Effekty dlitel'nogo primeneniya estrogen-gestagennoy terapii u zhenshchin reproduktivnogovozrasta s izolirovannym gipogonadotropnymgipogonadizmom

We examined 56 normoprolactinemic women of reproductive age (18-45 y.o.) with isolated hypogonadotropic hypogonadism
(group 1) initially and on treatment with 2 mg of 17beta-estradiol and 10 mg of dydrogesterone in sequenced manner (HRT), duration
of HRT was from 18 to 42 (median 36) months; 45 healthy women (20-38 y.o.) were included in control group 2. Initially hypercholesterolemia
was observed in 50% of cases in group 1 and 6.6% in group 2 (z=12,29, p=0,0005); nevertheless, the difference in lipid levels
between groups 1 and 2 was not statistically significant: total cholesterol levels 5,2 (4,3; 6,0) mmol/l and 4,63 (4,15; 5,15) mmol/l respectively
(1vs2, р=0,1); triglycerides 0,8 (0,62; 1,3) mmol/l and 0,76 (0,6; 0,85) mmol/l (1vs2, р=0,08); HDL 1,89 (1,24; 2,1) mmol/l
and 1,79 (1,44; 2,8) mmol/l (1vs2, p=0,85); LDL 2,7 (2,2; 3,2) mmol/l and 2,75 (2,3; 3,3) mmol/l (1vs2, p=0,64). In group 1 decrease
of total cholesterol and triglycerides concentrations was found on HRT: total cholesterol 4,8 (3,95; 5,1) mmol/l (before vs on treatment
p=0,041), triglycerides 0,65 (0,6; 0,9) (before vs on treatment p=0,044) respectively, changes in HDL and LDL levels were not revealed.
Initial concentrations of Ca++, P, and alkaline phosphatase (AP) were within normal range in all women. However, concentrations of
Ca++ and AP were higher in group 1 compared to group 2: Ca++ 1,13 (1,08; 1,19) mmol/l and 1,05 (1,03; 1,09) mmol/l (1vs2,
p=0,0016); AP 161,5 (141,8; 183) IU/l and 141,0 (119; 151) IU/l (1vs2, p=0,044). On HRT reduce in Ca++ and AP concentrations
was observed: Ca++ concentrations 1,05 (1,03; 1,10) mmol/l (before vs on treatment p=0,004), AP 139 (112; 143) IU/l (before vs on
treatment p=0,004). HRT was accompanied by improvement of clinical symptoms, had no influence on thyroid function, and provoked
physiological rise of prolactin levels.Thus, despite lacking the expressed biochemical disorders, isolated hypogonadotropic hypogonadism
in women of reproductive age have hidden negative impact on lipid and mineral metabolism. Long term HRT is safe and significantly
improved parameters of lipid and mineral homeostasis in this cohort of patients.

hypogonadotropic hypogonadism in women, lipid metabolism, mineral metabolism, hormonal replacement therapy

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