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Influence of hormone replacement therapy in postmenopausal women with type 2 diabetes and hyperlipidemia on lipid and glucose metabolism

Vuksanović Miljanka (Centar za endokrinologiju, dijabetes i bolesti metabolizma, Kliničko-bolnički centar 'Zvezdara', Beograd)
Beljić Teodora (Centar za endokrinologiju, dijabetes i bolesti metabolizma, Kliničko-bolnički centar 'Zvezdara', Beograd)
Popović Srđan (Institut za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)

Introduction. Hormone replacement therapy (HRT) is less frequently prescribed to postmenopausal women with diabetes type 2 who have poor lipid status despite well known favorable effect of HRT on lipid levels. Objective. The aim of this study was to assess the effect of oral HRT in postmenopausal women with type 2 diabetes and hyperlipidemia. Method. Continuously combined HRT, estradiol 2mg + norethisterone acetate 1mg was given to 30 women with diabetes type 2 and hyperlipidemia and two control groups of postmenopausal women (30 with hyperlipidemia only and 30 healthy women) over a 6-month period. Total cholesterol (t- HOL), triglycerides, LDL-cholesterol, HDL-cholesterol, glycosylated hemoglobin A1c (HbA1c) were evaluated in 3-month intervals. Fasting and postprandial glucose levels were evaluated monthly. Results. HRT significantly decreased levels of t-HOL (χ2 Friedman=11.712; p<0.01) and LDL-c (χ2 Friedman=10.403; p<0.01) in postmenopausal women with type 2 diabetes. However, the effect was more pronounced in two control groups. Triglycerides (χ2 Friedman=5.400; p≥0.05) and HDL-c (χ2 Friedman=1.113; p>0.05) did not change in postmenopausal women with type 2 diabetes. Six month of oral HRT significantly decreased HbA1c (F=44.693; p<0.01). Fasting and postprandial glycemia was decreased but not significantly (χ2 Friedman=6.527; p>0.05). Conclusion. Six-month application of HRT is effective in lowering the lipid levels and HbA1c in postmenopausal women with type 2 diabetes. However, target lipid levels were not achieved.

Keywords: hormone replacement therapy, type 2 diabetes, hyperlipidemia