Oestrogenic Activity at Menopausal Age in Women With Diabetes Mellitus (»diabète Gras«)

Abstract

A cytological investigation has been made into the occurrence of oestrogenic effects in female diabetic patients of menopausal age. A significant difference from a control group in the frequency of oestrogenic smears has been found. This difference is attributed to the diabetic patients with obesity and/or hypertension. The signs of oestrus are shown to be probably of adrenal origin. The possible significance of this with regard to the hereditary and environmental aspects of endometrial cancer is discussed.

The bimodal age distribution of patients with mammary carcinoma.Evidence for the existence of 2 types of human breast cancer

“…The combination of obesity and hypertension, however, is strikingly different in this regard, being associated with a definite impairment of glucose tolerance. The breast cancer women differ from essentially normal women in 2 respects: (I) in normal women the maximum blood glucose value is reached after 30 minutes, whereas in breast cancer patients this occurs after 60 minutes; (2) at least 2% hours are needed for this. These features are noted even in breast cancer patients without obesity or hypertension.…”

A prospective study in general practice on breast‐cancer risk in postmenopausal women

“…Moreover, we had found by means of endocrine cytology that among postmenopausal women there was an increased frequency of karyopycnotic (" estrogenic ") smears in those who were obese, hypertensive and diabetic (de Waard and Baanders, 1961 ;de Waard and Oettle, 1965). Since these estrogens originated outside the ovaries (Bruinsma and de Waard, 1959) we felt confident that they were synthetized as such in the adrenal cortex. Subsequently, it was found that only the precursors of extra-ovarian estrogens are synthetized in the adrenal cortex; the conversion of androstenedione to estrogens (mainly estrone) takes place in peripheral tissues ( MacDonald et a/., 1969;Poortman et al, 1973) inter alia in adipose tissue (Schindler et al, 1972).…”

Hormonal aspects in the causation of human breast cancer: Epidemiological hypotheses reviewed, with special reference to nutritional status and first pregnancy

“…d) It decreased in obese women when they succeeded in achieving significant weight loss [10]. e) The stimulus was of extra-ovarian, most probably of adrenal origin [10,11].…”