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Estradiol-mediated effects on insulin action depend on timing of postmenopausal HT
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In early postmenopausal women, the incidence of type 2 diabetes can be reduced by the estradiol-mediated effects on insulin action, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
“These data suggest that the physiologic effect of [estradiol] on glucoregulatory insulin action (glucose disposal) depends on the timing of treatment relative to menopause,” the researchers wrote. “In contrast, the effect of [estradiol] on antilipolytic insulin action (insulin-suppression of lipolysis) did not differ by time since menopause.”
Rachael E. Van Pelt, PhD, of the University of Colorado Anschutz Medical Campus, and colleagues evaluated early postmenopausal (≤ 6 years of final menses; n = 22) and late postmenopausal (≥ 10 years since final menses; n = 24) women who were hormone therapy-naive to determine the effect of timing of estradiol therapy after menopause on insulin action.
Both late and early postmenopausal groups were randomly assigned to placebo or short-term transdermal estradiol.
No difference was found between the two groups for BMI and fat mass. The late postmenopausal group had lower fat-free mass compared with the early postmenopausal group (P < .05).
Fasting glucose, insulin concentrations and insulin-mediated glucose disposal did not differ between the two groups at baseline.
After 1 week of estradiol therapy, insulin-mediated glucose disposal increased in the early postmenopausal group compared with an increase in the late postmenopausal group. There was an inverse relationship found between estradiol-mediated change in insulin-mediated glucose disposal and time since menopause (P = .05).
“An [estradiol]-mediated improvement in insulin action may be one mechanism by which HT reduces the incidence of [type 2 diabetes] in early postmenopausal women; this effect of [estradiol] may be reversed in late postmenopausal women,” the researchers wrote. “The physiologic data from this small, well-controlled clinical study should not be interpreted as evidence to support the use of [estradiol] early in menopause to prevent [type 2 diabetes]. Instead, the data further our understanding of how timing of [estradiol] administration relative to menopause impacts [estradiol] action.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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