The benefits of oestrogens on postprandial lipid metabolism are lost in post-menopausal women with Type 2 diabetes.
OBJECTIVE
Women with Type 2 diabetes appear to lose the protection against cardiovascular disease (CVD) afforded by oestrogens. We examined the effects of oestrogen hormone replacement therapy (HRT) on postprandial clearance of dietary fat in non-diabetic and diabetic post-menopausal women.


METHODS
In a cross-sectional study, fasting subjects [HRT+ and HRT- control and diabetic women; Type 2 diabetes (DM) HRT+n = 8, DM HRT-n = 14, control HRT+n = 7, control HRT-n = 11] consumed a meal containing the stable isotope 1,1,1-[13]C-tripalmitin, with blood and breath sampled for 6 and 24 h, respectively, in the postprandial period.


RESULTS
In diabetic women, there were no differences between the HRT+ and HRT- groups for any of these parameters. In contrast, in HRT+ compared with HRT- control women, the triglyceride (TG) area under the curve was lower [AUC; HRT+ median (range) 7.7 (4.1, 12.8) mmol/l per 6 h, HRT- 9.7 (3.9, 18.5) mmol/l per 6 h, P < 0.05] and [13]C-palmitic acid in the TG fraction was also lower [HRT+ 23.2 (10.3, 41.3) ng/ml per 6 h, HRT- 47.7 (12.6, 77.2) ng/ml per 6 h, P < 0.05], suggesting the lower postprandial triglyceridaemia associated with HRT in non-diabetic women is because of better chylomicron clearance.


CONCLUSIONS
The oestrogen-associated advantage in clearance of dietary lipid we observed in non-diabetic post-menopausal women is not seen in post-menopausal diabetic women. This is likely to promote an atherogenic lipoprotein profile and may contribute to the loss of CVD protection seen in diabetic women.
Masding
M G
MG
Southampton University Hospitals NHS Trust, Southampton, UK. mike.masding@poole.nhs.uk
Stears
A J
AJ
Burdge
G C
GC
Wootton
S A
SA
Sandeman
D D
DD
D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000494:pharmacology*; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008875:Middle Aged; D019308:Palmitic Acid / Q000097:blood; D017698:Postmenopause / Q000502:physiology; D019518:Postprandial Period / Q000502:physiology*; D014280:Triglycerides / Q000097:blood*
D001786:Blood Glucose; D004967:Estrogens; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides; D019308:Palmitic Acid; D002784:Cholesterol