Evaluation of the effects of various gestagens on insulin sensitivity, using homeostatic model assessment, in postmenopausal women on hormone replacement therapy.

The objective of the present study was to compare the effects of various gestagens on insulin sensitivity in postmenopausal women on hormone replacement therapy (HRT). This prospective study enrolled 156 postmenopausal women who had menopausal status for at least 6 months. Group 1 was treated with 17β-estradiol (E 2 ; 2 mg) plus norethisterone acetate (NETA; 1 mg); Group 2 was given E 2 (2 mg) plus medroxyprogesterone acetate (MPA; 2.5 mg); Group 3 was given E 2 (2 mg) plus dydrogesterone (DG; 10 mg); and Group 4 was given E 2 (2 mg) plus micronized progesterone (MP; 100 mg). Group 5 was the surgical menopausal group and was given only E 2 (2 mg) continuously. All 156 subjects completed the 3-month follow-up on the trial. The patients were analyzed by using homeostatic model assessment (HOMA) for insulin sensitivity before treatment and 3 months after treatment, comparing the effects of various HRT regimens on insulin sensitivity. No significant differences were found in the baseline characteristics of the patients ( p > 0.05). There were no significant differences in mean values of HOMA before HRT among the five groups ( p > 0.05). There were statistically significant differences in mean values of HOMA only in Group 1 (E 2 + NETA) and Group 3 (E 2 + DG) after HRT ( p > 0.05). E 2 + NETA and E 2 + DG were found to improve insulin sensitivity in postmenopausal women after 3 months of treatment, whereas E 2 + MPA, E 2 + MP and E 2 only did not show such an effect in postmenopausal women. [ABSTRACT FROM AUTHOR]

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