Effect of Bilateral Oophorectomy and Peroral Estradiol Valerate Therapy on Serum Lipids

Punnonen, R.; Rauramo, L

doi:10.1002/j.1879-3479.1976.tb00560.x

Cited by 19 publications

(21 citation statements)

References 18 publications

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“…Ethinyl estrogens increase serum triglycerides (1,11,31) while non-alkylated estrogens in doses com monly used in replacement therapy post-menopausally do not. This has been dem onstrated both in women with natural menopause (19,(30)(31)(32) and after oophorec tomy (3, 25,29) in line with the present findings. From clinical experience it can be inferred that the given doses of EE and E2V are the lowest that, to a large extent, will extinguish or ameliorate estrogen-deficiency symptoms.…”

Section: Discussionsupporting

confidence: 80%

Lipid Metabolic Studies in Oophorectomized Women: Effects Induced by Two Different Estrogens on Serum Lipids and Lipoproteins

Silfverstolpe¹,

Gustafson²,

Samsioe³

et al. 1980

Gynecol Obstet Invest

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11 oophorectomized women (mean age 34.5 ± 5.9) were given the 17-C-alkylated ethinyl estradiol (EE) 20 µg/day and the non-alkylated estrogen, estradiol valeri-anate (E₂V) 2 mg/day for 6 weeks in separate periods preceded by 6 weeks without hormonal replacement therapy. Blood samples were drawn before and after 6 weeks on each estrogen. Serum phospholipids, cholesterol and triglycerides were assessed. Preparative ultra-centrifugation with the isolation of the very low density (VLDL; d < 1.006 g/ml); the low density (LDL; d = 1.006–1.063 g/ml) and the high density lipoprotein (HDL;d > 1.063 g/ ml) fraction was carried out. In the three lipoprotein fractions, phospholipid, total cholesterol, free cholesterol and triglycerides were determined. An oral glucose tolerance test with concomitant plasma insulin determinations was performed. In the present study EE caused an increase in serum total and LDL triglycerides while there was a reduction of triglycerides in serum as well as in VLDL and LDL when E₂V was administered. There was a positive correlation between plasma insulin values during oral glucose tolerance test and serum and VLDL triglycerides when E₂V was administered. This finding supports earlier studies indicating that insulin (or rather the insulin-glucagon relationship) influences the hepatic triglyceride production rate. Both EE and E₂V increased HDL cholesterol, but E₂V did not induce a concomitant increase in serum triglycerides which would suggest a more physiological effect from the latter compound since fertile females have lower serum triglycerides and higher HDL cholesterol levels than males of corresponding age. The same differences are true in a comparison between fertile and post-menopausal women.

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Section: Discussionsupporting

confidence: 80%

Lipid Metabolic Studies in Oophorectomized Women: Effects Induced by Two Different Estrogens on Serum Lipids and Lipoproteins

Silfverstolpe¹,

Gustafson²,

Samsioe³

et al. 1980

Gynecol Obstet Invest

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“…This was achieved by enforcing a mythical concept that the early and late decelerations must be truly uniform (same in size and shape) [ 25 , 30 ] and gradual. Consequently, with near extinction of early and late decelerations, the midwives who are the front-line workers reported that CTG interpretation had become dysfunctional because of completely new-found difficulties in pattern recognition, thus affecting their performance and confidence [ 2 , 28 ]. On the other hand, many senior obstetricians have simply continued to interpret CTGs based on their past experience and conceptual understanding of the traditional British categorization of decelerations using the flexibility and discretion they can exercise [ 14-17 , 24 , 28 ].…”

Section: Misguided Discontinuation Of the Traditional British Categormentioning

confidence: 99%

“…Hence, decelerations which consistently occur during the contractions (most common) should not be called “variable”. But these get included anyway [ 2 , 13 ] because they are “rapid” and because all decelerations vary in depth and duration anyway! The reference given by FIGO (2015) [ 3 ] for this definition is the seminal paper of Ball and Parer [ 36 ].…”

Section: Critical Analysis Of Figo (2015) Definitions Of Decelerationmentioning

confidence: 99%

“…Atypical variable fetal heart rate (FHR) decelerations had become the commonest cause of suspicious and pathological CTGs in UK after 2007. However, in 2014, the National Institute for Health and Care Excellence (NICE) made a major correction by disbanding the subcategorization of variable FHR decelerations into typical and atypical which raises doubts about the science behind its previous stance [ 1 , 2 ]. Currently, the British obstetricians are divided on whether to follow NICE (2014) or the International Federation of Gynecology and Obstetrics (FIGO, 2015) guidelines or some other locally modified “convenient” version [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Critical Imperative for the Reform of British Interpretation of Fetal Heart Rate Decelerations: Analysis of FIGO and NICE Guidelines, Post-Truth Foundations, Cognitive Fallacies, Myths and Occam’s Razor

