Aguilar-Salinas C A, Arita Melzer O, Sauque Reyna L, Lopez A, Velasco Perez M L, Guillen L E, Gomez Perez F J, Rull Rodrigo J A
Department of Endocrinology and Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
Isr Med Assoc J. 2001 Feb;3(2):137-43.
Information is lacking on the effects of hormone replacement therapy in women with diabetes, especially during moderate chronic hyperglycemia.
To study the effects of HRT on the lipid profile and the low density lipoprotein subclass distribution in women with type 2 diabetes under satisfactory and non-satisfactory glycemic control.
Fifty-four postmenopausal women after a 6 week run-in diet were randomized to receive either placebo (HbA1c < 8%, n = 13; HbA1c > 8%, n = 17) or HRT (HbA1c < 8%, n = 11; HbA1c > 8%, n = 13) for 12 weeks. HRT consisted of cyclical conjugated estrogens 0.625 mg/day plus medrogestone 5 mg/day. At the beginning and at the end of each treatment period the LDL subclass distribution was estimated by density gradient ultracentrifugation.
At the baseline and during the study, the HbA1c level was significantly higher in hyperglycemic patients than in the near-normoglycemic controls (baseline 10.2 +/- 2.9 vs. 6.5 +/- 0.7%, P < 0.01). They showed a trend for higher total and LDL cholesterol, triglycerides and lower high density lipoprotein-cholesterol compared to near-normoglycemic controls, as well as significantly higher triglyceride concentrations in very low density lipoprotein, intermediate density lipoprotein and LDL-1 particles and cholesterol content in LDL-1 and -2 particles. HRT decreased LDL-cholesterol in both groups. In the normoglycemic patients a small increase in HbA1c was observed (6.5 +/- 0.7 vs. 7.4 +/- 1%, P = 0.04). In all cases, HRT did not modify the proportion of LDL represented by denser LDLs.
HRT did not modify the LDL subclass distribution, even in the presence of moderate chronic hyperglycemia in women with type 2 diabetes.
关于激素替代疗法对糖尿病女性的影响，尤其是在中度慢性高血糖期间的影响，目前缺乏相关信息。
研究激素替代疗法对血糖控制良好和控制不佳的2型糖尿病女性血脂谱及低密度脂蛋白亚类分布的影响。
54名绝经后女性在进行6周的适应性饮食后，随机分为接受安慰剂组（糖化血红蛋白<8%，n = 13；糖化血红蛋白>8%，n = 17）或激素替代疗法组（糖化血红蛋白<8%，n = 11；糖化血红蛋白>8%，n = 13），为期12周。激素替代疗法包括每天服用0.625毫克周期性结合雌激素加5毫克甲羟孕酮。在每个治疗期开始和结束时，通过密度梯度超速离心法评估低密度脂蛋白亚类分布。
在基线期和研究期间，高血糖患者的糖化血红蛋白水平显著高于血糖接近正常的对照组（基线期分别为10.2±2.9%和6.5±0.7%，P<0.01）。与血糖接近正常的对照组相比，她们的总胆固醇、低密度脂蛋白胆固醇、甘油三酯有升高趋势，高密度脂蛋白胆固醇降低，极低密度脂蛋白、中间密度脂蛋白和低密度脂蛋白-1颗粒中的甘油三酯浓度以及低密度脂蛋白-1和-2颗粒中的胆固醇含量也显著更高。激素替代疗法使两组的低密度脂蛋白胆固醇降低。在血糖正常的患者中，观察到糖化血红蛋白有小幅升高（6.5±0.7%对7.4±1%，P = 0.04）。在所有情况下，激素替代疗法均未改变较致密低密度脂蛋白所代表的低密度脂蛋白比例。
即使在2型糖尿病女性存在中度慢性高血糖的情况下，激素替代疗法也未改变低密度脂蛋白亚类分布。
