EFFECT OF 17-BETA-ESTRADIOL ON PLASMA-LIPIDS AND LDL OXIDATION IN POSTMENOPAUSAL WOMEN WITH TYPE-II DIABETES-MELLITUS

In type II diabetes mellitus the altered hormonal state after menopaus e may represent an additional cardiovascular risk factor. Estrogen rep lacement therapy (ERT) is associated with a decreased cardiovascular r isk, at least in nondiabetic postmenopausal women. We studied the effe ct of ERT on plasma lipids and lipoproteins and on LDL oxidation in 40 postmenopausal women with type II diabetes but with minimal vascular complications in a randomized placebo-controlled trial. Twenty patient s were treated orally with 2 mg/d micronized 17 beta-estradiol and 20 patients with placebo for 6 weeks. Plasma total cholesterol (-6%, P=.0 4), LDL cholesterol(-16%, P=.0001), and apoB (-11%, P=.001) levels dec reased and HDL cholesterol (20%, P=.0001) and apoA-I (14%, P=.0001) le vels increased after ERT compared with placebo. Glycated hemoglobin (H bA1c) decreased significantly after ERT (-3%, P=.03), the cholesterol content of the LDL particles decreased (-5%, P=.006), triglyceride con tent increased (16%, P=.01), and LDL particle size did not change sign ificantly. ERT had no effect on parameters of LDL oxidation. We conclu de that plasma levels of HDL cholesterol, apoA-I, LDL cholesterol, apo B, and glycated hemoglobin are improved in postmenopausal women with t ype II diabetes mellitus after treatment with 17 beta-estradiol, indic ative of a better metabolic control, and that ERT has no effect on LDL oxidizability.