The impact of tibolone and hormone therapy on serum C-reactive protein, tumor necrosis factor-α and hepatocyte growth factor in postmenopausal women

Ozer, Kamer; Erenus, Mithat; Yoldemir, Tevfik

doi:10.1080/13697130802479580

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…In a randomised, double-blind, PL-controlled, crossover study T did not significantly increase CRP levels, unlike a conventional dose of EPT, suggesting no induction of inflammation in healthy PMW [39,40]. Recently, Sezer Ozer et al showed a significant increase of CRP and a reduction of hepatocyte growth factor and TNF in PMW aged 47-52 years [43], while Vural et al have previously shown that the postmenopausal increase of plasma TNFa, IL-4, IL-10, IL-12 is not reversed by T probably due to its progestogenic and androgenic properties [44].…”

Section: Crp and Inflammatory Markersmentioning

confidence: 93%

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Biglia

Maffei

Lello

et al. 2010

Gynecological Endocrinology

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Section: Crp and Inflammatory Markersmentioning

confidence: 93%

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Biglia

Maffei

Lello

et al. 2010

Gynecological Endocrinology

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“…Tibolone has complex effects on lipid profile and, along with beneficial effects on a few cardiovascular markers (total cholesterol, LDL, lipoprotein (a) levels), it seems to decrease HDL cholesterol [74,75,76,77]. Moreover, it is associated with C-reactive protein elevation and modulation of other inflammatory markers [77,78]. Despite these features, tibolone appears to exert antiatherogenic properties and was found to reduce atherosclerosis progression in animals [79,80] and in humans [81,82].…”

Section: Formulationmentioning

confidence: 99%

Cardiovascular Risk/Benefit Profile of MHT

et al. 2019

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Background and Objectives: Data emerging from the Women’s Health Initiative (WHI) study point toward an association between menopausal hormone therapy (MHT) and cardiovascular (CV) risk. However, post hoc subgroup analyses stratifying participants according to their age and time since menopause, have opened the way to a better understanding of the relationship between estrogen and CV risk. The aim of this review was to revise the current literature and evaluate the CV risk or benefit following administration of MHT considering several factors such as MHT timing, dose, route of administration, and formulation. Materials and Methods: An electronic databases search of MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google Scholar; British Library) was performed, with the date range from each database’s inception until June 2019. All the studies evaluating MHT and cardiovascular risk, including thromboembolism or stroke, were selected. Results: Timing of MHT initiation was shown to be a critical factor in CV risk assessment. In concordance with the “timing hypothesis”, healthy symptomatic women who initiated MHT when aged younger than 60 years, or who were within 10 years of menopause onset, have demonstrated a reduction in both coronary heart disease (CHD) risk and all-cause mortality. In particular, MHT therapy was associated with improvement of subclinical signs of atherosclerosis. Venous thromboembolism (VTE) risk is reduced when low doses of oral estrogen are used. Moreover, transdermal hormonal application significantly reduces CV risk compared with oral administration. MHT impact on the CV system is influenced by either factors inherent to the specific regimen, or factors inherent to the specific patient. Hence, individualization of care is necessary. Conclusion: CV risk calculation should be considered by clinicians in order to exclude patients with high CV risk, in whom MHT is contraindicated. Assessing risks and benefits in a patient-centered approach according to individual’s features, health status, and personal preferences is important in order to realize a safe and effective treatment.

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Seventeen year risk of all-cause and cause-specific mortality associated with C-reactive protein, fibrinogen and leukocyte count in men and women: the EPIC-Norfolk study

et al. 2013

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There is strong evidence from observational studies suggesting serum C-reactive protein (CRP) is associated with cardiovascular and all-cause mortality. However, less is known about whether there are differences in the association of CRP with all-cause or cause specific mortality by sex, smoking, body mass index (BMI), or physical activity. We aimed to investigate these interactions and also investigate and compare the association of CRP and other inflammation markers (i.e., fibrinogen and leukocyte count) with all-cause and cause-specific mortality. Men and women aged 40-79 were recruited in 1993-1997 in the EPIC-Norfolk cohort study. A total of 16,850 participants with high-sensitivity assayed CRP data who had no known cancer, myocardial infarction and stroke at baseline were entered in the analysis to test the association of CRP, fibrinogen and leukocyte count with risk of all-cause and cause specific mortality. A total of, 2,603 all-cause deaths (1,452 in men) including 823 cardiovascular and 1,035 cancer deaths, were observed after 231,000 person-years of follow-up (median 14.3 years). CRP was positively associated with risk of all-cause, cardiovascular, and non-cancer non-cardiovascular mortality independent of established risk factors. The hazard ratio of all-cause mortality (95 % CI) for participants with CRP in the range of 3-10 and >10 mg/l (vs. <0.5 mg/l) was 1.56 (1.26-1.93) and 1.87 (1.43-2.43) respectively in men and 1.34 (1.07-1.68) and 1.98 (1.50-2.63) in women. The association was less positively graded in women with the increased risk being significant only at higher levels of the CRP distribution. The association persisted in never smokers and did not vary by levels of BMI or physical activity. Although fibrinogen and leukocyte count were also positively associated with mortality risk, only CRP remained a significant predictor of mortality when the inflammation markers were adjusted for one another in multivariable models. Serum CRP levels were a long-term predictor of risk of cardiovascular and non-cardiovascular mortality independent of known risk factors, fibrinogen, and leukocyte count.

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The impact of tibolone and hormone therapy on serum C-reactive protein, tumor necrosis factor-α and hepatocyte growth factor in postmenopausal women

Abstract: The positive impact of both tibolone and hormone therapy on inflammatory markers appears to be protective against cardiovascular diseases. However, the clinical implications of these findings are yet to be evaluated in large clinical trials.

Cited by 5 publications

References 24 publications

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Cardiovascular Risk/Benefit Profile of MHT

Seventeen year risk of all-cause and cause-specific mortality associated with C-reactive protein, fibrinogen and leukocyte count in men and women: the EPIC-Norfolk study

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