Hormonal agents used in lowering lipoprotein(a).

Chem Phys Lipids. 1994 Jan;67-68:345-50.

Hormonal agents used in lowering lipoprotein(a).

Soma MR, Meschia M, Bruschi F, Morrisett JD, Paoletti R, Fumagalli R, Crosignani
P.

Institute of Pharmacological Sciences, University of Milan, Italy.

Lipoprotein(a) (Lp(a)) plasma concentrations in Caucasian populations are
classified as a quantitative genetic trait. Although the prevailing view has been
that Lp(a) levels are affected by age and gender, recent data are beginning to
indicate otherwise. Lp(a) levels change throughout life especially in females
after menopause. Lp(a) levels decrease in women treated with anabolic steroids
such as stanozolol and danazol. The Lp(a) plasma concentration is also profoundly
affected by sex hormone variations during pregnancy. In men with prostatic cancer
Lp(a) levels are reduced about 50% by estrogen therapy, and increased 20% by
orchidectomy. We have evaluated the changes in Lp(a) and lipid levels in
postmenopausal women following estrogen/progestogen replacement therapy. The mean
level of Lp(a) in treated women was about 50% lower after 6 and 12 months of
replacement therapy. A significant correlation between basal Lp(a) levels and the
changes at either 6 or 12 months was observed, suggesting that therapy was
particularly efficacious in those women with high basal Lp(a) levels. One year
after therapy cessation, Lp(a) concentrations tended to return to pre-therapy
values. In addition estrogen-progestogen treatment significantly lowered
total-cholesterol (12%) and LDL-cholesterol (28%), and increased HDL-cholesterol
(18%). From these studies it appears that sex hormones are actively involved in
the modulation of plasma Lp(a) levels and that both female and male sex hormones
possess a lowering effect. The results confirm a direct effect of sex hormones on
Lp(a) metabolism and suggest that estrogen-progestogen treatment of
postmenopausal women can improve the lipid profile not only by lowering total-
and LDL-cholesterol and raising HDL cholesterol, but also by lowering plasma
Lp(a).