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Plasma endothelin in postmenopausal women with type 2 diabetes mellitus and metabolic syndrome: a comparison of oral combined and transdermal oestrogen‐only replacement therapy
Author(s) -
Saltevo J.,
Puolakka J.,
Ylikorkala O.
Publication year - 2000
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1046/j.1463-1326.2000.00087.x
Subject(s) - medicine , endocrinology , transdermal , hormone replacement therapy (female to male) , norethisterone acetate , metabolic syndrome , diabetes mellitus , crossover study , menopause , norethisterone , population , placebo , testosterone (patch) , pharmacology , alternative medicine , environmental health , pathology , research methodology
SUMMARYAim Type 2 diabetes and metabolic syndrome are major cardiovascular risk factors in postmenopausal women, but the role of vasoconstrictive endothelin‐1 (ET‐1) in these conditions is not known. We studied the levels of ET‐1 and the effect of postmenopausal hormonal therapy on ET‐1 levels in postmenopausal women. Methods We compared plasma levels of ET‐1 in 22 postmenopausal type 2 diabetic women and 14 postmenopausal women with metabolic syndrome with plasma levels in 10 healthy postmenopausal control women. The basal values for ET‐1 were measured for all groups. These women were then randomised to receive in a double‐dummy, crossover trial: either oral continuous oestradiol (2.0 mg) + norethisterone acetate (1.0 mg) per day or continuous transdermal oestrogen‐only (50 μg/day) for 3 months. Between the active therapy there were 3‐month wash‐out periods. ET‐1‐values were measured again at the end of each treatment period. Results The type 2 diabetic women had significantly (p < 0.003) elevated ET‐1 levels (4.8 ± 1.0 pg/ml) whereas those with metabolic syndrome (4.4 ± 1.7 pg/ml) had non‐significantly (NS) elevated ET‐1 levels compared to controls (3.6 ± 0.3 pg/ml). Both oral and transdermal hormone replacement therapy (HRT) failed to affect plasma ET‐1 except in 14 hypertensive women from the diabetes and metabolic syndrome groups who were on angiotensin convertase enzyme (ACE) inhibitors. These women's ET‐1 levels before oral HRT (4.6 ± 1.1 pg/ml) fell to 4.1 ± 0.9 pg/ml (p < 0.05). Conclusions Type 2 diabetes in postmenopausal women is associated with elevated ET‐1 levels. Oestrogen replacement therapy does not affect the levels of ET‐1 in postmenopausal women with type 2 diabetes or metabolic syndrome.