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Fröhlich, M.* ; Mühlberger, N. ; Hanke, H.* ; Imhof, A.* ; Döring, A. ; Pepys, M.P.* ; Koenig, W.*

Markers of inflammation in woman on different hormone replacement therapies.

Ann. Med. 35, 353-361 (2003)

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BACKGROUND AND AIM. To measure in ̄ammatory markers in postmenopausal women on different forms of hormone in postmenopausal women on different forms of hormone replacement therapy (HRT). replacement therapy (HRT). METHOD. C-reactive protein (CRP), ®brinogen, plasma METHOD. C-reactive protein (CRP), ®brinogen, plasma viscosity (PV), albumin and white blood cell (WBC) count viscosity (PV), albumin and white blood cell (WBC) count were determined in 749 postmenopausal women. were determined in 749 postmenopausal women. RESULTS. CRP concentration was signi®cantly higher in RESULTS. CRP concentration was signi®cantly higher in women on estrogen monotherapy (difference of the median women on estrogen monotherapy (difference of the median (d) 0.96 (d) 0.96 mg/l, mg/l, P P = = 0.013), compared to those without HRT, 0.013), compared to those without HRT, but there was no difference in women on combined HRT. but there was no difference in women on combined HRT. Fibrinogen concentration was signi®cantly lower in women Fibrinogen concentration was signi®cantly lower in women on estrogen monotherapy (d 0.25 on estrogen monotherapy (d 0.25 g/l, g/l, P P = = 0.004) and 0.004) and combined HRT (d 0.4 combined HRT (d 0.4 g/l, g/l, P P < < 0.001), compared to women 0.001), compared to women without HRT. Similarly, PV was signi®cantly lower in women without HRT. Similarly, PV was signi®cantly lower in women on estrogen monotherapy (d 0.017 on estrogen monotherapy (d 0.017 mPa mPa ⋅ ⋅ s, s, P P = = 0.007) and 0.007) and women on combined HRT (d 0.039 women on combined HRT (d 0.039 mPa mPa ⋅ ⋅ s, s, P P < < 0.001), 0.001), compared to those without HRT. No differences were found compared to those without HRT. No differences were found for WBC count and the negative acute phase marker for WBC count and the negative acute phase marker albumin in the various treatment groups. In contrast to albumin in the various treatment groups. In contrast to oral estrogen administration, levels o fCRP, ®brinogen and oral estrogen administration, levels o fCRP, ®brinogen and PV in women on transdermal estrogen therapy did not differ PV in women on transdermal estrogen therapy did not differ from the no-HRT group. There was no association between from the no-HRT group. There was no association between these markers o fin ̄ammation and plasma estrogen levels. these markers o fin ̄ammation and plasma estrogen levels. CONCLUSION. Oral estrogen monotherapy was associated CONCLUSION. Oral estrogen monotherapy was associated with highest concentrations o fCRP. In contrast, other with highest concentrations o fCRP. In contrast, other markers o fin ̄ammation were either similar or lower in the markers o fin ̄ammation were either similar or lower in the oral HRT group, compared to the group o fwomen without oral HRT group, compared to the group o fwomen without HRT, suggesting that higher CRP concentrations re ̄ect HRT, suggesting that higher CRP concentrations re ̄ect estrogen effects on CRP expression rather than a systemic estrogen effects on CRP expression rather than a systemic pro-in ̄ammatory effect. pro-in ̄ammatory ef

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