Low- and standard-estrogen dosage in oral therapy: dose-dependent effects on insulin and lipid metabolism in healthy postmenopausal women.
OBJECTIVE
To evaluate the influences of different doses of daily oral unopposed 17beta-estradiol compared with placebo, both on glucose tolerance and lipid metabolism in healthy postmenopausal women.


METHODS
Forty-eight normoinsulinemic postmenopausal women were enrolled in the study. Patients were assigned to receive randomly 1 mg (group A) or 2 mg (group B) of oral micronized estradiol therapy daily or to the placebo (group C), for 12 weeks.


RESULTS
The low-dose estradiol treatment determined an improvement of the peripheral insulin sensitivity, made evident by a significant increase both in the metabolic index and oral glucose insulin sensitivity index (p < 0.01 and p < 0.05, respectively) as well as a decrease in the homeostasis model assessment-estimated insulin resistance (p < 0.01). Conversely, in the standard-dose group, the metabolic index significantly decreased (p < 0.05), showing a slight deterioration in insulin sensitivity. For lipid metabolism, the 1 mg dose showed a neutral effect, while 2 mg had a beneficial effect on low density lipoprotein cholesterol, but caused an increase in triglycerides (p < 0.01 and p < 0.05, respectively).


CONCLUSIONS
The oral low dose of unopposed estradiol therapy had a favorable effect on glycoinsulinemic metabolism in healthy postmenopausal women; however, the standard dose caused a slight but significant deterioration in insulin sensitivity.
Villa
P
P
Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
Sagnella
F
F
Perri
C
C
Suriano
R
R
Costantini
B
B
Macrí
F
F
Ricciardi
L
L
Lanzone
A
A
D001786:Blood Glucose / Q000187:drug effects; D050260:Carbohydrate Metabolism / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D007558:Italy; D050356:Lipid Metabolism / Q000187:drug effects*; D008875:Middle Aged; D012016:Reference Values; D014280:Triglycerides / Q000097:blood; D016387:Women's Health
D001786:Blood Glucose; D008078:Cholesterol, LDL; D007328:Insulin; D014280:Triglycerides; C014529:estradiol-3-glucoside; D004958:Estradiol