Effect of oral and transdermal hormone therapy on hyaluronic acid in women with and without a history of intrahepatic cholestasis of pregnancy
Received 27 March 2007; received in revised form 3 July 2007; accepted 13 October 2007. published online 18 February 2008.
Objective
Intrahepatic cholestasis of pregnancy predisposes women to liver disorders years after affected pregnancy. We compared the basal levels and responses of hyaluronic acid, a marker of liver fibrosis, and liver transaminases to postmenopausal hormone therapy in women with (n = 20) and without (n = 20) a history of intrahepatic cholestasis of pregnancy.
Study Design
This was a randomized, double-blind, placebo-controlled, crossover trial.
Results
Basal levels of hyaluronic acid were similar in both groups. Two weeks of oral estradiol 2.0 mg/day led to significant but similar (10.9% to 15.4%) rises in hyaluronic acid in both groups. Increasing the dose of oral estradiol to 4.0 mg/day resulted in normalization of the levels, whereas the addition of medroxyprogesterone acetate led to falls (11.0% to 10.7 %) in hyaluronic acid. Transdermal estradiol 50 μg led to a rise (3.2 %) in hyaluronic acid only in the control group. Other liver markers were normal at baseline and during hormone therapy.
Conclusion
Normal basal levels and/or normal responses of hyaluronic acid and other liver markers to hormone therapy in women with previous intrahepatic cholestasis suggest that this therapy does not predispose these women to liver diseases.
aDepartment of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
bDepartment of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland.
Reprints: Olavi Ylikorkala, MD, FRCOG (hon.), Professor, Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland, P.O. Box 140, 00029 HUS, Finland.
This study was supported by an unrestricted research grant from the Ida Montini Foundation and the Päivikki and Sakari Sohlberg Foundation.
Cite this article as: Tuomikoski P, Aittomäki K, Mikkola TS, et al. Effect of oral and transdermal hormone therapy on hyaluronic acid in women with and without a history of intrahepatic cholestasis of pregnancy. Am J Obstet Gynecol 2008;198:375.e1-375.e5.
ABSTRACT
Effect of oral and transdermal hormone therapy on hyaluronic acid in women with and without a history of intrahepatic cholestasis of pregnancy