Effects of estrogen/medrogestone therapy on the apoprotein B-containing lipoproteins in postmenopausal women with type 2 diabetes mellitus under satisfactory and non-satisfactory glycemic control.
BACKGROUND
Information is lacking on the effects of hormone replacement therapy in women with diabetes, especially during moderate chronic hyperglycemia.


OBJECTIVE
To study the effects of HRT on the lipid profile and the low density lipoprotein subclass distribution in women with type 2 diabetes under satisfactory and non-satisfactory glycemic control.


METHODS
Fifty-four postmenopausal women after a 6 week run-in diet were randomized to receive either placebo (HbA1c < 8%, n = 13; HbA1c > 8%, n = 17) or HRT (HbA1c < 8%, n = 11; HbA1c > 8%, n = 13) for 12 weeks. HRT consisted of cyclical conjugated estrogens 0.625 mg/day plus medrogestone 5 mg/day. At the beginning and at the end of each treatment period the LDL subclass distribution was estimated by density gradient ultracentrifugation.


RESULTS
At the baseline and during the study, the HbA1c level was significantly higher in hyperglycemic patients than in the near-normoglycemic controls (baseline 10.2 +/- 2.9 vs. 6.5 +/- 0.7%, P < 0.01). They showed a trend for higher total and LDL cholesterol, triglycerides and lower high density lipoprotein-cholesterol compared to near-normoglycemic controls, as well as significantly higher triglyceride concentrations in very low density lipoprotein, intermediate density lipoprotein and LDL-1 particles and cholesterol content in LDL-1 and -2 particles. HRT decreased LDL-cholesterol in both groups. In the normoglycemic patients a small increase in HbA1c was observed (6.5 +/- 0.7 vs. 7.4 +/- 1%, P = 0.04). In all cases, HRT did not modify the proportion of LDL represented by denser LDLs.


CONCLUSIONS
HRT did not modify the LDL subclass distribution, even in the presence of moderate chronic hyperglycemia in women with type 2 diabetes.
Aguilar-Salinas
C A
CA
Department of Endocrinology and Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico. caguilarsalinas@yahoo.com
Arita Melzer
O
O
Sauque Reyna
L
L
Lopez
A
A
Velasco Perez
M L
ML
Guillen
L E
LE
Gomez Perez
F J
FJ
Rull Rodrigo
J A
JA
D000368:Aged; D001055:Apolipoproteins B / Q000032:analysis / Q000187:drug effects*; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D004311:Double-Blind Method; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology; D008077:Lipoproteins, LDL / Q000032:analysis / Q000187:drug effects*; D008524:Medrogestone / Q000008:administration & dosage*; D008875:Middle Aged; D017698:Postmenopause; D011336:Probability; D012016:Reference Values; D016896:Treatment Outcome
D001055:Apolipoproteins B; D001786:Blood Glucose; D004966:Estrogens, Conjugated (USP); D008077:Lipoproteins, LDL; D008524:Medrogestone