Long-term effects of oral estradiol and dydrogesterone on carbohydrate metabolism in postmenopausal women.
OBJECTIVE
To determine in postmenopausal women the long-term effects on carbohydrate metabolism of the administration of oral micronized 17 beta-estradiol (2 mg/day continuously) and cyclical dydrogesterone (10 mg/day for 14 days per 28-day cycle).


METHODS
A 2-year open-label prospective, non-comparative study was carried out of 13 healthy postmenopausal women receiving cyclical estradiol and dydrogesterone and serving as their own controls. Concentrations of blood glucose, plasma insulin, C-peptide, glucagon and free fatty acids (FFAs) were determined before treatment (base-line) and at 6, 12 and 24 months of hormone replacement therapy under fasting conditions and during a standard 75-g, 3-h, oral glucose tolerance test (OGTT).


RESULTS
Fasting blood glucose levels were unchanged throughout the study, and the mean areas under the curves (AUCs) for glucose response increased slightly but non-significantly versus baseline; fasting plasma insulin levels tended a decrease, and AUCs for insulin responses to the glucose load fell by 23% from baseline (not significant); fasting C-peptide levels and AUCs were unchanged; plasma glucagon fasting levels and responses were in the normal range and stable throughout the study; and plasma FFA fasting levels decreased significantly, as well as FFA AUCs during OGTTs, at the 12th and 24th months of the study.


CONCLUSIONS
During a 2-year treatment with oral estradiol and cyclical dydrogesterone, a direct progesterone derivative, tolerance to glucose was unchanged, fasting plasma insulin and insulin response to repeated glucose loads were decreased, and C-peptide levels remained unchanged, indicating a potential improvement in insulin sensitivity and clearance, as in younger women; additionally, a slightly enhanced antilipolytic activity of insulin was observed.
Gaspard
U J
UJ
Department of Gynecology, University of Liège, Sart Tilman University Hospital, B 35, B-4000 Liège I, Belgium.
Wery
O J
OJ
Scheen
A J
AJ
Jaminet
C
C
Lefebvre
P J
PJ
D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D004394:Dydrogesterone / Q000008:administration & dosage*; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008066:Lipolysis; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies
D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D004958:Estradiol; D005934:Glucagon; D004394:Dydrogesterone