폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 혈청 지질 및 지단백에 미치는 영향

이임순,전섭,이순곤,이해혁,이권해,정집광,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Objective : The purpose of our study is to evaluate the effect of different administration method of progestogen on lipid profiles including total cholesterol, LDL(low density lipoprotein)-cholesterol, HDL(high density lipoprotein)-cholesterol, triglycerides during hormone replacement therapy in postmenopausal women. Methods and Materials : Seventy-one postmenopausal women who were assigned to following groups (Group I : conjugated equine estrogen(CEE), 0.625 mg/day plus continuous medroxyprogesterone acetate (MPA), 2.5mg/day, Group II : CEE, 0.625 mg/day plus cyclic MPA, 5mg/day for 12days/month. And we measured serum total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides before hormone replacement therapy(HRT) and 12 months later after hormone replacement therapy. Results: 1. Total cholesterol decreased in group I,III. 2. HDL-cholesterol increased in group I,II,III. 3. LDL-cholesterol decrease in group I,II. 4. Triglycerides increased in group I,II,III. There was significance in serum total cholesterol and LDL-cholestrerol among three groups. Conclusions : Estrogen alone or in combination with progestogen both in cyclic and continuous use improves lipid profiles, so medroxyprogesterone acetate(MPA) does not seem to blunt estrogenic effect on lipid profiles.

폐경기 여성에서 1년간 호르몬 대치 요법이 혈청 지질에 미치는 영향

이해혁,남계현,김승형,이임순,이권해,최승도 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Cardiovascular disease is one of the most common cause of death in postmenopausal women. After the onset of menopause, the risk of cardiovascular disease is increased. Several risk factors of cardiovascular disease are well known to us. Among the risk factors, the changes of lipid profiles are roles for cardiovascular disease. Estrogen appears to protect the development of cardiovascular disease, by several mechanism. Especially the protective effect is believed to be mediated by the changes of lipid profiles. Decreased high-density lipoprotein (HDL)-cholesterol and increased low density lipoprotein (LDL)-cholesterol are important factors for development of cardiovascular disease. The purpose of this study was to evaluate the effect of hormone replacement therapy on the lipid profiles to include total cholesterol (TC), high density lipoprotein(HDL)-cholesterol, low density lipoprotein(LDL)-cholesterol, and triglycerides. We measured lipid profiles in 31 postmenopausal women and gave each conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12) for 12months. The levels of serum TC, LDL-cholesterol, and triglycerides were decreased significantly (p<0.05) and HDL-cholesterol was increased significantly (p<0.05) after 12months of hormone replacement therapy. These data suggest that hormone replacement therapy appears to protect agianst the development of cardiovascular disease by the changes of lipid profiles.

Skin Rejuvenation in Women using Menopausal Hormone Therapy: A Systematic Review and Meta-Analysis

Pivazyan Laura,Avetisyan Julietta,Loshkareva Maria,Abdurakhmanova Amina 대한폐경학회 2023 대한폐경학회지 Vol.29 No.3

Objectives: To evaluate the effect of menopausal hormone therapy (MHT) on skin aging in menopausal women.Methods: Studies were identified by searching PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov databases using the key words “hormone replacement therapy” AND “skin” AND “menopausal.” Studies that used and compared oral/transdermal MHT with placebo or another type of treatment in menopausal women aged 45–55 years were selected.Results: From 1,526 studies identified, 15 studies comprising 1,589 patients were included in the final analysis. Our meta-analysis aimed to compare skin elasticity (standard [Std] mean difference = 0.28; 95% confidence interval [CI], 0.03–0.54; P = 0.03), skin thickness (Std. mean difference = 1.27; 95% CI, 0.88–1.66; P < 0.00001), collagen content (Std. mean difference = 2.01; 95% CI, 1.42–2.61; P < 0.00001), and skin dryness (Std. mean difference = 0.15; 95% CI, −0.05 to 0.35; P = 0.14).Conclusions: MHT increases elasticity and collagen content in the skin, thereby reducing the severity of wrinkles and increasing skin thickness. Nevertheless, more well-conducted clinical trials are required to answer all questions in an evidence-based manner.

Tibolone and Breast Cancer

Jae Kyung Lee,Hyewon Yun,Heeyon Kim,Bo Hyon Yun,Seok Kyo Seo 대한폐경학회 2023 대한폐경학회지 Vol.29 No.3

Tibolone, a selective tissue estrogenic activity regulator, is a synthetic steroid with distinct pharmacological and clinical characteristics in contrast to conventional menopausal hormone therapy. Tibolone induces estrogenic activity in the brain, vagina, and bone but remains inactive in the endometrium and breast. In particular, several studies have investigated whether tibolone usage increases the risk of breast cancer. This study aims to determine the effects of tibolone on the breast by focusing on the relation between tibolone use and breast cancer. Our investigation emphasizes recent studies, particularly those based on Asian populations.

