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CHANGES OF CARDIOMETABOLIC RISK FACTORS IN EARLY AND LONG-TERM USE OF MENOPAUZAL HORMONE THERAPY IN WOMEN OF THE CLIMACTERIC PERIOD

Aim:changes in the main cardiometabolic risk factors in women of the climacteric period in early and long-term use of combined drospirenone-containing menopausal hormone therapy.Material and Methods.The study included 210 menopausal women divided into 3 groups: 1 group (n=48) included women who, after reaching menopause, switched from a drospirenone-containing hormonal contraceptive to taking menopausal hormone therapy; in the second group (n=84) — women who started taking hormone therapy in the period of early postmenopause. Menopausal hormone therapy was used for 1 mg of 17β-estradiol and 2 mg of drospirenone-“Angeliq®”. The control group (n=78) included women in early postmenopausal women who did not take hormonal therapy. The duration of follow-up is 5.2 (4.8, 5.7) years. Lipid metabolism, uric acid, immunoreactive insulin and C-peptide, oral glucose tolerance test, HOMA-IR index were calculated. The waist circumference and waist circumference/thigh circumference were determined.Results.Against the backdrop of prolonged menopausal hormonal therapy, a decrease in the atherogenicity of blood plasma was noted. In women of the control group, an increase in atherogenic lipid fractions was revealed by the end of the study. Patients of the first group of significant changes in the circumference of the waist and the ratio of waist circumference/thigh circumference were not detected. In women of the second group with initially higher values of the waist circumference and the ratio of the waist circumference/thigh circumference than in the patients of the 1st group, a decrease in the severity of abdominal obesity was established. Women of the control group noted an increase in the value of these indicators by the end of the study. In women receiving menopausal hormone therapy, there was a significant decrease in immunoreactive insulin and C-peptide, a decrease in the HOMA-IR index, combined with a decrease in basal and postprandial blood glucose levels. In women of the control group, as the abdominal obesity progresses, the increase in the studied indicators is noted.Conclusion.The study suggests the possibility of using a combination of 1 mg of 17β-estradiol and 2 mg of drospirenone for prolonged menopausal hormone therapy in patients with early postmenopausal metabolic disorders. Early and longterm use of menopausal hormone therapy has some additional advantages before prescribing hormone therapy in the early postmenopausal period with more favorable changes in the lipid spectrum of the blood, less pronounced abdominal obesity and insulin resistance.