Table 5.
Carbohydrate metabolism: features of studies comparing oral and transdermal hormone replacement therapy
| Author, year | Study type | Compared groups | Results |
|---|---|---|---|
| Godsland IF et al. 1993 | Randomized controlled trial |
Group 1 o-CEE 0.625 mg/LNG 0.075 mg 12 days Group 2 t- E2 0.05 mg/NETA 0.25 mg 14 days Group 3 Control group |
O-estrogen determined a deterioration in glucose tolerance (p = 0.05) O-estrogens caused a decrease in insulin resistance during the combined NETA treatment phase, higher compared to t-E2 (p < 0.05) t-E2 showed no changes reported in insulin values and insulin sensitivity |
| OʼSullivan A et al. 1998 | Randomized controlled trial |
Group 1 o-CEE 1.25 mg / MPA 10 mg 12 days Group 2 t-E2patch 0.01 mg / MPA 10 mg 12 days |
O-E2 Lower IGF-1 compared to t-E2 (p < 0.01) Reduction in lipid oxidation measured 30–60 min post-prandially (p < 0.01) Increase in carbohydrates oxidation (p < 0.05) Increase the proportion of fat tissue (5.2%) and decreased proportion of non-fat tissue (2%) compared to t-E2 (P < 0.01) No changes in BMI in the both route of administration |
| Karjalainen A et al. 2001 | Randomized controlled trial |
Group 1 o-estrogen valereate 2 mg Group 2 t-E2 beta-oestradiol gel 1 mg |
Both o-E2 and t-E2 reduced in HbA1c levels (p < 0.05) The OGTT and postprandial insulin levels did not change significantly C-peptide levels increased by 8% in both treated groups O-E2 decreased IGF-1 values and increased GH values (p < 0.05) |
| dos Reis CM et al. 2003 | Randomized controlled trial |
Group 1 o-CEE 0.625 mg Group 2 t-E2 patch 0.05 mg Group 3 Control group |
No difference in body weight, visceral fat, BMI, o-E2 or t-E2 Statistical decrease in IGF-I (p < 0.05) and increase in GH values (p < 0.05) with o-E2. No significant changes in t-E2 group Increase in fat tissue content with o-E2 (12%, p < 0.05). No significant changes with t-E2 Proportion of non-fat component increased with t-E2 (3%, p < 0.05) and decreased with o-E2 (7%, p < 0.05) Fat oxidation decreased and carbohydrate oxidation increased with o-E2.Opposite changes recorded with t-E2 (p < 0.05) |
| Shakir YA et al. 2004 | Randomized controlled trial |
Group 1 o-E2 1 mg/MPA 10 mg 14 days Group 2 t-E2 product 0.05 mg/MPA 10 mg 14 days |
The lowest number of women with IGT was found in the group on t-E2 compared to the groups on o-E2 regimen (16.4% vs 31%, P = 0.001) IGT is more common in the continuous o-E2 regimen (31.8%) compared to the sequential o-E2 and t-E2 (18.5%, P = 0.002) |
| Chu CM et al. 2006 | Randomized controlled trial |
Group 1 o-E2 1 mg/MPA 10 mg/14 days Group 2 t-E2 preparation 0.05 mg/MPA 10 mg 14 days |
o-E2 in patients with IR determined a deterioration of the IR markers: Ratio of fasting glucose to insulin decreased (p < 0.01) Insulin concentration increased (p < 0.01) HOMA index increased (p < 0.05) T-E2 in patients with IR did not determine significant changes in IR markers: Ratio of fasting glucose to insulin decreased (p < 0.05) |
| De Lauzon-Guillain B et al. 2009—E3N Study | Cohort study |
Group 1 o-CEE Group 2 t-estrogen Group 3 Never-use HRT |
Lower risk for DM was observed in HRT users (HR 0.82; 95% CI 0.72–0.93) compared to never-users HRT Adjustment for BMI during follow-up did not change the association O-E2 reduced the risk of DM compared to t-E2 (HR = 0.61 vs 0.78 P = 0.031) Subjects on HRT had a higher BMI increase per year than those controls (p < 0.001) |
IGF-1 insuline-like growth factor 1, OGTT oral glucose-tolerant test, IGT impairment glucose tolerance, IR insuline resistance, DM diabetes mellitus, BMI body mass index, HRT hormone replacment therapy, HR hazard ratio, o-CEE conjugated equine estrogens