Kernohan A F B, Sattar N, Hilditch T, Cleland S J, Small M, Lumsden M A, Connell J M C, Petrie J R
Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Clin Endocrinol (Oxf). 2007 Jan;66(1):27-34. doi: 10.1111/j.1365-2265.2006.02679.x.
Low-dose hormone replacement therapy (HRT) has attracted interest for the treatment of postmenopausal symptoms in diabetes because of concerns about increased risk of coronary heart disease (CHD) and stroke with conventional HRT containing conjugated equine oestrogens (CEEs) and medroxyprogesterone acetate (MPA).
We assessed the effects on glucose homeostasis and cardiovascular risk factors of continuous oral 17beta oestradiol (1 mg) and norethisterone (0.5 mg) in postmenopausal women with type 2 diabetes.
Double-blind, randomized placebo-controlled trial.
Hyperinsulinaemic isoglycaemic clamp and cardiovascular risk factors were assessed before and after 3 months of treatment.
Twenty-eight women completed the study. HRT decreased fasting glucose compared with placebo [-9.4% with HRT vs.+2.3% for placebo, 95% confidence interval (CI) -23.2 to -0.3] and total cholesterol (-13.7 vs.+1.0%, 95% CI -22.4 to -3.1%) No significant effect was seen on metabolic clearance rate of glucose, glycated haemoglobin (HbA1c), triglycerides, high density lipoprotein (HDL)-cholesterol or C-reactive protein (CRP).
In women with type 2 diabetes, low-dose HRT decreased fasting glucose and total cholesterol without detectable adverse effects on glucose clearance, triglycerides and CRP as reported with conventional HRT.
由于担心含结合马雌激素（CEEs）和醋酸甲羟孕酮（MPA）的传统激素替代疗法（HRT）会增加冠心病（CHD）和中风风险，低剂量HRT已引起人们对糖尿病绝经后症状治疗的兴趣。
我们评估了连续口服17β雌二醇（1毫克）和炔诺酮（0.5毫克）对2型糖尿病绝经后妇女血糖稳态和心血管危险因素的影响。
双盲、随机、安慰剂对照试验。
在治疗3个月前后评估高胰岛素正常血糖钳夹和心血管危险因素。
28名女性完成了研究。与安慰剂相比，HRT降低了空腹血糖[-HRT组为-9.4%，安慰剂组为+2.3%，95%置信区间（CI）-23.2至-0.3]和总胆固醇（-13.7%对+1.0%，95%CI-22.4至-3.1%）。对葡萄糖代谢清除率、糖化血红蛋白（HbA1c）、甘油三酯、高密度脂蛋白（HDL）胆固醇或C反应蛋白（CRP）未见显著影响。
在2型糖尿病女性中，低剂量HRT降低了空腹血糖和总胆固醇，对葡萄糖清除率、甘油三酯和CRP未检测到如传统HRT报道的不良反应。
