Effects of tibolone on plasma homocysteine levels in postmenopausal women

Çelik, Hüsnü; Ayar, Ahmet; Tuğ, Niyazi; Çıkım, Gürkan; Kılıç, Nermin; Parmaksız, Cem

doi:10.1016/s0015-0282(02)03207-7

Cited by 15 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consistent with this most studies have reported a reduction in Lp(a) with tibolone (Table 4). Tibolone does not increase homocysteine (82) and no increase in thromboembolic events has been reported with this therapy (94). Tibolone has been reported to be associated with an increase in CRP in one cross-sectional study (70), but this requires confirmation.…”

Section: Tibolone and Selective Estrogen Receptor Modulatorsmentioning

confidence: 96%

See 1 more Smart Citation

New Markers for Cardiovascular Disease Risk in Women: Impact of Endogenous Estrogen Status and Exogenous Postmenopausal Hormone Therapy

Davison

Davis

2003

The Journal of Clinical Endocrinology & Metabolism

107

View full text Add to dashboard Cite

The role of estrogen in altering cardiovascular disease risk in women is contentious. Menopause is associated with increased risk for ischemic heart disease and cerebrovascular disease, which collectively are the main causes of morbidity and mortality in women of developed nations. Observational studies suggest a protective role of estrogen, whereas recent randomized controlled trials report a negative role for oral estrogen in primary and secondary prevention of cardiovascular events. Inflammatory mechanisms underlie the process of arterial thrombus formation following atheromatous plaque rupture, and as such modulation of the inflammatory process may be a potential means of reducing cardiovascular risk. Sex steroids may influence inflammatory processes and hence modify cardiovascular risk. The objective of the study was to review the current understanding of the relationships between C-reactive protein (CRP), homocysteine, IL-6, and lipoprotein (a) [Lp(a)] and endogenous estrogen status, exogenous estrogen treatment, and cardiovascular disease risk. The design was a review of all relevant published, peer- reviewed studies. Raised levels of CRP, homocysteine, Lp(a), IL-6, and CRP are each independently associated with increased risk for cardiovascular events in women. Changes in these parameters across the menopausal transition cannot clearly be attributed to hormonal changes. With respect to the effects of exogenous postmenopausal therapy, oral estrogen use is consistently associated with elevations in CRP, no change or a reduction in homocysteine, varied effects on IL-6, and a consistent reduction in Lp(a). Transdermal estradiol overall has no significant effect on any of these parameters. Progestin use appears to attenuate the effect of oral estrogen on CRP and is associated with a reduction in Lp(a). Like oral estrogen, tibolone use is associated with a rise in CRP, with no change in homocysteine and consistent lowering of Lp(a). Selective estrogen receptor modulators modestly lower homocysteine and Lp(a), have varied effects on CRP, and have no reported effects on IL-6. Despite these varied effects of postmenopausal hormone treatment on inflammatory markers, homocysteine, and Lp(a), there is no evidence that change in these markers results in modification of cardiovascular risk. Further studies are required to specifically investigate whether treatments that increase or decrease these markers in fact modulate the risk of cardiovascular events in women.

show abstract

Section: Tibolone and Selective Estrogen Receptor Modulatorsmentioning

confidence: 96%

“…In contrast to the changes seen in CRP and IL-6, oral estrogen therapy alone or in combination with progestin is associated with a reduction in homocysteine levels in postmenopausal women (Table 2) (24, 64,71,81,82).…”

Section: Oral Estrogenmentioning

confidence: 99%

New Markers for Cardiovascular Disease Risk in Women: Impact of Endogenous Estrogen Status and Exogenous Postmenopausal Hormone Therapy

Davison

Davis

2003

The Journal of Clinical Endocrinology & Metabolism

107

View full text Add to dashboard Cite

show abstract

“…Data pertaining to the effects of tibolone on homocysteine are limited. In an randomized controlled trial, Celik 60 administered tibolone (2.5 mg/day) to 24 women 44 . In a small study involving only 43 postmenopausal women, Barnes and colleagues reported neither tibolone or oral CEE plus MPA had any significant effect on homocysteine levels 61 .…”

Section: Exogenous Postmenopausal Htmentioning

confidence: 99%

Homocysteine, estrogen and cognitive decline

2006

View full text Add to dashboard Cite

There are data to suggest an underlying link between homocysteine levels and cognitive decline. There is also evidence for a link between both the menopause transition and use of exogenous estrogen therapy and homocysteine levels. Clinical data do not support a role for exogenous estrogen in the prevention of dementia in older women; however, the 'window of opportunity' theory suggests that there is a need for randomized controlled trials to evaluate the role of estrogen in the early postmenopausal years to protect against cognitive decline in later life.

show abstract

“…It does not influence glucose tolerance but ameliorates insulin sensitivity [6,7]. Tibolone does not significantly modify coagulation [2] and circulating homocysteine [8], but seems to increase C-reactive protein [9]. An increase of resting forearm blood flow, and its response to anoxic exercise seems to be induced by tibolone [10], although recent reports did not show an amplification of endothelium-dependent vasodilatation during its administration [11].…”

Section: Introductionmentioning

confidence: 99%