Menopausal hyperinsulinism and hypertension - new approach

Gynecol Endocrinol. 2020 Aug;36(8):709-713. doi: 10.1080/09513590.2020.1768370. Epub 2020 May 21.

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.

Keywords: Hyperinsulinism; drospirenone; estradiol; hypertension grade I; menopause.

MeSH terms

  • Adult
  • Androstenes / administration & dosage*
  • Drug Administration Schedule
  • Estradiol / administration & dosage*
  • Estrogen Replacement Therapy / methods*
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Humans
  • Hyperinsulinism / blood
  • Hyperinsulinism / complications
  • Hyperinsulinism / drug therapy*
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Insulin / blood
  • Insulin Resistance / physiology
  • Menopause / drug effects
  • Menopause / physiology
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Androstenes
  • Insulin
  • Estradiol
  • drospirenone