Fernandes Cesar E, Pompei Luciano M, Machado Rogério B, Ferreira José Arnaldo S, Melo Nilson R, Peixoto Sergio
ABC School of Medicine, São Paulo, Brazil.
Maturitas. 2008 Mar 20;59(3):249-58. doi: 10.1016/j.maturitas.2008.02.001. Epub 2008 Mar 21.
To evaluate the lipid profile, insulin resistance and vasomotricity, and the interaction between these factors, in postmenopausal women receiving hormone therapy.
A prospective, randomized, double-blind study was carried out in which 77 postmenopausal women received one of the three treatment regimens: (A) 2mg oral micronized estradiol (E2) (n=25); (B) 2mg oral E2+1mg oral norethisterone acetate (NETA) (n=28); or C) placebo (n=24), daily for 6 months. Evaluations were carried out at baseline and at the end of treatment on lipid and lipoprotein profiles, homeostasis model assessment of insulin resistance (HOMA-IR) and pulsatility index (PI) of the internal carotid artery by Doppler ultrasonography.
Mean increases of 15.6% and 2.4% and a reduction of 6.4% in high-density lipoprotein (HDL) levels were found for the E2, E2+NETA and placebo groups, respectively. Reductions of 9.5% and 3.7% and an increase of 12.1% in low-density lipoprotein (LDL), and reductions of 20.0% and 3.8% and an increase of 28.8% in the LDL:HDL ratio were found for the E2, E2+NETA and placebo groups, respectively (p<0.001 in all cases). Insulin levels and HOMA-IR decreased 12.8% and 12.3% in the E2 group and increased 12.9% and 16.0% in the E2+NETA group (p<0.05), respectively. Carotid PI following treatment was 1.18+/-0.23, 1.38+/-0.20 and 1.41+/-0.21 for the E2, E2+NETA and placebo groups, respectively (p=0.0006).
Oral estrogen therapy led to an improvement in lipid profile, insulin resistance and carotid blood flow, which was cancelled when NETA was associated.
评估接受激素治疗的绝经后女性的血脂谱、胰岛素抵抗和血管舒缩功能，以及这些因素之间的相互作用。
开展一项前瞻性、随机、双盲研究，77名绝经后女性接受三种治疗方案之一：（A）口服2mg微粒化雌二醇（E2）（n = 25）；（B）口服2mg E2 + 1mg醋酸炔诺酮（NETA）（n = 28）；或（C）安慰剂（n = 24），每日服用，持续6个月。在基线期和治疗结束时评估血脂和脂蛋白谱、胰岛素抵抗的稳态模型评估（HOMA-IR）以及通过多普勒超声测量颈内动脉的搏动指数（PI）。
E2组、E2 + NETA组和安慰剂组的高密度脂蛋白（HDL）水平分别平均升高15.6%、2.4%和降低6.4%。E2组、E2 + NETA组和安慰剂组的低密度脂蛋白（LDL）分别降低9.5%和3.7%以及升高12.1%，LDL:HDL比值分别降低20.0%和3.8%以及升高28.8%（所有情况p < 0.001）。E2组胰岛素水平和HOMA-IR分别降低12.8%和12.3%，E2 + NETA组分别升高12.9%和16.0%（p < 0.05）。治疗后E2组、E2 + NETA组和安慰剂组的颈动脉PI分别为1.18±0.23、1.38±0.20和1.41±0.21（p = 0.0006）。
口服雌激素治疗可改善血脂谱、胰岛素抵抗和颈动脉血流，而与NETA联合使用时这种改善作用消失。
