Effects of natural oestrogen/progestogen substitution therapy on carbohydrate and lipid metabolism in post-menopausal women

Luotola, H.; Pyörälä, Tapani; Loikkanen, M.

doi:10.1016/0378-5122(86)90032-0

Cited by 42 publications

(15 citation statements)

References 23 publications

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“…Intervention studies in postmenopausal women show that transdermal 17b-estradiol exerts either moderately positive effects on glucose metabolism (198) or no effect at all (199,200). Oral administration of 17b-estradiol and norethisterone reduces the glycemic response after an OGTT in women with impaired glucose tolerance, without any change in the acute insulin response in some (201), but not in other (202) studies.…”

Section: Insulin Sensitivitymentioning

confidence: 99%

Epidemiological, endocrine and metabolic features in Turner syndrome

2004

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Turner syndrome is one of the more common genetic disorders, associated with abnormalities of the X chromosome, and occurring in about 50 per 100 000 liveborn girls. Turner syndrome is usually associated with reduced adult height, gonadal dysgenesis and thus insufficient circulating levels of female sex steroids, and infertility. A number of other signs and symptoms are seen more frequently with the syndrome. Morbidity and mortality are increased. The average intellectual performance is within the normal range. A number of recent studies have provided new insights with respect to epidemiology, cardiology, endocrinology and metabolism. Treatment with GH during childhood and adolescence allows a considerable gain in adult height, although verylong-term consequences of this treatment are not clear. Puberty has to be induced in most cases, and female sex hormone replacement therapy is given during the adult years. The proper dose of hormone replacement therapy (HRT) has not been established, and, likewise, benefits and/or drawbacks from HRT have not been thoroughly evaluated. Since the risk of cardiovascular and endocrinological disease is clearly elevated, proper care during adulthood is emphasized. In summary, Turner syndrome is a condition associated with a number of diseases and conditions which are reviewed in the present paper.

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Section: Insulin Sensitivitymentioning

confidence: 99%

Epidemiological, endocrine and metabolic features in Turner syndrome

2004

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“…Fasting insulin levels decreased nonsignificantly in women on active treatments, and changes in 2-h insulin did not differ between treatments or with the treatments. Furthermore, estrogen replacement therapy did not change HbA 1c and insulin area under the OGTT curve in patients with diabetes (37,38) or change glucose tolerance or glucose uptake by the hyperinsulinemiceuglycemic clamp in healthy postmenopausal women (15,16).…”

Section: Conclusion -mentioning

confidence: 99%

Hormone Replacement Therapy, Insulin Sensitivity, and Abdominal Obesity in Postmenopausal Women

2002

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OBJECTIVE -The purpose of this study was to determine whether insulin sensitivity differs between postmenopausal women taking estradiol, women on estrogen plus progesterone hormone replacement therapy (HRT), and women not on HRT and whether differences are explained by the differences in total and/or abdominal adiposity and fat deposition in the muscle.RESEARCH DESIGN AND METHODS -We studied 28 obese, sedentary postmenopausal Caucasian women. Women taking oral estrogen (n ϭ 6) were matched for age (57 Ϯ 3 vs. 58 Ϯ 2 years), weight (87.9 Ϯ 6.0 vs. 83.0 Ϯ 3.9 kg), and BMI (33.9 Ϯ 1.7 vs. 33.9 Ϯ 1.9 kg/m 2 ) with women not on HRT (n ϭ 6). Eight women taking oral estrogen plus progesterone were matched with eight different women not on HRT for age (59 Ϯ 2 vs. 60 Ϯ 2 years), weight (82.8 Ϯ 3.7 vs. 83.7 Ϯ 4.1 kg), and BMI (30.7 Ϯ 1.0 vs. 29.9 Ϯ 1.3 kg/m 2 ).RESULTS -VO 2max (maximal aerobic capacity), percentage of fat, total body fat mass, and fat-free mass (FFM) were similar between groups. Visceral fat, subcutaneous abdominal fat, sagittal diameter, and mid-thigh low-density lean tissue (intramuscular fat) did not differ by hormone status. Basal carbohydrate and fat utilization was not different among groups. Fasting plasma glucose and insulin did not differ by hormone use. Glucose utilization (M) was measured during the last 30 min of a 3-h hyperinsulinemic-euglycemic clamp (40 mU ⅐ m 2 ⅐ min Ϫ1 ). Postmenopausal women taking oral estrogen had a 31% lower M than women not on HRT (42.7 Ϯ 4.0 vs. 61.7 Ϯ 4.7 mol ⅐ kg FFM ⅐ min Ϫ1 , P Ͻ 0.05). M was 26% lower in women taking estrogen plus progesterone (44.0 Ϯ 3.5 vs. 59.7 Ϯ 6.2 mol ⅐ kg FFM ⅐ min Ϫ1 , P Ͻ 0.05) than women not on HRT. M/I, the amount of glucose metabolized per unit of plasma insulin (I), an index of insulin sensitivity, was 36% lower in women taking estrogen compared with matched women not on HRT (P Ͻ 0.05) and 28% lower in women taking estrogen plus progesterone compared with matched women not on HRT (P Ͻ 0.05).CONCLUSIONS -Postmenopausal women taking oral estrogen or those taking a combination of estrogen and HRT are more insulin-resistant than women not on HRT, even when women are of comparable total and abdominal adiposity.