폐경기 여성에서 호르몬 대치 요법시 병행투여된 프로제스토젠 투여 방법에 따른 혈청지질 및 지단백에 미치는 영향

이순곤,이권해 한국의학사 1998 診斷과治療 Vol.18 No.7

한국 폐경 여성에서 호르몬 대체요법시 치료 제제에 따른 유방 치밀도의 변화

이동윤 ( Dong Yun Lee ),김상돈 ( Sang Don Kim ),최영식 ( Young Sik Choi ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( Jung Gu Kim ),문신용 ( Shin Yong Moon ),김석현 대한폐경학회 2003 대한폐경학회지 Vol.9 No.3

목적 : 본 연구는 한국 폐경 여성에서 호르몬 대체요법과 연관된 유방 치밀도의 변화를 평가하기 위하여 시행되었다. 연구 대상 및 방법 : 본 연구에서는 호르몬 대체요법을 시행 받은 폐경 여성 294명을 대상으로 치료 제제에 따라 매일 tibolone 2.5 mg을 투여 받은 군(n=119), conjugated equine estrogen(CEE) 0.625 mg/medroxyprogesterone(MPA) 2.5 mg으로 지속적 병합요법을 시행 받은 군(n=93), CEE 0.625 mg으로 단독요법을 시행 받은 군(n=40) 및 raloxifene 30 mg을 투여 받은 군(n=42)으로 대변하였으며, 호르몬 대체요법을 시행 받지 않은 폐경 여성 36명을 대조군으로 설정하였다. 대상 여성에서 유방촬영술(mammography)을 호르몬 치료 시작 전과 치료 1년 후에 각각 시행한 후 유방 치밀도(breast density)의 변화를 후향적으로 각 군에서 비교 관찰하였다. 결과 : 대상 여성의 연령, 분만력, 폐경 연령, 폐경 후 기간, 체중, 신장 및 체질량지수(BMI)는 각 군간에 통계학적으로 유의한 차이가 없었다. 호르몬 대체요법 1년 후 유방촬영술에서 관찰된 유방 치밀도의 증가는 지속적 병합요법군에서 25.8%(24/93)로서 tibolonerns의 11.8%(14/119), raloxifene군의 2.4%(1/42)에 비하여 각각 유의하게 높았다(p<0.05). 결론 : 본 연구 결과 호르몬 대체요법을 시행 받은 폐경 여성에서 관찰된 유방 치밀도의 변화는 치료 제제에 따라 상이하다는 것을 확인하였으며, 특히 progestogen을 이용한 지속적 병합요법이 유방 치밀도 변화에 중요한 영향을 미치는 것으로 사료된다. Objective : This study was performed to evaluate the mammographic changes in breast density that were associated with hormone replacement therapy(HRT) in Korean postmenopausal women. Materials and Methods : In this retrospective study, 294 postmenopausal women were classified as the four groups according to the regimen of HRT; a daily treatment of tibolone 2.5 mg(n=119), conjugated equine estrogen(CEE) 0.625 mg/medroxyprogeserone(MPA) 2.5 mg(n=93), CEE 0.625 mg only(n=40) or raloxifene 60 mg(n=42), and they were compared with the control group of postmenopausal non-HRT users(n=36). Mammography was performed at baseline and after 1 year of treatment, and the incidence of changes in mammographic density was evaluated and compared among the groups. Results: There were no significant differences in age, parity, age at menopause, years after menopause, weight, height, and body mass index(BMI) among the groups. The risk of an increase in mammographic density after 1 year of treatment was significantly higher in CEE/MPA group(24/93, 25.8%), compared with tibolone(14/119, 11.8%) and raloxifene(1/42, 2.4%) group(p<0.05). Conclusion : This study showed that the changes in mammographic breast density related to postmenopausal HRT were dependent on the regimen of HRT. The continuous administration of progestogen as a component of the combined HRT seems to affect the breast density significantly.

호르몬 대치요법이 60세 이상의 폐경후 여성 골밀도에 미치는 영향

김우선 ( Woo Sun Kim ),윤병구 ( Byung Koo Yoon ),김지영 ( Ji Young Kim ),최두석 ( Doo Seok Choi ),이제호 ( Je Ho Lee ),김주한 ( Joo Han Kim ),김광원 ( Kwang Won Kim ),민용기 ( Yong Ki Min ) 대한폐경학회 2007 대한폐경학회지 Vol.13 No.2

