The effects of oestrogen replacement therapy on haemostatic variables in postmenopausal women with non-insulin-dependent diabetes mellitus.
Women with diabetes mellitus have an increased risk of developing coronary heart disease which may be related at least partially to unfavourable changes in haemostasis. The effect of oestrogen replacement therapy on haemostasis has not been studied systematically in women with non-insulin-dependent diabetes mellitus (NIDDM) and therefore this study was performed for that purpose. Twenty-five postmenopausal women with NIDDM were treated with 2 mg of 17-beta-oestradiol orally for 3 months in a double-blind, crossover, placebo-controlled trial. During the last 16 days of active treatment, 1 mg of norethisterone acetate was added for 10 days for endometrial protection. Blood samples were taken at baseline and after 68 days of active or placebo treatment. Treatment with oestradiol was followed by a marked decrease in the activity of plasminogen activator inhibitor, compared with placebo. The activity of tissue plasminogen activator increased significantly. Levels of antithrombin decreased during treatment with oestradiol, whereas no changes were seen in levels of fibrinogen, von Willebrand factor, prothrombin fragment 1+2, protein S, protein C or resistance to activated protein C. In conclusion, oestrogen replacement therapy in postmenopausal women with NIDDM improved the fibrinolytic activity, while only clinically insignificant alterations in the clotting system were seen. These changes in haemostasis may have a favourable impact on the risk for coronary heart disease in diabetic women.
Hahn
L
L
Department of Obstetrics, Sahlgrenska University Hospital East, Göteborg, Sweden.
Mattsson
L A
LA
Andersson
B
B
Tengborn
L
L
D000368:Aged; D000991:Antithrombins / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects; D001779:Blood Coagulation Factors / Q000378:metabolism; D001786:Blood Glucose; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D004958:Estradiol / Q000494:pharmacology* / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood* / Q000187:drug effects; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D000991:Antithrombins; D001779:Blood Coagulation Factors; D001786:Blood Glucose; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D004958:Estradiol