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“…Low-dose dydrogesterone associated with oestradiol may lead to a decrease in the concentration of circulating insulin [38]. Finally, oestrogen plus norethisterone acetate was found to have no effect on glucose and insulin metabolism [39], but seemed to improve insulin sensitiv- The number of cases and total of women do not add up to the totals as data are not tabulated for weak oestrogens (43 diabetes cases/2,376 total women), and other intramuscularly administered oestrogen or progestogen; androgen; nasally administered oestrogen; transdermally administered progestagen; or tibolone or unknown MHT (126 diabetes cases/7,457 total women) c Model 1: adjusted for the same covariates as model 1 in Table 2 d Conjugated equine oestrogens were only marginally used by women in our cohort (0.7%), so separate estimates for conjugated equine oestrogens and oestradiol compounds are not provided e Data are not presented as there are fewer than five cases in this MHT category f Model 2, as model 1 with adjustment for BMI (<22, 22-25, 25-27, 27-30, ≥30 kg/m 2 ) as a time-dependent variable ity. The meta-analysis by Salpeter et al [15] found no differences in insulin resistance between unopposed and combined treatments.…”

Section: Discussionmentioning

confidence: 93%

Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort

et al. 2009

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Aims/hypothesis Two US randomised trials found a lower incidence of type 2 diabetes in women treated by menopausal hormone therapy (MHT) with oral conjugated equine oestrogen combined with medroxyprogesterone acetate. The purpose of this study was to evaluate the influence of various MHTs, according to their formulation and route of administration, on new-onset diabetes in a cohort of postmenopausal French women. Methods The association between MHT use and new-onset diabetes was investigated by Cox regression analysis in 63,624 postmenopausal women in the prospective French cohort of the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N). Cases of diabetes were identified through self-reporting or drugreimbursement record linkage, and further validated. Results 1,220 new-onset diabetes cases were validated. We observed a lower risk of new-onset diabetes among women who had ever used MHT (HR 0.82 [95% CI 0.72-0.93]), compared with those who had never used MHT. Adjustment for BMI during follow-up (rather than according to baseline BMI) did not substantially modify this association.An oral route of oestrogen administration was associated with a greater decrease in diabetes risk than a cutaneous route (HR 0.68 [95% CI 0.55-0.85] vs 0.87 [95% CI 0.75-1.00], p for homogeneity = 0.028). We were not able to show significant differences between the progestagens used in combined MHT. Conclusions/interpretation Use of MHT appeared to be associated with a lower risk of new-onset diabetes. This relationship was not mediated by changes in BMI. Further studies are needed to confirm the stronger effect of oral administration of oestrogen compared with cutaneous administration.

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Effects of natural oestrogen/progestogen substitution therapy on carbohydrate and lipid metabolism in post-menopausal women

Cited by 42 publications

References 23 publications

Epidemiological, endocrine and metabolic features in Turner syndrome

Epidemiological, endocrine and metabolic features in Turner syndrome

Hormone Replacement Therapy, Insulin Sensitivity, and Abdominal Obesity in Postmenopausal Women

Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort

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