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Timing of estradiol therapy after menopause linked to insulin action

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SAN DIEGO — Estradiol increased glucose disposal rate among women who were in the last 6 years of menses, according to study findings presented here.

“New incidence of type 2 diabetes is reduced by 30% in postmenopausal women randomized to estrogen-based hormone therapy compared with placebo,” the researchers wrote. “[Type 2 diabetes] risk reduction is particularly strong when women are treated with [hormone therapy] early after menopause (aged 50-59 years, < 10 years past menopause), suggesting that timing of treatment may be important.”

Rocio Ines Pereira, MD, and colleagues from the Unviersity of Colorado Anschutz Medical Center in Aurora, Colorado, evaluated 41 women who had never used hormone therapy and were either early postmenopausal (n = 21; ≤ 6 years of final menses) or late postmenopausal (n = 21; ≥ 10 years since last menses) to determine if the timing of estradiol administration following menopause has an effect on insulin action.

Rocio Ines Pereira

No significant differences between the two groups were found for BMI or fat mass whereas fat-free mass was larger among the late postmenopausal group compared with the early postmenopausal group (P < .05).

Glucose disposal rate at baseline did not differ between the two groups. Glucose disposal rate increased among the early postmenopausal group after 1 week of estradiol and decreased in the late postmenopausal group (P < .05).

“Taken together, our data demonstrated that there was not an inevitable decline in insulin action with age or time since menopause per se,” the researchers wrote. “However, [estradiol] action on [glucose disposal rate] was dependent on time since menopause, such that there was a benefit early (≤ 6 years) in menopause but harm later (≥ 10 years) in menopause. [Estradiol]-mediated effects on insulin action may be one mechanism by which [hormone therapy] reduces the incidence of [type 2 diabetes] in early postmenopausal women.”

Reference:

Periera RI, et al. OR15-5. Presented at: The Endocrine Society Annual Meeting; March 5-8, 2015; San Diego.

Disclosure: The researchers report no relevant financial disclosures.