Transdermal 17-beta-estradiol and risk of developing type 2 diabetes in a population of healthy, nonobese postmenopausal women.
Transdermal 17-beta-estradiol and risk of developing type 2 diabetes in a population of healthy, nonobese postmenopausal women.
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DOI：
10.2337/diacare.27.3.645
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发表时间：
2004-03
期刊：
影响因子：
16.2
通讯作者：
R. Rossi;G. Origliani;M. G. Modena
中科院分区：
文献类型：
--
作者：
R. Rossi;G. Origliani;M. G. Modena
目的 各种观察性和随机研究表明，口服雌激素的绝经后妇女 2 型糖尿病的发病率有所降低。尚未对接受透皮 17-β-雌二醇治疗的绝经后妇女 2 型糖尿病的发病率进行研究。我们研究的目的是评估透皮 17-β-雌二醇对健康、非肥胖绝经后妇女群体 2 型糖尿病发病率的影响。研究设计和方法 1998 年 1 月至 2002 年 12 月期间，共有 673 名健康、非肥胖的绝经后妇女（平均年龄 54 +/- 5 岁）入组：其中 144 名（21.4%）服用透皮 17-β-雌二醇，529 名（78.6%）在绝经后期间从未服用过激素。数据的最终阐述于 2003 年 7 月进行，平均随访时间为 3.7 +/- 0.7 年（范围从 0.5 年到 5 年）。结果 随访期间，60 名患者罹患 2 型糖尿病，相当于每 1,000 名女性年中有 22 例。在“激素非使用者”组中，糖尿病的发生率为 10%（529 名女性中的 54 名；相当于 26.5 例/1,000 名女性年），而在“激素使用者”组中，糖尿病的发生率为 4.16%（144 名女性中的 6 名；相当于 12.1 例/1,000 名女性年）。透皮 17-β-雌二醇作为一种治疗方法出现，可显着降低患糖尿病的风险（RR 2.19，95% CI 1.79-3.56；P=0.006）。结论 我们的结果表明，使用透皮 17-β-雌二醇的非肥胖、健康绝经后妇女群体中 2 型糖尿病的发病率显着降低。这可能表明，在某些女性中，绝经后发生的雌激素缺乏可能是糖尿病发生过程中的一个基本步骤。
OBJECTIVE Various observational and randomized studies have demonstrated a reduction in the incidence of type 2 diabetes in postmenopausal women who received estrogen orally. No studies have been performed on the incidence of type 2 diabetes in postmenopausal women treated with transdermal 17-beta-estradiol. The purpose of our study was to assess the influence of transdermal 17-beta-estradiol on the incidence of type 2 diabetes in a population of healthy, nonobese postmenopausal women. RESEARCH DESIGN AND METHODS Between January 1998 and December 2002, 673 healthy, nonobese postmenopausal women (mean age 54 +/- 5 years) were enrolled: 144 (21.4%) of these took transdermal 17-beta-estradiol and 529 (78.6%) had never taken hormones during their postmenopausal period. Final elaboration of the data took place in July 2003, with a mean follow-up of 3.7 +/- 0.7 years (ranging from 0.5 to 5 years). RESULTS Type 2 diabetes developed in 60 patients during the follow-up period, which is the equivalent of 22 cases per 1,000 women-years. In the "hormones nonusers" group, diabetes developed in 10% (54 of 529 women; equivalent of 26.5 cases/1,000 women-years), whereas in the "hormones users" group, diabetes developed in 4.16% (6 of 144 women; equivalent of 12.1 cases/1,000 women-years). Transdermal 17-beta-estradiol emerged as a treatment that significantly reduced the risk of developing diabetes (RR 2.19, 95% CI 1.79-3.56; P=0.006). CONCLUSIONS Our results suggest a significant reduction in the incidence of type 2 diabetes in our population of nonobese, healthy postmenopausal women who used transdermal 17-beta-estradiol. This could suggest that, in some women, the estrogen deficiency that occurs after menopause could represent a fundamental step in the process of diabetogenesis.