The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis

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Abstract

Importance: The incidence of dyslipidemia increases after menopause. Menopause hormone therapy (MHT) is recommended for menopause related disease. However, it is benefit for lipid profiles is inconclusive.

Objective: To conduct a systematic review and meta-analysis of randomized controlled trials to evaluate the effects of MHT on lipid profile in postmenopausal women.

Evidence Review: Related articles were searched on PubMed/Medline, EMBASE, Web of Science, and Cochrane Library databases from inception to December 2020. Data extraction and quality evaluation were performed independently by two reviewers. The methodological quality was assessed using the “Cochrane Risk of Bias checklist”.

Results: Seventy-three eligible studies were selected. The results showed that MHT significantly decreased the levels of TC (WMD: −0.43, 95% CI: −0.53 to −0.33), LDL-C (WMD: −0.47, 95% CI: −0.55 to −0.40) and LP (a) (WMD: −49.46, 95% CI: −64.27 to −34.64) compared with placebo or no treatment. Oral MHT led to a significantly higher TG compared with transdermal MHT (WMD: 0.12, 95% CI: 0.04–0.21). The benefits of low dose MHT on TG was also concluded when comparing with conventional-dose estrogen (WMD: −0.18, 95% CI: −0.32 to −0.03). The results also showed that conventional MHT significantly decreased LDL-C (WMD: −0.35, 95% CI: −0.50 to −0.19), but increase TG (WMD: 0.42, 95%CI: 0.18–0.65) compared with tibolone. When comparing with the different MHT regimens, estrogen (E) + progesterone (P) regimen significantly increased TC (WMD: 0.15, 95% CI: 0.09 to 0.20), LDL-C (WMD: 0.12, 95% CI: 0.07–0.17) and Lp(a) (WMD: 44.58, 95% CI:28.09–61.06) compared with estrogen alone.

Conclusion and Relevance: MHT plays a positive role in lipid profile in postmenopausal women, meanwhile for women with hypertriglyceridemia, low doses or transdermal MHT or tibolone would be a safer choice. Moreover, E + P regimen might blunt the benefit of estrogen on the lipid profile.

Clinical Trial Registration: [ https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018092924], identifier [No. CRD42018092924].

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Author and article information

Contributors

Guangning Nie: URI : https://loop.frontiersin.org/people/1579151/overview

Xiaofei Yang: URI : https://loop.frontiersin.org/people/1704754/overview

Yangyang Wang: URI : https://loop.frontiersin.org/people/1723347/overview

Wanshi Liang: URI : https://loop.frontiersin.org/people/1722154/overview

Xuewen Li: URI : https://loop.frontiersin.org/people/1399097/overview

Qiyuan Luo: URI : https://loop.frontiersin.org/people/1722174/overview

Hongyan Yang: URI : https://loop.frontiersin.org/people/1036950/overview

Jian Liu: URI : https://loop.frontiersin.org/people/1723368/overview

Jiajing Wang: URI : https://loop.frontiersin.org/people/1722235/overview

Qinghua Guo: URI : https://loop.frontiersin.org/people/1722258/overview

Qi Yu: URI : https://loop.frontiersin.org/people/782436/overview

Xuefang Liang: URI : https://loop.frontiersin.org/people/1723660/overview

Journal

Journal ID (nlm-ta): Front Pharmacol

Journal ID (iso-abbrev): Front Pharmacol

Journal ID (publisher-id): Front. Pharmacol.

Title: Frontiers in Pharmacology

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1663-9812

Publication date (Electronic): 12 April 2022

Publication date Collection: 2022

Volume: 13

Electronic Location Identifier: 850815

Affiliations

[1] ¹ Department of Gynecology , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou, China

[2] ² The Second Clinical Medical College of Guangzhou University of Chinese Medicine , Guangzhou, China

[3] ³ Department of Standardization of Traditional Chinese Medicine , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou, China

[4] ⁴ State Key Laboratory of Dampness Syndrome of Chinese Medicine , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou, China

[5] ⁵ Department of Cardiovascular Medicine , Guangdong Provincial Hospital of Chinese Medicine , Guangzhou, China

[6] ⁶ Health Science Center , Shenzhen University , Shenzhen, China

[7] ⁷ Department of Gynecology , Peking Union Medical College Hospital , Beijing, China

Author notes

Edited by: Changting Xiao, University of Saskatchewan, Canada

Reviewed by: Željko Reiner, University Hospital Centre Zagreb, Croatia

Mihnea-Alexandru Găman, Carol Davila University of Medicine and Pharmacy, Romania

*Correspondence: Guangning Nie, guangningnie@ 123456gzucm.edu.cn ; Qi Yu, yuqimd@ 123456163.com ; Xuefang Liang, liangxuefang@ 123456gzucm.edu.cn

[ † ]

These authors have contributed equally to this work

This article was submitted to Drugs Outcomes Research and Policies, a section of the journal Frontiers in Pharmacology

Article

Publisher ID: 850815

DOI: 10.3389/fphar.2022.850815

PMC ID: 9039020

PubMed ID: 35496275

SO-VID: f17ed874-e896-4c02-b64b-1d010d9a3c2a

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis

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Journal of Applied Pharmaceutical Science

Most cited references 120

The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.

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