Sex hormones and lipoprotein(a) concentration

Abstract

the results obtained for SERMs are conflicting whereas AIs do not seem to reduce Lp(a) concentration. The effect of hormonal therapy on lipids is complex, depending on drugs and way of administration. Moreover, both androgens and estrogen could determine, in specific settings, severe adverse effects. These drugs are not currently recommended either for treatment of dyslipidemias with increased Lp(a) level or for the prevention of cardiovascular disease.

What is the Impact of Sex on Cardiovascular Disease Risk Factors in Patients with Chronic Kidney Diseases in China: A Cross-sectional Study

“…In previous studies, androgens had a greater affection of decreasing the level of Lp(a) compared with estrogens. (28).Besides, most of the women with CKD patients are old, and mostly are in menopause (14). Thus, there is a possibility of women with CKD have a worse situation of Lp(a) compared with men with CKD and we need to promote the realization of Lp (a) in women with CKD.…”

Tibolone decreases Lipoprotein(a) levels in postmenopausal women: A systematic review and meta-analysis of 12 studies with 1009 patients

“…The magnitude of reduction of Lp(a) with tibolone is similar to that of niacin. The influences of the dose and duration of used drugs on Lp(a) is also of concern [25]. Niacin can reduce Lp(a) in a dose-dependent manner [53].…”

“…The estrogenic property of tibolone is a possible explanation of the reduction of Lp(a) [25]; however, the details in the involvement of estrogens in the Lp(a) regulation still remain to be fully clarified [54]. One of the mechanism potentially responsible might be the fact that Lp(a) gene has an estrogen response element and tibolone may active this and reduce hepatic output of Apo(a) [55].…”

“…Additionally, tibolone is reported to modulate other lipoprotein factors, i.e. the drug with its androgenic properties can reduce high-density lipoprotein cholesterol (HDL-C) as an unfavorable change [25]. However, there are findings that the change of HDL-C is usually transient [33]; on the other hand there are more and more data that we should not focus on HDL-C as it is not main target of the lipid-lowering therapy, also due to the lasting debate on HDL functionality in different patients' groups [42,60,61].…”

“…Tibolone itself has no activities, but two estrogenic metabolites (3a-and 3b-hydroxy [OH] tibolone) and the third metabolite (D4-tibolone) exert the effects on climacteric symptoms, and the third metabolite also exerts additional progestogenic effects in endometrium [23,24]. Tibolone treatment can modulate the lipid profile and its possible reduction of Lp(a) has been observed [25], although the effects of tibolone on Lp(a) were not previously analyzed within systematic review and meta-analysis [22]. Therefore, we performed a meta-analysis to evaluate the efficacy of tibolone treatment on circulating Lp(a) levels in postmenopausal women.…”