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Panminerva Medica 1998 March;40(1):18-21

lingua: Inglese

Effects of hor­mone replace­ment ther­a­py on glu­cose metab­olism

Colacurci N., Zarcone R., Mollo A., Russo G., Passaro M., De Seta L., De Franciscis P.

From the Department of Gynaecology and Obstetrics, School of Medicine II University of Naples, Naples, Italy


Objective. To eval­u­ate ­the rela­tion­ship ­between hor­mone replace­ment ther­a­py ­and glu­cose metab­olism, ­and ­the pos­sible ­role ­played by ­the admin­is­tra­tion ­route.
Design. Prospective ran­dom­ized ­study.
Materials ­and meth­ods. Eighty-­four ­patients in ­either sur­gi­cal or spon­ta­ne­ous men­o­pause ­were ran­dom­ly allo­cat­ed ­into ­four ­groups: 15 ­patients in sur­gi­cal men­o­pause ­were treat­ed ­with estro­gens ­alone admin­is­tered trans­der­mi­cal­ly (17 ­beta-estrad­i­ol, 50 μg/­day); 15 ­patients in sur­gi­cal men­o­pause ­were treat­ed ­with ­oral con­ju­gat­ed ­equine estro­gens (0.625 mg/­day); 18 ­patients in spon­ta­ne­ous men­o­pause ­were treat­ed ­with trans­der­mic estro­gens ­plus ­oral pro­gest­ag­en (17 ­beta-estrad­i­ol 50 µg/­day, ace­tate medrox­y­pro­ges­to­gen 10 mg/­day ­for 12 ­days ­per ­month); 16 ­patients in spon­ta­ne­ous men­o­pause ­were treat­ed ­with ­oral con­ju­gat­ed ­equine estro­gens (0.625 mg/­day) ­plus ­oral pro­gest­ag­en (10 mg/­day ­for 12 ­days ­per ­month).Twenty ­patients ­not giv­en ­any med­i­ca­tion rep­re­sent­ed ­the con­trol ­group. Before start­ing ­the ­trial ­and ­after ­six ­months of ther­a­py, glu­cose ­and insu­lin lev­els ­before ­and ­after an ­oral glu­cose load­ing ­test ­were eval­u­at­ed. Data anal­y­sis ­was per­formed by ­means of Student’s “t”-­test, ANO­VA ­was ­used to com­pare ­mean lev­els ­between ­the ­groups. Significance ­was ­set at p<0.005.
Results. Dosages ­made ­after 6 ­months of thera­py ­showed com­par­able ­basal glu­cose lev­els in ­all ­the stud­ied ­group, ­while ­basal insu­line lev­els in ­patients tak­ing estro­gen ­alone ­were low­er (76.88±23.66 vs 95.91±24.57 in ­group 1, 80.51±13.34 vs 96.91±18.97 in ­group 2) ­than pre­treat­ment val­ues. No sig­nif­i­cant dif­fer­ence in glu­cose lev­els ­was ­found ­after glu­cose ­load in ­the ­four ­groups.
Conclusion. Women treat­ed ­with estro­gen ­alone ­have a ten­den­cy to a low­er insu­lin ­response, ­which ­could indi­cate a great­er insu­lin sen­si­tiv­ity. This ­effect ­seems to be ­more evi­dent in trans­der­mic admin­is­tra­tion ­than ­with ­oral admin­is­tra­tion. The addi­tion of pro­ges­tagen ­seems to ­wane ­the ­increase in insu­lin sen­si­tiv­ity ­induced by estro­gens.

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