Changes in Atherosclerosis Risk Factors Induced by
Hormone Replacement Therapy or Ethanol Consumption
By Tommi Koivu
Tampere University Press
Distributed by Coronet Books Inc.
$72.50 Paper original
Atherosclerosis is a chronic disease of large and medium sized arteries, characterized by retention of lipoproteins and accumulation of cholesterol in the arterial wall and subsequent narrowing of the arterial lumen. Atherosclerosis is the main cause of death in Western countries. The use of hormone replacement therapy (HRT) to prevent atherosclerosis has been an area of controversy in recent years. However, despite a multitude of earlier studies, there were no previous randomized clinical trials on whether estrogen treatment and estrogen receptor gene variation influence the progression of atherosclerosis in women. Moderate ethanol consumption has been shown to affect the serum lipid profile favorably, and there is a J-shaped association between alcohol consumption and the incidence of coronary heart disease. Nevertheless, associations between the lipid profile and the biomarkers of alcohol consumption carbohydrate-deficient transferrin (CDT) and gamma-glutamyl transferase (GGT) were unresolved.
The aims of this study were to investigate the possible effects of postmenopausal HRT on the oxidation of low density lipoprotein (LDL) particles and progression of cardiovascular diseases and to look for associations between the genotype of estrogen receptor and progression of atherosclerosis. The effects of alcohol consumption on the lipid profile were studied in relation to laboratory biomarkers of alcohol use.
Postmenopausal HRT by estradiol valerate alone, combined estradiol valerate–levonorgestrel, and combined estradiol valerate–medroxyprogesterone acetate was found to be associated with less severe atherosclerotic lesions and diminished LDL oxidation. Genetic variation in the estrogen gene may modulate the effect of postmenopausal estrogen therapy on progression of atherosclerosis. Alcohol consumption, associated with high serum CDT concentration, was associated with a favorable anti-atherogenic lipid profile, whereas alcohol consumption associated with liver induction and elevated serum GGT activity may favor pro-atherogenic effects on lipid profile. Thus, the biomarkers of alcohol consumption, CDT and GGT seem to detect different populations of subjects in regard to cardiovascular lipid risk factors.
Acta Universitatis Tamperensis; 1659
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