Androgenic progestogens oppose the decrease of insulin-like growth factor I serum level induced by conjugated oestrogens in postmenopausal women. Preliminary report.
Oral oestrogen treatment in postmenopausal women causes a decrease of insulin-like growth factor I (IGF-I) serum level, probably through a hepatocellular effect. To explore the possibility that the androgenic progestogens oppose this effect, serum IGF-I and sex hormone binding globulin (SHBG) were evaluated in two groups of patients treated respectively with oral conjugated oestrogens (oCE) or transdermal oestradiol (tdE2), in a first phase with the addition of dydrogesterone (DYDR), a non-androgenic progestogen, and subsequently with the addition of norethisterone acetate (NETA). With respect to basal values, treatment with oCE+DYDR caused an increase of SHBG (P < 0.002) and a decrease of IGF-I serum levels (P < 0.05); the shift to NETA addition opposed both effects: SHBG levels decreased partially but significantly (P < 0.01 vs. oCE + DYDR) and IGF-I returned to basal values with a significant increase with respect to the oCE + DYDR phase (P < 0.02). No changes were observed in the tdE2 + DYDR treated women; in this group the shift to NETA addition caused a significant decrease of SHBG values (P < 0.001 vs. before treatment and vs. tdE2 + DYDR phase) and a slight increase of IGF-I values. These differential effects on IGF-I and SHBG serum levels might be relevant as far as breast cancer risk is concerned.
Campagnoli
C
C
Department of Endocrinologic Gynaecology, St. Anna Hospital, Turin, Italy.
Biglia
N
N
Lanza
M G
MG
Lesca
L
L
Peris
C
C
Sismondi
P
P
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001943:Breast Neoplasms / Q000097:blood / Q000139:chemically induced; D002979:Climacteric / Q000097:blood / Q000187:drug effects*; D004359:Drug Therapy, Combination; D004394:Dydrogesterone / Q000008:administration & dosage* / Q000009:adverse effects; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*
D004966:Estrogens, Conjugated (USP); D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D004394:Dydrogesterone; D000077563:Norethindrone Acetate; D009640:Norethindrone