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Low-dose hormone therapy and carbohydrate metabolism
Cairu Li1, Göran Samsioe, Christer Borgfeldt
1Department of Obstetrics and Gynecology, Lund University Hospital, Sweden.
Objective:
To evaluate the influence by two low doses of oral continuous-combined formulations of 17 beta-estradiol (E(2)) and norethisterone acetate (NETA) on carbohydrate metabolism in healthy postmenopausal women.
Design:
A double-blind, randomized, placebo-controlled trial.
Setting:
Volunteers at a university hospital.
Subject:
One hundred twenty healthy postmenopausal women.
Intervention(S):
One hundred twenty women were randomized to three treatment arms: (1) E(2) 1 mg/NETA 0.25 mg group (n = 40); (2) E(2) 1 mg/NETA 0.5 mg group (n = 40); (3) placebo group (n = 40). A total of 102 women completed 12 months of treatment. An oral glucose tolerance test (OGTT) was performed at baseline and at 3, 6, and 12 months.
Main Outcome Measure(S):
Fasting glucose, fasting insulin, total area under the curve (AUC) and insulin/glucose index during OGTT.
Result(S):
Fasting levels of glucose and insulin declined significantly in the E(2)/NETA 0.5 mg group. At OGTT, the total AUC for insulin declined in both active arms. The curve for glucose increased significantly in the E(2)/NETA 0.25 mg group. A lower insulin/glucose index was observed during OGTT in both active regimens when compared with placebo. In the active treatment groups, a significant reduction of fasting glucose and/or fasting insulin was encountered in women with higher basal fasting levels (fasting glucose >4.2 mmol/L or log-fasting insulin >0.87).
Conclusion(S):
Oral low-dose E(2) 1 mg/NETA 0.5 mg regimen did not impair carbohydrate metabolism, but seemed to improve insulin sensitivity in healthy postmenopausal women.