低剂量激素治疗对绝经后妇女血脂、血糖控制、甲状腺激素和雄激素水平的影响

A. Karsidag, Nevriye Alkan, Esra Esim Büyükbayrak, B. Kars, Meltem Pirimoglu, O. Ünal, M. Turan
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引用次数: 0

摘要

目的:比较醋酸去甲睾酮(NETA)和屈螺酮对甲状腺激素、血糖控制、血脂和雄激素水平的影响。材料和方法:50名卵巢和子宫完整、有血管舒缩症状但其他方面健康的绝经后妇女被前瞻性纳入研究,其中41人完成了研究。患者随机分为两组,分别给予1mg E2 / 0.5 mg NETA (n=21)或1mg 17 s E2 / 2mg drospirenon (n=20)治疗,疗程3个月。治疗后比较两组内及两组间甲状腺激素、血脂、雄激素水平。统计分析除采用描述性统计方法配对和非配对t检验外,还采用Mann-Whitney U检验和卡方检验。以p≤0.05为差异有统计学意义。结果:两组患者治疗后体重指数(BMI)、子宫内膜厚度、甲状腺激素等指标在组内及组间均无差异。3个月后,NETA组总胆固醇(p=0.03)、胰岛素(p=0.009)、稳态模型评估(HOMA) (p=0.01)和纤维蛋白原(p=0.01)水平下降。低密度脂蛋白胆固醇水平降低(p= 0.02),甘油三酯水平升高(p=0.04)。NETA组和drospirenon组总睾酮水平均有下降(p=0.0001)。结论:NETA对绝经后妇女的脂质和碳水化合物代谢均有有益的影响。降螺脲能降低低密度脂蛋白胆固醇,增加甘油三酯水平,对碳水化合物代谢无影响。根据这些数据,建议绝经后有糖尿病风险的妇女使用含有低剂量激素治疗制剂的NETA来控制血管舒缩性不适是明智的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE EFFECTS OF LOW DOSE HORMONE THERAPY ON SERUM LIPID PROFILE, GLISEMIC CONTROL, THYROID HORMONES AND ANDROGEN LEVELS IN POSTMENOPAUSAL WOMEN
SUMMARY Objective: To compare the effects of norethisterone acetate (NETA) and drospirenone on thyroid hormones, glisemic control, serum lipid profile and androgen levels. Material and methods: 50 postmenopausal women with intact ovaries & uterus who have vasomotor complaints but otherwise healthy were prospectively enrolled into the study and 41 of them completed the study. Patients were randomly divided into two groups and prescribed 1mg E2 / 0.5 mg NETA (n=21) or 1mg 17 s E2 / 2 mg drospirenon (n=20) for 3 months. After the treatment thyroid hormones, glisemic control, lipid profile and androgen levels were compared both within the groups and between the groups. For the statistical analysis besides descriptive statistical methods paired and unpaired t test, Mann-Whitney U test and chi square test were used. Statistical significance level was accepted as p≤ 0.05. Results: There was no difference regarding body mass index (BMI), endometrial thickness and thyroid hormones both within the groups and between the groups after the treatment. Total cholesterol (p=0.03), insulin (p=0.009), Homeostasis model assessment (HOMA) (p= 0.01) and fibrinogen (p=0.01) levels were decreased in NETA group after three months. In drospirenon group there was decrease in LDL cholesterol level (p= 0.02), increase in trigliseride level (p=0.04). There was decrement in total testosterone level in both NETA (p=0.0001) and drospirenon (0.001) groups. Conclusion: NETA have beneficial effects on both lipid and carbohydrate metabolism in postmenopausal women. Drospirenon decreases LDL cholesterol while increasing trigliseride level and has no effect on carbohydrate metabolism. Under the light of these data it is wise to suggest NETA containing low dose hormone therapy preparations in postmenopausal women with diabetes risk for controlling vasomotor complaints.
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