Transdermal 17-beta-estradiol and risk of developing type 2 diabetes in a population of healthy, nonobese postmenopausal women.
OBJECTIVE
Various observational and randomized studies have demonstrated a reduction in the incidence of type 2 diabetes in postmenopausal women who received estrogen orally. No studies have been performed on the incidence of type 2 diabetes in postmenopausal women treated with transdermal 17-beta-estradiol. The purpose of our study was to assess the influence of transdermal 17-beta-estradiol on the incidence of type 2 diabetes in a population of healthy, nonobese postmenopausal women.


METHODS
Between January 1998 and December 2002, 673 healthy, nonobese postmenopausal women (mean age 54 +/- 5 years) were enrolled: 144 (21.4%) of these took transdermal 17-beta-estradiol and 529 (78.6%) had never taken hormones during their postmenopausal period. Final elaboration of the data took place in July 2003, with a mean follow-up of 3.7 +/- 0.7 years (ranging from 0.5 to 5 years).


RESULTS
Type 2 diabetes developed in 60 patients during the follow-up period, which is the equivalent of 22 cases per 1,000 women-years. In the "hormones nonusers" group, diabetes developed in 10% (54 of 529 women; equivalent of 26.5 cases/1,000 women-years), whereas in the "hormones users" group, diabetes developed in 4.16% (6 of 144 women; equivalent of 12.1 cases/1,000 women-years). Transdermal 17-beta-estradiol emerged as a treatment that significantly reduced the risk of developing diabetes (RR 2.19, 95% CI 1.79-3.56; P=0.006).


CONCLUSIONS
Our results suggest a significant reduction in the incidence of type 2 diabetes in our population of nonobese, healthy postmenopausal women who used transdermal 17-beta-estradiol. This could suggest that, in some women, the estrogen deficiency that occurs after menopause could represent a fundamental step in the process of diabetogenesis.
Institute of Cardiology, University of Modena and Reggio Emilia, Modena, Italy. rossi.r@policlinico.mo.it
Rosario
R
Rossi
Giorgia
G
Origliani
Maria G
MG
Modena
D000279:Administration, Cutaneous; D001161:Arteriosclerosis / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control*; D004958:Estradiol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008593:Menopause; D008875:Middle Aged
D001786:Blood Glucose; D004958:Estradiol