Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with noninsulin-dependent diabetes mellitus
Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with noninsulin-dependent diabetes mellitus
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DOI：
10.1210/jc.82.2.638
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发表时间：
1997-02-01
影响因子：
5.8
通讯作者：
Bjorntorp, P
中科院分区：
文献类型：
--
作者：
Andersson, B;Mattsson, LA;Bjorntorp, P
女性高雄激素性与胰岛素抵抗密切相关，是心血管疾病和非胰岛素依赖型糖尿病（NIDDM）的危险因素。因此，在一项双盲、交叉、安慰剂对照试验中，25名绝经后NIDDM和性激素结合球蛋白值低于60 nmol/L（作为中度高雄激素性的指标）的妇女口服2 mg 17-β-雌二醇治疗3个月。在积极治疗的最后16天，加用1 mg醋酸炔诺酮保护子宫内膜10天，测定血糖、糖化血红蛋白、胰岛素、C肽、脂蛋白、性类固醇激素、GK、胰岛素样生长因子I（IGF-I），用正葡萄糖高胰岛素钳夹法测定胰岛素敏感性。所有代谢测量均在基线时和活性药物或安慰剂治疗68天后进行。与安慰剂治疗期间相比，雌二醇治疗后性激素结合球蛋白显着增加，游离睾酮减少。血糖、糖化血红蛋白、c肽、总胆固醇、低密度脂蛋白胆固醇、IGF-1均显著降低（P < 0.01 ~ P < 0.001），而高密度脂蛋白胆固醇升高总之，绝经后NIDDM妇女雌激素替代治疗可改善高雄激素血症，并且这伴随着葡萄糖稳态和脂蛋白谱的显著改善。
Hyperandrogenicity in women is closely associated with insulin resistance and a risk factor for cardiovascular disease and noninsulin-dependent diabetes mellitus (NIDDM). Therefore, 25 postmenopausal women with NIDDM and sex hormone-binding globulin values less than 60 nmol/L, as an indicator of a moderate hyperandrogenicity, were treated with 2 mg 17-beta-estradiol orally for 3 months in a double-blind, cross-over, placebo-controlled trial. During the last 16 days of active treatment, 1 mg norethisterone acetate was added for 10 days for endometrial protection.Blood glucose, glycosylated hemoglobin, insulin, c-peptide, lipoprotein profile, sex steroid hormones, GK, and insulin-like growth factor I (IGF-I) were measured, and insulin sensitivity was determined by the euglycemic hyperinsulinemic clamp method. All metabolic measurements were taken at baseline and after 68 days of active or placebo treatment.Estradiol treatment, compared with the placebo period, was followed by a marked increase of sex hormone-binding globulin and a decrease of free testosterone. Blood glucose, glycosylated hemoglobin, c-peptide, total cholesterol, low-density lipoprotein cholesterol, and IGF-1 decreased significantly (P < 0.01-P < 0.001), whereas high density lipoprotein cholesterol rose (P < 0.001).In conclusion, estrogen replacement therapy in postmenopausal women with NIDDM ameliorated hyperandrogenicity, and this was accompanied by marked improvements in glucose homeostasis and lipoprotein profile.