Title
Short-term oestrogen replacement therapy improves insulin resistance, lipids and fibrinolysis in postmenopausal women with NIDDM
Author
Brussaard, H.E.
Gevers Leuven, J.A.
Frölich, M.
Kluft, C.
Krans, H.M.J.
Gaubius Instituut TNO
Publication year
1997
Abstract
Oestrogen replacement therapy is associated with a decreased risk of cardiovascular disease in postmenopausal women. Patients with non-insulin- dependent diabetes mellitus (NIDDM) have an increased cardiovascular risk. However, oestrogen replacement therapy is only reluctantly prescribed for patients with NIDDM. In a double blind randomized placebo controlled trial we assessed the effect of oral 17 β-estradiol during 6 weeks in 40 postmenopausal women with NIDDM. Glycated haemoglobin (HbA(1c)), insulin sensitivity, suppressibility of hepatic glucose production, lipoprotein profile and parameters of fibrinolysis were determined. The oestrogen treated group demonstrated a significant decrease of HbA(1c) and in the normotriglyceridaemic group a significantly increased suppression of hepatic glucose production by insulin. Whole body glucose uptake and concentrations of non-esterified fatty acids did not change. LDL-cholesterol- and apolipoprotein B levels decreased, and HDL-cholesterol, its subfraction HDL2-cholesterol and apolipotrotein A1 increased. The plasma triglyceride level remained similar in both groups. Both the concentration of plasminogen activator inhibitor-1 antigen and its active subfraction decreased. Tissue type plasminogen activator activity increased significantly only in the normotriglyceridaemic group. Oestrogen replacement therapy improves insulin sensitivity in liver, glycaemic control, lipoprotein profile and fibrinolysis in postmenopausal women with NIDDM. For a definite answer as to whether oestrogens can be more liberally used in NIDDM patients, long term studies including the effect of progestogens are necessary.
Subject
Biology
Coagulation factors
Glucose regulation
Hepatic glucose production
Insulin sensitivity
Lipoprotein profiles
Non-insulin-dependent diabetes mellitus
Oestrogen therapy
Apolipoprotein a1
Apolipoprotein b
Blood clotting factor
Glycosylated hemoglobin
High density lipoprotein cholesterol
Insulin
Low density lipoprotein cholesterol
Plasminogen activator
Adult
Aged
Cardiovascular disease
Cardiovascular risk
Clinical article
Estrogen therapy
Glucogenesis
Non insulin dependent diabetes mellitus
Postmenopause
C-Peptide
Cholesterol
Diabetes Mellitus, Type 2
Double-Blind Method
Estradiol
Estrogen Replacement Therapy
Fatty Acids, Nonesterified
Female
Fibrinolysis
Hemoglobin A, Glycosylated
Humans
Insulin Resistance
Lipids
Lipoproteins
Middle Aged
Plasminogen Activator Inhibitor 1
Postmenopause
Tissue Plasminogen Activator
Triglycerides
To reference this document use:
http://resolver.tudelft.nl/uuid:6a0a6d23-0b1f-41e5-9512-efe4d2bc1211
DOI
https://doi.org/10.1007/s001250050758
TNO identifier
233999
ISSN
0012-186X
Source
Diabetologia, 40 (7), 843-849
Document type
article