Question

Assertion (A): Systemic estrogens as HRT are indicated in post-menopausal women with hypertriglyceridemia.

Reason (R): The systemic estrogens induce the hepatic synthesis of lipoproteins.

• A. Both A and R are true and R is the correct explanation of A.
• B. Both A and R are true but R is NOT the correct explanation of A.
• C. A is true but R is false.
• D. A is false but R is true.

Hint:

Oral estrogen raises hepatic triglyceride output through its first-pass liver effect.

Answer 1

The Correct Option is D

Step 1: Understanding the Question:
We need to check whether oral systemic estrogen HRT is actually appropriate for a postmenopausal woman who already has high triglycerides, and whether the given reason is medically correct.

Step 2: Key Concept:
Oral estrogens are absorbed from the gut and pass through the liver before reaching the rest of the body, which is called a first-pass effect. In the liver, estrogen stimulates the synthesis of triglyceride-rich lipoproteins, mainly VLDL, raising serum triglyceride levels. In a woman who already has hypertriglyceridemia, this added rise can push triglycerides to dangerously high levels and even raise the risk of pancreatitis.

Step 3: Detailed Explanation:
Assertion (A) claims systemic estrogen HRT is indicated in such women. This is false: because oral estrogen further raises triglycerides through its hepatic effect, it is relatively contraindicated, or at least used with caution, in women who already have high triglycerides. If estrogen therapy is still needed, a non-oral route such as a transdermal patch is preferred, since it avoids the first-pass liver effect.
Reason (R) states that systemic estrogens induce hepatic synthesis of lipoproteins. This is true and is exactly the mechanism that explains why oral estrogen is risky in hypertriglyceridemia, even though the assertion wrongly concludes that estrogen is therefore indicated rather than cautioned against.

Step 4: Final Answer:
A is false but R is true.