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Gene variation simulates cholesterol response to oestrogen

According to a new study shows that women with a specific gene variant have a dramatic increase in 'good' cholesterol when they take oestrogen.// Previous research suggests that hormone replacement therapy (HRT) might protect women from heart disease. Now doctors at Forest University have discovered a strong genetic influence in how a woman's cholesterol profile responds to HRT.

An analysis of over 300 women with heart problems who took HRT or placebo showed that those with a specific gene variant had dramatic increases in high density lipoprotein (HDL or 'good' cholesterol). The gene concerned is called the oestrogen receptor alpha and, in this study, 20 per cent of the women carried it. They had a two to three times greater increase in HDL compared to women who did not have this variant of the gene.

Having high HDL should decrease the risk of heart disease although it is not yet known whether the current findings will mean fewer heart attacks for these women. The study may explain why previous research has shown no particular benefit from HRT in women with established heart disease - such research focusses on all women, not just the subgroup with the gene variant. The dramatic increases in HRT in this group would be diluted by results from those women who don't respond so well.

More research is needed before genetic testing for oestrogen receptor alpha can be recommended for women considering HRT. But this study promises a way of detecting those women who can most benefit from hormone replacement.


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