| Subject: |
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Life Sciences/Human health and pathology
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| PMID (PubMed ID): |
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 (12869355) |
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| Title: |
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Differential effects of oral and transdermal estrogen/progesterone regimens on sensitivity to activated protein C among postmenopausal women: a randomized trial. |
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| Author(s): |
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Emmanuel Oger1, Martine Alhenc-Gelas2, Karine Lacut1, Marie-Thérèse Blouch1, 3, Nathalie Roudaut4, Véronique Kerlan1, 4, Michel Collet1, 5, Jean-François Abgrall3, Martine Aiach2, Pierre-Yves Scarabin6, Dominique Mottier1, |
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| Laboratory: |
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| Abstract: |
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OBJECTIVE: Activated protein C (APC) resistance not related to the factor V Leiden mutation is a risk factor for venous thrombosis. Oral estrogen replacement therapy (ERT) has been reported to induce APC resistance. Little is known about the effect of transdermal estrogen. METHODS AND RESULTS: We enrolled 196 postmenopausal women who were randomly allocated to receive either 1 mg 17beta-estradiol orally (n=63) or 50 microg 17beta-estradiol transdermally per day (n=68), both associated with 100 mg progesterone daily or placebo (n=65) for 6 months. An activated partial thromboplastin time (APTT)-based test and the effect of APC on thrombin potential (ETP) were used. Oral ERT induced an ETP-based APC resistance compared with both placebo (P=0.006) and transdermal ERT (P<0.001), but there was no significant effect of transdermal ERT compared with placebo (P=0.191). There was no significant effect of ERT on the APTT-based APC sensitivity ratio. Prothrombin fragment 1+2 plasma levels were significantly higher after 6 months of treatment in women allocated to oral ERT compared with those on placebo and transdermal ERT and were positively and significantly correlated with changes in ETP-based APC sensitivity ratio. CONCLUSIONS: Our data show that oral, unlike transdermal, estrogen induces APC resistance and activates blood coagulation. These results emphasize the importance of the route of estrogen administration. |
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| Fulltext language: |
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English |
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| Publication type: |
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Article in peer-reviewed journal |
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| DOI: |
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10.1161/01.ATV.0000087141.05044.1F |
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| Journal: |
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| Arteriosclerosis, Thrombosis, and Vascular Biology (Arterioscler Thromb Vasc Biol) |
| Publisher |
American Heart Association |
| ISSN |
1079-5642 (eISSN : 1524-4636) |
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| Audience: |
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international |
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| Publication date: |
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2003-09-01 |
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| Submission date: |
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2003-07-17 |
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| Volume: |
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23 |
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| Issue: |
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9 |
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| Page, identifiant, ...: |
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1671-6 |
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| MeSH Classification: |
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Administration – Cutaneous – Administration – Oral – Estrogens – Female – Humans – Postmenopause – Progesterone – Protein C |
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