Low-dose estrogen and drospirenone combination: effects on glycoinsulinemic metabolism and other cardiovascular risk factors in healthy postmenopausal women.
OBJECTIVE
To evaluate the effects of a daily E2 (1 mg) plus drospirenone oral formulation (2 mg) on glycoinsulinemic metabolism, lipid profile, and endothelial function in symptomatic healthy menopausal women.


METHODS
Randomized, double-blind study.


METHODS
Operative Division of Endocrinological Gynecology, Catholic University of the Sacred Heart, Rome, Italy.


METHODS
Forty postmenopausal women.


METHODS
Patients were randomly submitted to receive treatment with an oral dose of E2 (1 mg) plus drospirenone (2 mg) (group A) or placebo (group B).


METHODS
Hormonal and lipid assessment; evaluation of glucose and insulin metabolism by the clamp test and the oral glucose tolerance test; evaluation of endothelial function by the vascular reactivity test.


RESULTS
Total cholesterol levels, low-density lipoprotein cholesterol levels, and nonesterified fatty acids levels significantly decreased both after 3 and 6 months. No changes in high-density lipoprotein, triglycerides, apolipoprotein A1, apolipoprotein B, and lipoprotein (a) were found. Treatment resulted in few changes in glycoinsulinemic metabolism. We observed a significant reduction of the area under curve of insulin after 6 months of therapy. Endothelial function was significantly influenced by treatment, and an improvement in both flow-mediated dilatation and nitrate-mediated dilatation values after 6 months was observed.


CONCLUSIONS
Low-dose E2/drospirenone treatment did not reveal any negative effect on carbohydrate metabolism, acting in a neutral way on insulin sensitivity. The treatment induced favorable changes in lipid profile and showed a significant improvement of vascular reactivity.
Villa
Paola
P
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. paolavilla@rm.unicatt.it
Suriano
Rosanna
R
Ricciardi
Luigi
L
Tagliaferri
Valeria
V
De Cicco
Simona
S
De Franciscis
Pasquale
P
Colacurci
Nicola
N
Lanzone
Antonio
A
D000736:Androstenes / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects; D004734:Energy Metabolism / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000379:methods; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D008875:Middle Aged; D015990:Placebo Effect; D017698:Postmenopause / Q000187:drug effects / Q000378:metabolism*; D012307:Risk Factors; D014664:Vasodilation / Q000187:drug effects
D000736:Androstenes; D001786:Blood Glucose; D004338:Drug Combinations; D007328:Insulin; C488382:estradiol-drospirenone combination; D004958:Estradiol