Tibolonun transdermal östradiol tedavisiyle yükselmiş serum lipoprotein (a) düzeylerine etkisi
Amaç: Cerrahi menopozdaki hastalarda 17-â-östradiol ve tibolonun serum lipoprotein (a) düzeyi üzerindeki etkilerini değerlendirmek Materyal melod: Çalışmaya benign nedenlerle yapılan histerektomi ve bilateral salpingo-ooferektomi sonrası cerrahi menopoza giren 46 .olgu alındı. Çalışmaya alman tüm olgularda operasyon öncesi lipoprotein (a) seviyeleri ölçüldü. Olgulara postoperatif 10. gün transdermal 17- K-östradiol tedavisi başlandı. Bundan sonra bir yıl süre ile her üç ayda bir olguların lipoprotein (a), seviyelerine bakıldı. Takip sırasında serum lipoprotein (a) seviyesi 30 mg/dl üzerine çıkan hastaların tedavilerine tibolon eklendi. Bulgular: Transdermal östradiol başlamadan önce lipoprotein (a) seviyeleri ortalama 17.7 ±7 olarak ölçülürken 3 ay transdermal östradiol teda¬visi sonrasında ölçülen lipprotein(a) seviyeleri 33,1 ±29,4, 6 ay sonraki lipoprotein (a) seviyesi 54,6±28,4, 9.ay serum lipoprotein (a) seviyesi 43,0 ±8,9, 12.ayda lipoprotein (a) seviyesi 29,5 ±2,5 olarak ölçüldü. Tedavi öncesine göre 3,6,9 ve 12. aylardaki serum lipoprotein (a) seviyelerindeki artış anlamlı bulundu(p
Effects of tibolon on increased lipoprotein (a) levels by transdermal estradiol therapy
Objective: to evaluate the effects of tibolon on serum lipoprotein (a) levels in patients with surgical menopause . Materials and methods: Forty-sixpremenopausal women (mean age 42 ± 5,1) undergoing surgical menopause were included in the study and transdermal estradiol was started 10 days after surgery. Serum lipids including lipoprotein(a) were measured before and after the surgery for 1 year with 3 month- intervals. Tibolone was added to the therapy in patients with serum concentration of lipoprotein (a) greater than 30 mg/dl. Results: Thirty-five women were still under follow-up at the end of 12 months. In 19 of them lipoprotein(a) levels increased despite transdermal estradiol. Lipoprotein (a) level before transdermal estradiol therapy was 17,7 ± 7. Serum lipo¬protein (a) levels at the 3rd month, 6th month, 9th and 12th month of transdermal estrogen therapy were 33,1 ± 29,4, 54,6 ± 28,4 (p
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