[Influence of hormone replacement therapy in postmenopausal women with type 2 diabetes and hyperlipidemia on lipid and glucose metabolism].

Introduction: Hormone replacement therapy (HRT) is less frequently prescribed to postmenopausal women with diabetes type 2 who have poor lipid status despite well known favorable effect of HRT on lipid levels.

Objective: The aim of this study was to assess the effect of oral HRT in postmenopausal women with type 2 diabetes and hyperlipidemia.

Method: Continuously combined HRT, estradiol 2mg + norethisterone acetate 1mg was given to 30 women with diabetes type 2 and hyperlipidemia and two control groups of postmenopausal women (30 with hyperlipidemia only and 30 healthy women) over a 6-month period.

Effect of hormone replacement therapy on lipids and left ventricular function in postmenopausal smokers.

Objective: Menopause and smoking have negative effects on the cardiovascular system. The study was planned to investigate the influence of oral hormone replacement therapy (HRT) on heart function and lipids in postmenopausal smokers.

Methods: Lipid levels and left ventricular systolic and diastolic function by means of echocardiography were assessed before entering the study and at 6-month intervals during the 12 months of oral HRT in 62 postmenopausal women, 30 of whom were smokers and 32 were non-smokers.

[Effect of postmenopausal hormone substitution on the lipid profile and coagulation factors in female smokers].

Postmenopause and smoking impair lipid profile, induce hypercoagulability and reduce fibrinolytic capacity [1, 2]. Postmenopause induced lipid changes can be reversed by oestrogen replacement [3]. Oestrogens also reduce fibrinogen level [4] and have beneficial effects on endothelium [5].

Effect of estrogen replacement therapy on cardiac function in postmenopausal women with and without flushes.

Left ventricular heart function and its response to long-term estrogen replacement therapy was assessed in 30 postmenopausal women, 20 of whom had modest to severe hot flushes and 10 of whom had never had them. Continuous transdermal estradiol was given to women who had surgically induced menopause, and a combination of transdermal estradiol and sequential medroxyprogesterone acetate was given to those who had spontaneous menopause. Left ventricular systolic and diastolic function was evaluated by complete two-dimensional M-mode and pulsed Doppler echocardiography before and after 6 and 12 months of therapy.

The effect of hormone replacement therapy on diastolic left ventricular function in hypertensive and normotensive postmenopausal women.

Objectives: To evaluate the effect of hormone replacement therapy (HRT) on left ventricular diastolic function in a group of hypertensive and normotensive postmenopausal women.

Methods: Left ventricular diastolic function at rest was evaluated by M-mode, two-dimensional and Doppler echocardiography in 19 postmenopausal women with normal blood pressure and 11 postmenopausal women with mild hypertension, before treatment and during 12 months of HRT. Transdermal estradiol was used in women with a surgical menopause and a sequential regimen of transdermal estradiol and peroral medroxyprogesterone acetate in women with a spontaneous menopause.

Metabolic effects of tibolone in postmenopausal women with non-insulin dependent diabetes mellitus.

Objective: Postmenopausal women with non-insulin dependent diabetes (NIDDM) are frequently obese, hypertensive and hyperlipidaemic and hence at particular risk of coronary heart disease (CHD). They might therefore benefit from menopausal therapy. In view of the improvement in insulin sensitivity and the reduction in triglyceride levels induced by tibolone in healthy postmenopausal women we evaluated the effects of 12 months of tibolone on glycaemic control, serum insulin and lipid levels in postmenopausal women with NIDDM.

The effect of tibolone on cardiac flow in postmenopausal women with non-insulin dependent diabetes mellitus.

Objective: Postmenopausal women with non-insulin dependent diabetes (NIDDM) are frequently obese, hypertensive and hyperlipidaemic and hence at particular risk of coronary heart disease (CHD). They might therefore benefit from menopausal therapy. In view of the fact that oestrogen replacement increases cardiac flow but not limb flow whilst tibolone dilates forearm flow in healthy postmenopausal women, a study was undertaken to evaluate the effects of tibolone on cardiac flow in postmenopausal women with NIDDM.

Cardiac flow velocity in women with the polycystic ovary syndrome.

Objective: Women with the polycystic ovary syndrome (PCOS) often have several of the known risk factors for cardiovascular disease, including hyperinsulinaemia. We have therefore investigated variables of cardiac flow in young women with PCOS and related them to blood levels of reproductive hormones (LH, FSH, oestradiol and testosterone) and also of insulin.

Design: A prospective study.

The effect of oestrogen and progestogen replacement therapy on systolic flow velocity in healthy postmenopausal women.

The effects on left ventricular systolic outflow velocity of 3 months' treatment with either continuous transdermal oestradiol or cyclical transdermal oestradiol with medroxyprogesterone acetate were assessed in 34 healthy postmenopausal women. Cardiac flow was measured by pulsed wave Doppler echocardiography in 14 of these women and by continuous wave Doppler echocardiography in 20. Control studies were made in ten premenopausal women using pulse wave Doppler and in ten with continuous wave Doppler.

Effect of two different progestins (cyproterone acetate and norgestrel), administered in a cyclical estradiol valerate regimen, on markers of bone turnover.

It has been suggested that some progestogens could have a stimulating effect on bone formation. This study was therefore undertaken in order to compare the influence of cyproterone acetate and norgestrel on bone metabolism when administered in a discontinuous, sequentially combined regimen with estradiol valerate. Twenty healthy early postmenopausal women were randomly assigned to treatment with either Cyclo-Progynova, containing 0.

Improved metabolic control does not reverse left ventricular filling abnormalities in newly diagnosed non-insulin-dependent diabetes patients.

In this study left ventricular diastolic function at rest was evaluated in ten newly diagnosed, non-insulin-dependent diabetic patients by Doppler echocardiography, performed at the onset of disease and after 6 and 12 months of adequate glycaemic control. Glycosylated haemoglobin A1C, total cholesterol and triglyceride levels were assessed at the same time. The control group consisted of ten healthy subjects of matching age and body mass index.

[Effect of obesity on metabolic processes in bone tissue].

The aim of the present study was to evaluate the state of bone mass in obese individuals. Osteocalcin (OC) and parathormone (PTH) were measured (by RIA) in the sera of 137 obese, 32 premenopausal women, 65 postmenopausal women and 40 males, as well as in 28 controls, non-obese individuals. Values of OC and PTH were similar in the sera of all obese patients.

[Frequency of vascular complications in diabetic patients with subclinical cardiac dysfunction].

In young diabetic patients left ventricular diastolic and systolic abnormalities exist, that are registered by echocardiography. A greater frequency of peripheral neuropathy and autonomic neuropathy was found in the group of patients with left ventricular filling abnormalities. In diabetics with systolic cardiac dysfunction the extent of all microvascular complications was greater.

[Cardiac microangiopathy in diabetics].

Diabetes mellitus induces microvascular damage within the myocardium, without coexistent changes in the extramural coronary arteries. Nonenzymatic glucosylation forms the biochemical basis of diabetic microangiopathy, which further causes specific structural changes of the heart muscle. These changes increase left ventricular stiffness and lead to diastolic filling abnormalities, that may be the first sign of diabetic cardiomyopathy.