Effects of low-dose continuous combined hormone replacement therapy on glucose homeostasis and markers of cardiovascular risk in women with type 2 diabetes

Kernohan, A. F. B., Sattar, N., Hilditch, T., Cleland, S. J., Small, M., Lumsden, M. A., Connell, J. M. C. and Petrie, J. R. (2007) Effects of low-dose continuous combined hormone replacement therapy on glucose homeostasis and markers of cardiovascular risk in women with type 2 diabetes. Clinical Endocrinology, 66(1), pp. 27-34. (doi:10.1111/j.1365-2265.2006.02679.x)

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Publisher's URL: http://dx.doi.org/10.1111/j.1365-2265.2006.02679.x

Abstract

<b>Background:</b>  Low-dose hormone replacement therapy (HRT) has attracted interest for the treatment of postmenopausal symptoms in diabetes because of concerns about increased risk of coronary heart disease (CHD) and stroke with conventional HRT containing conjugated equine oestrogens (CEEs) and medroxyprogesterone acetate (MPA) .<p></p> <b>Objectives:</b>  We assessed the effects on glucose homeostasis and cardiovascular risk factors of continuous oral 17β oestradiol (1 mg) and norethisterone (0•5 mg) in postmenopausal women with type 2 diabetes. <p></p> <b>Design:</b>  Double-blind, randomized placebo-controlled trial. <p></p> <b>Assessments:</b>  Hyperinsulinaemic isoglycaemic clamp and cardiovascular risk factors were assessed before and after 3 months of treatment. <p></p> <b>Results:</b>  Twenty-eight women completed the study. HRT decreased fasting glucose compared with placebo [−9•4% with HRT vs.+2•3% for placebo, 95% confidence interval (CI) −23•2 to −0•3] and total cholesterol (−13•7 vs.+1•0%, 95% CI −22•4 to −3•1%) No significant effect was seen on metabolic clearance rate of glucose, glycated haemoglobin (HbA1c), triglycerides, high density lipoprotein (HDL)-cholesterol or C-reactive protein (CRP). <p></p> <b>Conclusions:</b>  In women with type 2 diabetes, low-dose HRT decreased fasting glucose and total cholesterol without detectable adverse effects on glucose clearance, triglycerides and CRP as reported with conventional HRT. <p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Dr Stephen and Sattar, Professor Naveed and Petrie, Professor John and Lumsden, Professor Maryann and Connell, Professor John
Authors: Kernohan, A. F. B., Sattar, N., Hilditch, T., Cleland, S. J., Small, M., Lumsden, M. A., Connell, J. M. C., and Petrie, J. R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Clinical Endocrinology
Publisher:Blackwell Publishing
ISSN:0300-0664
ISSN (Online):1365-2265
Published Online:20 October 2006
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
392521Regulation of aldosterone and cortisol synthesis in hypertension and cardiovascular diseaseEleanor DaviesMedical Research Council (MRC)G0400874Institute of Cardiovascular and Medical Sciences
392522Regulation of aldosterone and cortisol synthesis in hypertension and cardiovascular diseaseEleanor DaviesMedical Research Council (MRC)G0400874Institute of Cardiovascular and Medical Sciences