The effects of hormon replacement therapy with 1 mg 17-beta estradiol+0.5 mg norenindrone asetat on lipid, carbohydrate methabolizm

A total of 78 postmenopausal women, between ages 45-63 were enrolled in our study during a period of 18 months until March 2004, at the outpatient clinic of the Department of Obstetrics and Gynecology at Gazi University Medical School, Ankara, Turkey. The patients were allocated to 2 case groups according to their wishes for taking HRT. 1 mg 17 beta etinil estradiol + 0.5 mg NETA was applied to 40 healthy women for 6 months and 38 healthy women were allocated in the control group. Before beginning the study, all patients were examined, patients with any history of diabetes mellitus or hypertension and patients having abnormalities in biochemical parameters were excluded from the study. Clinical and epidemiological parameters such as age, waist to hip ratio, body mass index, duration of menopause, smoking and laboratory parameters such as serum FSH, E2, fasting glucose, insulin, Apo A, Apo B, lipoprotein A, HDL, VLDL, total cholesterol, LDL, trigliserid, CRP, homocysteine, fibrinogen levels were evaluated and 75 mg oral glucose loading test was performed in all patients at the beginning of therapy and after 6 months. After 6 months of HRT, the weight, body mass index and waist to hip ratios increased; total cholesterol, HDL, VLDL, trigliserid, Apo A, Apo B, fasting glucose levels and sistolic tansion remained unchanged. Diastolic tansion decreased and the change was statistically significant. There was a significant decrease in insulin, HbAlc, 75 mg oral glucose loading test results which shows improvement in carbohidrate methabolism in the postmenopausal patients using HRT. CRP and homocysteine concentration increased significantly which are believed to be independent risk factors for cardiovascular disease. In contrast to this finding, HRT decreased fibrinogen and lipoprotein(a) concentrations. In conclusion, HRT improves glucose methabolism, but it has unfavorable effects on cardiovascular system in postmenopausal women.