Menopausal hyperinsulinism and hypertension – new approach

Abstract

Aim: to test effects of estradiol (E2) 1 mg and drospirenone (DRSP) 2 mg in treatment of normal weight menopausal women with typical menopausal symptoms, hyperinsulinism, and grade I hypertension.

Material and methods: The participants were 133 menopausal women, mean age 51.82 ± 3.25 years, body mass index (BMI) 24.9 ± 2.6 kg/m², waist/hip 0.80 ± 0.05, amenorrhoeic period 2.12 ± 2.10 years. All patients were treated with E2 1 mg and DRSP 2 mg during 12 months period. Blood samples were taken at 8 am before and during 12 months of therapy for: glycemia, lipids, hormonal analysis, follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, testosterone (T), prolactin (PRL), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG). Oral glucose tolerance test (OGTT) was performed with 75 g glucose in order to assess insulin secretion. All had grade I hypertension 24 h blood pressure monitoring was performed before and after 12 months of therapy.

Results: E2/DRSP significantly decreased total cholesterol, low-density lipoprotein (LDL), apolipoprotein B (ApoB), and increased high-density lipoprotein cholesterol (HDL) and apolipoprotein A (ApoA). Insulin area under the curve (AUC) significantly decreased (6586.1 ± 4194.2 vs. 5315.3 ± 2895.0, p < .05) and homeostatic model assessment (HOMA) (3.53 ± 2.18 vs. 3.0 ± 1.8, p < .05). FSH, LH decreased, E2 increased significantly. Of 24 h day blood pressure decreased significantly.

Conclusions: E2/DRSP represents suitable therapy for hyperinsulinemic, grade I hypertensive menopausal women with typical symptoms and normal weight.

摘要

目的：观察雌二醇（E2）1mg和屈螺酮（DRSP）2mg联合治疗在有典型绝经症状同时合并有高胰岛素血症和I级高血压体重正常的绝经期妇女中的疗效。材料与方法：本研究纳入133例绝经期妇女, 平均年龄51.82±3.25岁, 体重指数（BMI）24.9±2.6 kg/m², 腰/臀比0.80±0.05, 闭经时间2.12±2.10年。所有患者均给予E2 1mg和DRSP 2mg治疗12个月。治疗前和治疗12个月后上午8点采血：包括血糖、血脂、激素分析、卵泡刺激素（FSH）、黄体生成素（LH）、E2、睾酮（T）、催乳素（PRL）、硫酸脱氢表雄酮（DHEAS）和性激素结合蛋白（SHBG）。用75 g葡萄糖进行口服糖耐量试验（OGTT）以评估胰岛素分泌情况。治疗前和治疗12个月后进行24小时动态血压监测。结果：E2/DRSP显著降低总胆固醇、低密度脂蛋白（LDL）、载脂蛋白B （Apo B）, 显著升高高密度脂蛋白胆固醇（HDL）和载脂蛋白A （Apo A）。胰岛素曲线下面积（AUC）显著降低(6586.1±4194.2 vs 5315.3±2895.0, p<.05) , 稳态模型评价（HOMA）（3.53±2.18 vs. 3.0±1.8, p<.05）。FSH、LH明显下降, E2明显升高。24小时动态血压监测提示血压明显下降。结论：E2/DRSP适用于高胰岛素血症、有典型绝经症状、体重正常的I级高血压的绝经期女性。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Hyperinsulinism
• hypertension grade I
• menopause
• estradiol
• drospirenone

Disclosure statement

No potential conflict of interest was reported by the authors.