Effects of estradiol and norethisterone on lipids, insulin resistance and carotid flow

Fernandes, César Eduardo; Pompei, Luciano de Melo; Machado, Rogério Bonassi; Ferreira, José Arnaldo S.; Melo, Nilson Roberto de; Peixoto, Sérgio Viana

doi:10.1016/j.maturitas.2008.02.001

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Finally, there was another question. Although the estrogen effects on internal carotid artery PI is controversial, according to previously reports, 4,5 CEE treatment could reduce PI value by around 10%, while in the present research the authors found only ∼4% reduction of PI value. I doubt if the PI reduction reached around 10% in the present study the antagonist effect of MPA may appear then.…”

contrasting

confidence: 60%

Comment on ‘Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: A randomized pilot study’

Zhao

2012

J of Obstet and Gynaecol

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contrasting

confidence: 60%

Comment on ‘Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: A randomized pilot study’

Zhao

2012

J of Obstet and Gynaecol

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“…Spironolactone has been shown to increase blood levels of oestradiol by increasing peripheral conversion of testosterone into oestradiol [8]. Considering the known favourable effects of oestrogens on lipid profile, it is interesting that the alterations of serum lipoproteins in our patients are in accordance with the effect of progesterone on HDL and LDL [9]. Therefore, it is tempting to attribute such changes in serum lipids to the progestagenic activity of spironolactone.…”

Section: Discussionmentioning

confidence: 89%

Short term effects of spironolactone on blood lipid profile: a 3‐month study on a cohort of young women with hirsutism

Nakhjavani

Hamidi

Esteghamati

et al. 2009

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Spironolactone is known to have antiandrogenic features and agonist activity at progesterone receptors, which are responsible for several of its hormonal side-effects.• The potential unfavourable influences of this medication on serum lipoproteins have long been a concern but literature lacks sufficient data on this issue. WHAT THIS STUDY ADDS• Spironolactone can adversely affect serum lipids by decreasing high-density lipoprotein and increasing low-density lipoprotein in women treated for hirsutism on a short-term basis. AIMSTo investigate the effects of spironolactone on serum lipids in women with hirsutism over a 3-month period. METHODSIn a prospective setting, 27 hirsute women (20 with polycystic ovary syndrome and seven with idiopathic hirsutism) with a mean age of 23.0 Ϯ 5.1 years were studied at baseline and 3 months after receiving a daily dose of 100 mg of spironolactone. Patients did not receive any other medications and did not go through a specific diet during the study. Lipid profile, fasting blood glucose, testosterone, dehydroepiandrosterone sulphate (DHEAS) and prolactin (PRL) were measured at baseline and 3 months after therapy. RESULTSMean body mass index of patients was 26.1 Ϯ 5.1 kg m -2 before treatment and 25.9 Ϯ 5.7 kg m -2 after treatment (NS). The therapy was associated with a significant decline of mean high-density lipoprotein (HDL), 39. CI 4.4, 5.6) vs. 6.4 (95% CI 5.7,7.1) (P < 0.05). No significant change was noted in total cholesterol, triglyceride or fasting blood glucose levels. Serum values of testosterone, DHEAS and PRL decreased significantly after 3 months of therapy (P < 0.05). CONCLUSIONSSpironolactone might have adverse effects on serum lipoprotein levels by increasing LDL and decreasing HDL over a short course of treatment. While treating hirsutism with spironolactone, special care should be given to women with metabolic disorders such as dyslipidaemia.

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“…This is in line with findings that this progestogen can reduce some estrogen effects. 12 Surprisingly, the immunohistochemistry results did not replicate this significant finding for HPSE. A possible explanation for this apparent discrepancy between RNA levels encoding the enzyme and the actual level of protein in the vascular extracellular matrix could be a simultaneous increase in degradation of the RNA encoding this protein, or in the degradation of the actual protein, suggesting a greater turnover.…”

Section: Discussionmentioning

confidence: 89%

Is the Expression of the Components of the Carotid Matrix of Rats Influenced by Estrogen, Progestin and Tibolone?

Steiner

Theodoro

Garcia

et al. 2019

Rev Bras Ginecol Obstet

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Objective To analyze the effects of estrogen alone or in combination with progestogens and tibolone (TIB) on the expression of the extracellular matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9), of perlecan, and of heparanase (HPSE) of the vascular walls of the carotid arteries. Methods A total of 30 250-day-old ovariectomized Wistar rats were orally treated for 5 weeks with: a) 1 mg/kg of estradiol benzoate (EB); b) EB + 0.2 mg/kg of medroxyprogesterone acetate (MPA); c) EB + 0.2mg/kg of norethisterone acetate (NETA); d) EB + 2 mg/kg of dydrogesterone (DI); e) 1 mg/kg of TIB; f) placebo (CTR). Following treatment, the expression of mRNA for MMP-2, MMP-9, and HPSE was analyzed by real-time polymerase chain-reaction (PCR), and the expression of MMP-2, of MMP-9, of tissue inhibitor of metalloproteinase 2 (TIMP-2), and of perlecan was quantified by immunohistochemistry in the carotid arteries. Results The groups showed significant differences on mRNA HPSE expression (p = 0.048), which was higher in the EB, EB + MPA, and TIB groups. There was no statistically significant difference in mRNA MMP-2 or MMP-9 expression. The immunohistochemical expression of MMP-2, of TIMP-2, of MMP-9, of HPSE, and of perlecan showed no differences between groups. Conclusion Estradiol alone or associated with MPA and TIB treatment can increase mRNA HSPE expression of the walls of the carotid arteries in ovariectomized rats.

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Effects of estradiol and norethisterone on lipids, insulin resistance and carotid flow

Cited by 10 publications

References 31 publications

Comment on ‘Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: A randomized pilot study’

Comment on ‘Effect of conjugated estrogen versus conjugated estrogen associated with medroxyprogesterone acetate in postmenopausal women on internal carotid artery pulsatility index: A randomized pilot study’

Short term effects of spironolactone on blood lipid profile: a 3‐month study on a cohort of young women with hirsutism

Is the Expression of the Components of the Carotid Matrix of Rats Influenced by Estrogen, Progestin and Tibolone?

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