Sholapurkar

2017

J Clin Med Res

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Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex “pattern recognition” of CTG interpretation by clinicians depends. Unfortunately, the discrimination of FHR decelerations seems to be muddled since the British obstetrics adopted the concept of vast majority of FHR decelerations being “variable” (cord-compression). With proliferation of confusing waveform criteria, “atypical variables” became the commonest cause of suspicious/pathological CTG. However, National Institute for Health and Care Excellence (NICE) (2014) had to disband the “typical” and “atypical” terminology because of flawed classifying criteria. This analytical review makes a strong case that there are major and fundamental framing and confirmation fallacies (not just biases) in interpretation of FHR decelerations by NICE (2014) and International Federation of Gynecology and Obstetrics (FIGO) (2015), probably the biggest in modern medicine. This “post-truth” approach is incompatible with scientific practice. Moreover, it amounts to setting oneself for failure. The inertia to change could be best described as “backfire effect”. There is abundant evidence that head-compression (and other non-hypoxic mediators) causes rapid rather than shallow/gradual decelerations. Currently, the vast majority of decelerations are attributed to unproven cord compression underpinned by flawed disproven pathophysiological hypotheses. Their further discrimination based on abstract, random, trial and error criteria remains unresolved suggesting a false premise to begin with. This is not surprising considering that the commonest pathophysiology of intrapartum hypoxemia is contraction-induced reduction in uteroplacental perfusion (sometimes already compromised) and not cord compression at all. This distorted categorization causes confusion, false-alarm fatigue and difficulty in focusing on real pathological decelerations making CTG interpretation dysfunctional ultimately compromising patient safety. Obstetricians/midwives should demand reverting to the previous more scientific British categorization of decelerations based solely on time relationship to contractions as advocated by the pioneers like Hon and Caldeyro-Barcia, rather than accepting the current “post-truth” scenario.

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“…These changes in triglycerides were not observed by all investigators, for others reported only an early increase in total cholesterol and LDL cholesterol [5]. However, major studies in ovariectomized women were realized at short term after castration, and it has been observed also that the lipid changes disappeared after a longer term [6]. Estrogens could act directly on the regulation of arterial cells, because 17/3-estradiol administered to ovariectomized monkeys inhibited coronary atherosclerosis independently of plasma lipid variations [7].…”

mentioning

confidence: 93%

Long-Term Ovariectomy Effect on Plasma Glucose,Lipids,Antioxidant Vitamins, and Lipid Peroxides: Relationship with Aortic Cholesterol and Fatty Acid Distribution in Rats.

Douillet

Borson‐Chazot

Renaud

et al. 1997

J. Clin. Biochem. Nutr.

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SummaryThis study was performed to determine plasma lipid changes and antioxidant status in relation to cholesterol content and fatty acid distribution in the aorta of rats after long-term ovariectomy (OV). After 12 months, OV induced in rat plasma a significant increase in glucose, total cholesterol, and triglycerides compared with the corresponding values for the control rats (C) of the same age (p <0.0005, p < 0.005, p<0.0005, respectively). These changes were associated with a significant increase in lipid peroxide level (p <0.05) and a significant decrease in vitamin E in the plasma from group OV compared with the group C level (p<0.0001). Conversely, OV after 7 and 12 months induced a significant increase in vitamin C (p<0.001, p<0.0001, respectively). Concerning plasma fatty acid distribution, after 12 months, OV caused a significant increase in gamma and dihomo gamma linolenic acid (p < 0.0005, p<0.05, respectively). These changes were associated with a significant increase in aortic cholesterol in group OV (p<0.0005), and a significant decrease in the percentage of arachidonic acid (p <0.005) and of the total amount of fatty acids of the n-3 series (p<0.0001) and plasmalogen fatty acids (C16:0, p < 0.005; C 18:0, p < 0.05) compared with the corresponding values for group C. These results show that OV induced, independently of any effects of aging, plasma-specific lipid alterations with dysregulation of oxidative status, which could be crucial in the development of atherothrombotic disease.

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Effect of Bilateral Oophorectomy and Peroral Estradiol Valerate Therapy on Serum Lipids

Cited by 19 publications

References 18 publications

Lipid Metabolic Studies in Oophorectomized Women: Effects Induced by Two Different Estrogens on Serum Lipids and Lipoproteins

Lipid Metabolic Studies in Oophorectomized Women: Effects Induced by Two Different Estrogens on Serum Lipids and Lipoproteins

Critical Imperative for the Reform of British Interpretation of Fetal Heart Rate Decelerations: Analysis of FIGO and NICE Guidelines, Post-Truth Foundations, Cognitive Fallacies, Myths and Occam’s Razor

Long-Term Ovariectomy Effect on Plasma Glucose,Lipids,Antioxidant Vitamins, and Lipid Peroxides: Relationship with Aortic Cholesterol and Fatty Acid Distribution in Rats.

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