 
ABSTRACT Objective: The aim of this study was to investigate the changes of plasma nitrate/nitrite (NOx) and endothelin-1 (ET-1) in postmenopause in comparison with premenopausal state and assess the effects of different hormone replacement regimens on these vasoactive substances. Materials and methods: The study involved 50 healthy postmenopausal (PMW), and 25 healthy premenopausal women. PMW were randomly divided into two subgroups: women receiving cyclic hormone replacement therapy (HRT) [0,625mg conjugated estrogen (CEE) from day 1 to day 28 + 5mg medroxyprogesterone acetate (MPA) from day 18 to day 28] (n=25); second subgroup consisted of women receiving continuous HRT [0.625mg CEE + 2,5mg MPAfrom day 1 to day 28] (n=25) for two months. Statistical significance was analysed by Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed ranks, and Spearman correlation tests. Results: Compared with premenopausal individuals, PMW have decreased NOx and increased ET-1. There is a positive correlation between NOx and ET-1 in premenopausal women, suggesting that there is a balance between NOx and ET-1. This balance is changed with menopause. Two month durated HRT significantly elevates NOx that is diminished with menopause and does not change ET-1, thereby improves the NOx/ET-1 balance. Conclusion: Continuous HRT is more successful than cyclic HRT in improving the endothelial function and maintaining the critical balance between NOx and ET-1. Our data provide evidence for the existence of increased (3/4 of subjects) and reduced (1/4 of subjects) NOx levels in response to HRT, which suggest that a significant number (but not all) of the HRT receiving postmenopausal women profit from the beneficial effects of HRT.
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Abstract (Original Language): 
Amaç: Bu çal›flman›n amac› menopoz sonras› (postmenopozda) plazma nitrat/nitrit (NOx) ve endotelin-1 (ET-1) düzeylerinde meydana gelen de¤ifliklikleri, ve farkl› hormon replasman tedavilerinin (HRT) bu vazoaktif maddeler üzerindeki etkisini incelemekti. Gereç ve yöntem: Çal›flmaya 50 sa¤l›kl› postmenopozal (PMW) ve 25 sa¤l›kl› premenopozal kad›n dahil edildi. Postmenopozal kad›nlar rastgele iki alt gruba ayr›ld›: siklik HRT ve kesintisiz HRT alan alt gruplar. 1. grup (siklik HRT) 2 ay boyunca siklüsün 1-28 günleri aras›nda 0,625mg konjuge estojen (CEE) + 18-28 günleri aras›nda 5mg medroksiprogesteron asetat (MPA) alan kad›nlardan oluflturuldu. 2. grup (kesintisiz HRT) ise 2 ay boyunca siklüsün 1-28 günleri aras›nda 0,625mg CEE + 2,5mg MPAalan kad›nlardan oluflturuldu. Sonuçlar›n istatiksel de¤erlendirilmesinde Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed ranks, ve Spearman korelasyon testleri kullan›ld›. Bulgular: Premenopozal olanlara k›yasla postmenopozal kad›nlarda NOx konsantrasyonlar› azal›rken, ET-1 konsantrasyonlar› artmaktad›r. Premenopozal kad›nlarda NOx ve ET-1 aras›nda görülen pozitif korelasyon, bu iki parametre aras›nda bir denge oldu¤unu göstermektedir. Bu denge menopozda de¤iflmektedir. ‹ki ayl›k HRT menopozla azalan NOx’n›n artmas›na neden olurken, ET-1 üzerine bir etkisi yoktur, böylece HRT NOx ve ET-1 aras›ndaki dengeyi düzenlemektedir. Siklik HRT’ye k›yasla kesintisiz HRT endotel fonksiyonu ve NOx/ET-1 aras›ndaki kritik dengenin sürdürülmesinde daha baflar›l› oldu¤unu söyleyebiliriz. Sonuç: Sonuçlar›m›zdan da görüldü¤ü gibi, HRT’ye cavaben postmenopozal kad›nlar›n bir k›sm›nda (3/4) plazma NOx düzeyleri artmakta, bir k›sm›nda ise (1/4) azalmaktadır; bu da, hepsi olmasa da postmenopozal kadınların ço¤unun HRT'nin pozitif etkilerinden yararlandı¤ını söyleyebiliriz
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