Analisys of relation between cyp17 gene polymorphism and vasomotor symptoms in postmenopausal women with estrogen therapy

To evaluate the influence of CYP17 polymorphism on menopausal symptoms after estrogen treatment. Design: A total of 130 women were recruited, but only 100 of these were selected according to inclusion and exclusion criteria, and they were treated with 0.3mg/day of conjugated equine estrogens. One year later the study was completed with 70 women. The analysis of the Kuppermann Menopausal Index (KMI) symptoms was made with information provided by the patients on daily diary cards. Blood samples were analyzed and the women were divided into two groups based on the CYP17, 5´ untranslated region: GA (wild-type homozygote and heterozygote) and GB (mutated homozygote). Results: The values of KMI were similar in both groups (GA = 31.11 ± 9.95 and GB= 30.39 ± 7.74) at baseline. The symptoms in both groups decreased after one year of treatment when compared to those at baseline. The improvement rate was approximately 27.09% and 32.18%, in GA and GB, respectively. The levels of estrogen after treatment were higher in both groups in comparison with the baseline values. The testosterone level rose in GB with the one-year treatment (0.48 ± 0.16) reaching a higher level than the GA level after treatment. The SHBG level showed a significant increase after the one-year treatment in GB surpassing both the baseline and the after treatment values of GA (p<0.01). Conclusion: Our data suggest CYP17 polymorphism did not influence the unopposed estrogen during the one-year treatment. The extra production of estrogen and androgen may have been countered by the elevation of SBHG.Key words: Polymorphism; CYP17; estrogen; hot flashes.OBJETIVO: Avaliar a influência do polimorfismo do CYP17 em mulheres menopausadas em terapia estrogênica. Um total de 130 mulheres foram recrutadas, porém apenas 100 mulheres foram selecionadas seguindo os critérios de inclusão e exclusão; foi administrado 0.3mg/dia de estrogênios conjugados eqüinos. Após um ano, terminamos o estudo com 70 pacientes. Analisamos o Índice Menopausal de Kupperman (IMK) através de cartão diário. Amostras de sangue foram analisadas e as mulheres foram divididas em 2 grupos de acordo com o polimorfismo da 5’ região não traduzida do gene CYP17: GA (selvagem homozigoto e heterozigoto) e GB (mutado homozigoto). RESULTADOS: Os valores do IMK foram similares nos dois grupos no ínicio do estudo. Os sintomas diminuíram nos dois grupos após um ano de tratamento quando comparados ao tempo zero. A taxa de melhora foi de aproximadamente 27.09% e 32.18% no GA e GB, respectivamente. Os níveis de estrogênio após o tratamento foram maiores nos dois grupos quando comparados ao inicio do tratamento. O nível de testosterona aumentou no GB após 1 ano de terapia estrogênica (0.48 ± 0.16) alcançando níveis maiores do que o GA após o término do estudo. O nível de SHBG mostrou um aumento significativo após 1 ano de tratamento no GB ultrapassando os níveis iniciais e o GA (p