The effect of continuous combined HRT on glucose homeostasis and plasma lipids a placebo-controlled study in postmenopausal women with type 2 diabetes

• Published in: Maturitas 2006-03, Vol.53 (4), p.430-438
• Main Authors: THUNELL, Louise, ANDERSSON, Björn, GLASSELL, Marie, MATTSSON, Lars-Ake
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Blood Glucose - drug effects; Blood Glucose - metabolism; Body Mass Index; Cross-Over Studies; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Double-Blind Method; Estradiol - pharmacology; Estrogen Replacement Therapy - methods; Female; Gynecology. Andrology. Obstetrics; Humans; Hyperandrogenism - drug therapy; Hyperandrogenism - physiopathology; Lipid Metabolism - drug effects; Medical sciences; Middle Aged; Norethindrone - analogs & derivatives; Norethindrone - pharmacology; Puberal and climacteric disorders (male and female); Sex Hormone-Binding Globulin - drug effects; Sex Hormone-Binding Globulin - metabolism; Statistics, Nonparametric
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/j.maturitas.2005.07.008

Hyperandrogenicity in women is a risk factor for cardiovascular disease and noninsulin-dependent diabetes mellitus (NIDDM). Estradiol alone decreases hyperandrogenicity and have beneficial effects on glucose metabolism and plasma lipids in postmenopausal women with type 2 diabetes. To analyse effects on glucose homeostasis and plasma lipids by 2 mg estradiol and 1mg norethisterone acetate (NETA) given as a daily tablet during 6 months in postmenopausal women with type 2 diabetes. Randomised, double-blind, placebo-controlled, cross-over design. Thirty-one postmenopausal women with type 2 diabetes, glycosylated haemoglobin (HbA1c) of 6% or more and sex hormone-binding globulin (SHBG) values of 60 nmol/L or less were included. Anthropometric variables, blood pressure, sex steroid hormones, HbA1c, serum and lipoprotein lipids, plasminogen activator inhibitor 1 (PAI-1) and insulin-like growth factor 1 (IGF-1) were measured. An oral glucose tolerance test (OGTT) was performed and blood glucose, insulin and C-peptide were analysed. All measurements were taken at baseline and after each 6-month period. An increase of SHBG and a decrease in free testosterone and PAI-1 levels was induced by the estradiol/NETA treatment compared with placebo. Lipoprotein(a) decreased but otherwise lipid metabolism was unaffected. No differences were recorded in glucose homeostasis between active treatment and placebo. Estradiol/NETA therapy decreased hyperandrogenicity in postmenopausal women with type 2 diabetes. Lipoprotein(a) and PAI-1 which are independent risk factors for coronary heart disease decreased. No changes in glucose homeostasis were found.