연구목적: 호르몬 대치요법은 폐경후 여성의 골밀도 소실을 억제한다. 노인 인구가 증가하면서 골다공증 및 골다공증성 골절이 의학적, 사회 경제적 문제로 대두되고 있으나, 우리 나라 에서는 노인에게 시행한 호르몬 대치요법이 골밀도에 어떠한 영향을 미치는가에 대한 연구가 드물었다. 이에 본 연구에서는 60세 이상의 폐경후 여성에게 투여한 호르몬 대치요법이 골밀도에 미치는 영향을 조사하였다. 연구재료 및 방법: 삼성 서울 병원을 방문한 폐경후 여성 86명을 대상으로 하였다. 60세 미만 (n=58)과 60세 이상 (n=28)을 두 군으로 분류하여, conjugated estrogen 0.625 mg/day 또는 이와 동등한 역가를 가진 여성호르몬을 매월 25일 이상 투여하였다. 자궁이 있는 여성에게는 프로게트토겐을 지속적 또는 순차적으로 병합투여 하였다. 요추와 대퇴부의 골밀도는 이중에너지 X-선 흡수 계측법으로 호르몬 대치요법 전, 개시 6, 12, 24 개월에 측정하였다 결과: 60세 이상의 폐경 여성의 호르몬 대치요법 시행 24개월 후의 골밀도는 60세 이하 폐경 여성과 마찬가지로 치료 전에 비하여 유의하게 증가하는 양상을 보였다. 특히, 60세 이상 폐경 여성군의 호르몬 대치요법 시행 6개월 후 요추 골밀도의 증가율은 60세 이하의 여성보다 더욱 현저하였다 (3.6±3.7% vs. 5.7±7.3%, P<0.05). 골교체율 생화학적 표지자는 치료 전 두 군간 차이가 없었으며, 호르몬 대치요법 3개월 경과 후 두 군 모두 유의하게 감소된 양상을 보였다. 결론: 호르몬 대치요법을 받은 60세 이상의 폐경후 여성의 골밀도 증가는 60세 미만의 여성과 유사하였다. 또한 호르몬 대치요법 개시 6개월 후 요추 골밀도의 변화는 60세 이상의 여성에서 더욱 현저하였다. Objectives: Hormone replacement therapy (HRT) prevents bone loss in postmenopausal women. We studied the effect of HRT on bone mineral density (BMD) in Korean women over the age of 60. Methods: We measured BMD at the lumbar spine and femur neck by dual-energy X-ray absorptiometry at baseline, 6, 12, and 24 months after HRT in 86 Korean postmenopausal women (age over 60, n=28; below 60, n=58). Women were given 0.625 mg of conjugated estrogen or the equivalent for 25 days or more each month. Women with uterus received continuous or sequential progesterone additionally. Results: HRT in women over the age of 60 was equally effective as in younger women in increasing BMD. The percentage changes, especially of lumbar BMD at 6 months after HRT were greater in the older women (3.6±3.7% vs. 5.7±7.3%, P<0.05). There was no difference in biochemical markers of bone turnover (serum osteocalcin, urine deoxypyridinoline) at baseline between two groups, they decreased significantly in both groups at 3 months after HRT. Conclusion: Data shows that postmenopausal women over the age of 60 tend to respond to HRT with similar increments in BMD compared to those in women below the age of 60. Moreover, the increment in lumbar BMD of women over the age of 60 is greater than that of the women below the age of 60.

갱년기 증후군 환자의 Hormone Replacement Treatment에 대한 혈청지질, Hormone Receptor의 변화

이영진,최현일 연세대학교 원주의과대학 1993 원주의대논문집 Vol.6 No.1

호르몬 대체 요법 제공이 폐경기 이후 여성들의 운동기능에 미치는 영향: 체계적 문헌고찰 및 메타분석 연구

이한얼,박영민,강년주 한국운동역학회 2022 한국운동역학회지 Vol.32 No.2

Objective: The purpose of this systematic review and meta-analysis was to investigate potential effects of HRT (hormone replacement therapy) on motor functions in postmenopausal women. Method: In this meta-analysis, 19 studies that examined changes in motor functions between postmenopausal women with and without HRT intervention were qualified. We additionally conducted moderator variable analyses including: (1) motor function type, (2) hormone type, and (3) duration of HRT intervention. Results: The random effects model showed no significant overall effects (SMD = 0.199; SE = 0.115; 95% CI = -0.026~0.425; Z = 1.730; p = 0.084; I2 = 93.258%). Additional three moderator variable analyses revealed no significant effect sizes indicating that specific HRT protocols did not improve different motor functions in postmenopausal women. Conclusion: These meta-analytic findings suggest that HRT had no positive effects on motor functions in postmenopausal women.

갱년기증후군 환자의 Hormone Replacement Treatment에 대한 혈중지질의 변화

이영진(YJ Lee),홍민(M Hong) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.10

This is the clinical data that evaluate the clinical effect of estrogen replacement therapy in postmenopausal women especially on cardiovascular effect by change of serum lipid profiles. Estrogen replacement therapy is known to reduce the incidence of cardiovascular disease in postmenopausal women, and its beneficial effect is thought to be mediated in part by the favoable changes in serum lipid profile. We treated 360 cases of postmenopausal patient who visitied Wonju christian hospital during the 24 months of period from March 1993 to May 1995. The result were as follows; 1. Total cholesterol was significantly decreased(-3.46% - -8.64%) during all period. 2. HDL cholesterol was significantly increased(+5.16% - +6.73%) during all period. 3. Total cholesterol/HDL ratio was significanlty decreased(3.19-2.73) during all period. So we concluded that the estrogen replacement therapy was effective on the prevention of cardiovascular disease.