Effect of hormone therapy on the enteroinsular axis
Effect of hormone therapy on the enteroinsular axis
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激素治疗对肠岛轴的影响
DOI：
10.1097/01.gme.0000172266.47820.43
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发表时间：
2005
期刊：
影响因子：
2.7
通讯作者：
Z. Szafran
中科院分区：
文献类型：
--
作者：
K. Sztefko;I. Rogatko;T. Milewicz;J. Krzysiek;P. Tomasik;Z. Szafran
目的：绝经与胰岛素对葡萄糖的反应下降和胰岛素抵抗有关。已经证明，激素治疗（HT）可以改善绝经后妇女的碳水化合物代谢。然而，众所周知，胃肠激素在消化和吸收摄入的营养物质的协调以及胰腺内分泌功能的调节中起关键作用。因此，本研究的目的是探讨HT对绝经后妇女胃肠激素和碳水化合物代谢的影响。设计图：在90名健康绝经后妇女（平均年龄54.5岁，标准差3.34岁）中进行了前瞻性研究，其中49人完成了研究。随机分为两组，A组（n = 25）和B组（n = 8），分别采用HT（17β-雌二醇0.05 mg，每24 h 1次）+强地平5 mg/d（A组）和HT（17β-雌二醇半水合物2 mg，每24 h 1次）+强地平10 mg/d（B组）。对照组（C组，n = 16）不接受HT。在HT前和治疗6个月和12个月后，测量基础和餐后刺激的血糖、胰岛素、葡萄糖依赖性促胰岛素肽（GIP）、胰高血糖素样肽-1（GLP-1）和胆囊收缩素（CCK）血浆浓度以及基础雌激素水平。在相同的时间间隔内，对C组的所有研究参数进行测量。结果：经皮HT治疗12个月后，观察到空腹（P < 0.002）和餐后（P < 0.05）血糖水平下降。口服HT仅在治疗12个月时降低空腹血糖水平（P < 0.05）。无论给药途径如何，HT均降低餐后血浆胰岛素水平（口服HT：P < 0.05;经皮HT：P < 0.02）。经皮HT治疗6个月和12个月后，空腹血浆GIP水平降低（分别为P < 0.002和P < 0.001）。此外，餐后GIP水平在经皮HT治疗6个月和12个月后降低（两种情况下P < 0.002）。补充12个月后，通过经皮HT降低了空腹和餐后GLP-1水平。口服HT也降低了这些水平，但不显着。然而，观察到的差异可能不仅与给药途径有关，而且与雌二醇剂量的差异有关。无论给药途径如何，HT均不影响血浆CCK水平。结论：激素治疗显著影响绝经后妇女的肠胰岛轴，并有助于血糖水平的正常化。
Objective: Menopause is associated with a decline in insulin response to glucose and with insulin resistance. It has been proven that hormone therapy (HT) improves carbohydrate metabolism in postmenopausal women. However, it is known that gastrointestinal hormones play a key role in the coordination of digestion and absorption of ingested nutrients and in the regulation of pancreatic endocrine function. Therefore, the aim of this study was to investigate the effect of HT on gastrointestinal hormones and carbohydrate metabolism in postmenopausal women. Design: The prospective study was performed in 90 healthy postmenopausal women (mean age 54.5 years, standard deviation 3.34 years), of whom 49 completed the study. They were randomized and treated either with continuous transdermal HT (0.05 mg 17β-estradiol every 24 hours) combined with 5 mg oral dydrogesterone daily (group A, n = 25), or with oral HT (2 mg 17β-estradiol semihydrate every 24 hours) combined with 10 mg dydrogesterone as a continuous therapy (group B, n = 8). The control group (group C, n = 16) received no HT. Both basal and meal-stimulated plasma concentrations of glucose, insulin, glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), and cholecystokinin (CCK), as well as basal estrogen levels, were measured before HT and after 6 and 12 months of treatment. At the same time intervals, all the studied parameters were measured for group C. Results: After 12 months of the transdermal HT, a decrease in both fasting (P < 0.002) and postprandial (P < 0.05) plasma glucose levels was observed. Oral HT reduced only the fasting plasma glucose level in the 12th month of treatment (P < 0.05). Regardless of the route of administration, HT reduced postprandial plasma levels of insulin (oral HT: P < 0.05; transdermal HT: P < 0.02). Fasting plasma levels of GIP were reduced after 6 and 12 months of transdermal HT (P < 0.002 and P < 0.001, respectively). Moreover, levels of postprandial GIP were reduced after 6 and 12 months of transdermal HT (P < 0.002 in both cases). Fasting and postprandial GLP-1 levels were reduced by transdermal HT after 12 months of supplementation. Oral HT also decreased these levels, but not significantly. The observed differences may, however, be related not only to the route of administration, but also to the difference in the dose of estradiol. Regardless of the route of administration, HT did not influence plasma levels of CCK. Conclusions: Hormone therapy significantly influences the enteroinsular axis in postmenopausal women and contributes to the normalization of plasma glucose levels.
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影响因子：
16.2
作者：
Zhang, Y;Schaefer, CF;Lee, ET
通讯作者：
Lee, ET
年龄和血糖水平对β细胞对葡萄糖依赖性促胰岛素多肽的反应以及外周组织对内源性释放的胰岛素敏感性的影响。
DOI：
10.1210/jcem.83.8.5003
发表时间：
1998
期刊：
The Journal of clinical endocrinology and metabolism.
影响因子：
--
作者：
Meneilly,GS;Ryan,AS;Minaker,KL;Elahi,D
通讯作者：
Elahi,D
影响因子：
--
作者：
Hu, FB;Grodstein, F;Stampfer, MJ
通讯作者：
Stampfer, MJ
影响因子：
3.5
作者：
Cowan, LD;Go, OT;Welty, TK
通讯作者：
Welty, TK