Effects of HRT on liver enzyme levels in women with type 2 diabetes: a randomized placebo-controlled trial
Effects of HRT on liver enzyme levels in women with type 2 diabetes: a randomized placebo-controlled trial
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DOI：
10.1111/j.1365-2265.2006.02543.x
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发表时间：
2006-07-01
影响因子：
3.2
通讯作者：
Sattar, Naveed
中科院分区：
文献类型：
--
作者：
McKenzie, Joyce;Fisher, B. Miles;Sattar, Naveed
背景糖尿病、胰岛素抵抗和肝脏脂肪蓄积[如非酒精性脂肪性肝病（NAFLD）]之间的联系越来越紧密。最近的数据表明，激素替代疗法（HRT）可能会减少糖尿病的风险是耐人寻味的，但解释mechanisms aren 't clearly.Objective事后调查的可能性，HRT可能会有利地影响肝酶水平通常升高的糖尿病患者。我们检查了一项为期6个月的低剂量连续联合HRT试验的肝功能检查数据（1 mg 17 β雌二醇和0.5mg醋酸炔诺酮）。设计双盲，随机安慰剂对照。患者50名女性2型糖尿病患者。测量肝酶水平（AST、ALT、γ-谷氨酰转移酶[GGT]，结果45名女性完成了研究，其中19/100例为女性。活动组中有22例通过性激素变化来衡量依从性。相对于安慰剂接受者（n = 23），随机化并依从HRT的女性表现出ALT [-14（-23至-6）U/l，P = 0.002]，AST [-9.2（-14至-5）U/l，P < 0.001]和ALP [-60.8（-80至-42）U/l，P < 0.001]的显著降低。GGT的循环浓度也显著降低（P = 0.035）。所有的变化是显着的意向治疗analysis.Conclusion HRT含有低剂量的雌二醇和炔诺酮降低血清中的肝功能酶的浓度，可能是由于降低肝脏脂肪的积累。更好地了解这种HRT改善肝功能测试的机制可以帮助设计治疗NAFLD患者的新疗法。
Background Increasingly strong links are being recognized between diabetes, insulin resistance and liver fat accumulation [e.g. nonalcoholic fatty liver disease (NAFLD)]. Recent data indicating that hormone replacement therapy (HRT) may lessen diabetes risk is intriguing but explanatory mechanisms are unclear.Objective Post hoc investigation of the possibility that HRT may favourably influence liver enzyme levels commonly elevated in patients with diabetes. We examined liver function test data from a 6-month trial of a low-dose continuous combined HRT (1 mg 17 beta oestradiol and 0.5 mg norethisterone acetate).Design Double-blind, randomized placebo-controlled.Patients Fifty women with type 2 diabetes.Measurements Liver enzyme levels (AST, ALT, gamma-glutamylytransferase [GGT], and alkaline phosphatase [ALP]).Results Forty-five women completed the study with 19/22 in the active group demonstrating compliance as measured by sex hormone changes. Relative to placebo recipients (n = 23), women randomized and compliant to HRT demonstrated significant reductions in ALT [-14 (-23 to -6) U/l, P = 0.002], AST [-9.2 (-14 to -5) U/l, P < 0.001] and ALP [-60.8 (-80 to -42) U/l, P < 0.001]. Circulating concentrations in GGT were also significantly reduced (P = 0.035). All changes were significant using an intention-to-treat analysis.Conclusion HRT containing low-dose oestradiol and norethisterone reduces serum concentrations of liver function enzymes, potentially due to a lowering of liver fat accumulation. Better understanding of mechanisms by which this HRT improves liver function tests could help the design of new therapies to treat individuals with NAFLD.