Changes Of The Serum Levels And Clinical Significance Of Sexual Estrogen In Postmenopausal Women With Type 2 Diabetes

As the decline of estrogen in postmenopausal women, insulin resistance (IR)can occur,and type 2 diabetes, hyperlipidemia, high blood pressure,the incidence of metabolic diseases also will gradually rise,mean- while they influence each other,affecting the health of women.Objective:To study the changes of levels in serum estrogen for postmenopausal women with type 2 diabetes mellitus(T2DM)or postmenopausal women with T2DM and EH,as well as the relationships with insulin resistance,Blood Lipids,blood pressure,in order to provid a better clinical guidance to control blood pressure and correct glycolipid metabolic disorder,alleviate insulin resistance and prevent the occurrence of insulin resistance syndrome,delay the occurrence and development of chronic complication.Materials and methods:1 Subjects:choose 30 heathy postmenopausal women (group A) in medical examination center of our hospital from September 2009 to October 2010 as control group;75 postmenopausal women patients with T2DM hospitalized in our Endocrine Department over the same period.45 of them are merely T2DM(group B),the others had complication of EH as group C.The age of subjects rangs from 49 to 80.2 Criteria of diagnosis: The diagnosis of DM according to the new diagnostic criteria of WHO in 1999. The diagnosis of EH according to the Hypertension Guidance of WHO in 1999.all subjects have no drug history of sexual hormones and its antagonists; no gonadal and adrenal dysfunction;no Hepatic and renal dysfunction.3 Clinical data: The data was observed including age,asting insulin(FINS),fasting plasma glucose (FPG),estradiol(E2),triglyeride (TG),total cholesterol (TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP),diastolic blood pressure (DBP),fglycosylated hemoglobin (GHbA1c),body mass index (BMI).4 Method of statistics: Statistic software SPSS16.0 was used for data processing.All measurement data was expressed by median deviation , comparison of multiple groups used rank sum test,relevant parameters used spearman correlation analysis,P value <0.05 was considered to have statistical significance.Results:1 Three groups were separately compared :There is no significant difference in age(P>0.05); FINS,TG,TC,LDL-C,SBP,DBP,GHbA1c,HOMA-IR and BMIof groups B and C were higher than group A,E2 of groups B and C was lower than group A (P<0.05); compared to groups A and B, FINS,SBP,DBP,HOMA-IR of group C were higher ,E2 was lower (P<0.05);Age,TC,SBP and DBP of groups A and B had no significant difference(P>0.05); Age,FPG,TG,TC,HDL-C,LDL-C,GHbA1c and BMI of groups B and C had no significant difference(P>0.05).2 Relationships among the serum estrogen,IR,blood glucose,blood lipid and blood pressure of groups B and C.2.1 Group B:E2 was negtively related with FINS,TC,LDL-C,HOMA-IR(P<0.05或P<0.01); and HOMA-IR was positively related with TG,TC and LDL-C(P<0.05或P<0.01); E2 has no significant correlation with Age,FPG,TG,HDL-C,GHbA1c,BMI,SBP and DBP(P>0.05).2.2 Group C:E2 was negtively related with FINS,SBP,HOMA-IR,BMI(P<0.05或P<0.01),positively related with HDL-C(P<0.05); HOMA-IR was positively related with BMI(P<0.01);E2 has no significant correlation with Age,FPG,TG,TC,LDL-C,GHbA1c and DBP ( P>0.05).Conclusions:1. There is an obviously decline of estrogen,insulin resistance(IR) and glycolipid metabolic disorders in postmenopausal women with T2DM (and EH), decline of estrogen may be associated with the incidence of T2DM,EH .2. Estrogen is a protective hormone for women.Physiological level of estrogen is beneficial to insulin resistance,glycolipid metabolism and blood pressure control .3.For postmenopausal women with T2DM, decline of estrogen may be one important factor to have a high incidence of dyslipidemia and EH .4. Estrogen replacement therapy(ERT)is beneficial to control of DM,IR,dyslipidemia and EH, delay the occurrence and development of their chronic complications.