A study was conducted by Lee CC, Bloem CJ, Kasa-Vubu JZ, Liang LJ; published in Diabetes, Obesity & Metabolism (Nov 2011) to determine and compare the effect of treatment with transdermal estrogen and phytoestrogen on insulin sensitivity and SHBG levels in healthy postmenopausal women.
Materials and Methods: Forty-three healthy postmenopausal women age 68 ± 7 (mean ± SD) years who were not receiving hormonal replacement therapy completed a three month randomized drug therapy study. The participants were randomized to one of four groups: 0.05 mg or 0.1 mg transdermal estrogen/day, or 40 or 80 mg oral phytoestrogen (Promensil)/day Insulin sensitivity was indirectly measured using the Quantitative insulin sensitivity check index (QUICKI). Sex hormone-binding globulin (SHBG), total testosterone, estradiol, and fasting glucose and insulin levels for calculation of insulin sensitivity were obtained at baseline and at monthly intervals during 3 months of therapy.
Results: In healthy nondiabetic postmenopausal women, the rate of change in QUICKI was significantly different between the red clover based phytoestrogen and transdermal estrogen groups, so that after three months of therapy, QUICKI with red clover based phytoestrogen therapy was lower than that in the transdermal estrogen group, p = 0.01. Red clover based phytoestrogen therapy was not associated with any changes in SHBG levels whereas transdermal estrogen therapy significantly increased SHBG levels, p = 0.05.
Conclusions: In contrast to transdermal estrogen therapy, oral phytoestrogen therapy does not decrease androgenicity and is associated with a decrease in insulin sensitivity. These effects are similar to those of raloxifene and consistent with phytoestrogen's selective estrogen receptor modulator (SERM) properties.
Materials and Methods: Forty-three healthy postmenopausal women age 68 ± 7 (mean ± SD) years who were not receiving hormonal replacement therapy completed a three month randomized drug therapy study. The participants were randomized to one of four groups: 0.05 mg or 0.1 mg transdermal estrogen/day, or 40 or 80 mg oral phytoestrogen (Promensil)/day Insulin sensitivity was indirectly measured using the Quantitative insulin sensitivity check index (QUICKI). Sex hormone-binding globulin (SHBG), total testosterone, estradiol, and fasting glucose and insulin levels for calculation of insulin sensitivity were obtained at baseline and at monthly intervals during 3 months of therapy.
Results: In healthy nondiabetic postmenopausal women, the rate of change in QUICKI was significantly different between the red clover based phytoestrogen and transdermal estrogen groups, so that after three months of therapy, QUICKI with red clover based phytoestrogen therapy was lower than that in the transdermal estrogen group, p = 0.01. Red clover based phytoestrogen therapy was not associated with any changes in SHBG levels whereas transdermal estrogen therapy significantly increased SHBG levels, p = 0.05.
Conclusions: In contrast to transdermal estrogen therapy, oral phytoestrogen therapy does not decrease androgenicity and is associated with a decrease in insulin sensitivity. These effects are similar to those of raloxifene and consistent with phytoestrogen's selective estrogen receptor modulator (SERM) properties.
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