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https://hdl.handle.net/2440/52571
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Type: | Journal article |
Title: | Effects of the route of estrogen administration on insulinlike growth factor-I, IGF binding protein-3, and insulin resistance in healthy postmenopausal women: results from a randomized, controlled study |
Author: | Davis, S. Stuckey, B. Norman, R. Papalia, M. Drillich, A. Bell, R. |
Citation: | Menopause: The Journal of the North American Menopause Society, 2008; 15(6):1065-1069 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2008 |
ISSN: | 1072-3714 1530-0374 |
Statement of Responsibility: | Davis, Susan R.; Stuckey, Bronwyn G.A.; Norman, Robert J.; Papalia, Mary-Anne; Drillich, Ann; Bell, Robin J. |
Abstract: | <h4>Objective</h4>Oral estrogen therapy suppresses insulin like growth factor I (IGF-I) levels, whereas conventional dose transdermal estradiol (E2) does not. However, it has been proposed that if sufficiently high serum E2 levels are achieved, nonoral E2 will also suppress serum IGF-I. The aim of the study was to investigate the effects of intranasal E2 with norethisterone (E2/NET) versus oral E2/NET acetate on IGF-I, IGF binding protein 3, and insulin resistance in postmenopausal women.<h4>Design</h4>This was a randomized, multicenter, double-blind, double-dummy trial. Postmenopausal women were randomized to receive either daily intranasal E2/NET (175 microg/275 microg) as a spray and a placebo tablet (n = 41) or oral E2/NET acetate (1 mg/0.5 mg) plus placebo intranasal spray (n = 41) for 1 year. Fasting plasma concentrations of IGF-I, IGF binding protein 3, glucose and insulin, glucose and insulin at 120 minutes post-glucose challenge, and the homeostasis model assessment for insulin resistance were assessed at baseline and after 52 weeks of treatment.<h4>Results</h4>The two groups were well matched for all clinical and biochemical parameters at baseline. There were no significant between-group differences for fasting and 120-minute glucose, insulin, homeostasis model assessment for insulin resistance, and IGF binding protein 3. The mean IGF-I level at week 52 was significantly lower for women treated with oral versus intranasal therapy (116 +/- 21 [SD] versus 134 +/- 33 [SD], P = 0.005) and the mean difference in change over 52 weeks in IGF-I was significantly different between groups (-19, 95% CI:-37 to -1, P = 0.04).<h4>Conclusions</h4>In healthy postmenopausal women, intranasal E2 at a dose that results in serum levels that exceed the proposed threshold for growth hormone and IGF-I effects, does not alter IGF-I levels. This suggests that the effect of exogenous estrogen on IGF-I is a function of the method of administration rather than being dose related. |
Keywords: | Humans Cardiovascular Diseases Insulin Resistance Estradiol Norethindrone Insulin-Like Growth Factor I Insulin-Like Growth Factor Binding Protein 3 Glucose Tolerance Test Estrogen Replacement Therapy Administration, Intranasal Administration, Oral Postmenopause Dose-Response Relationship, Drug Middle Aged Female |
Rights: | Copyright © 2008 The North American Menopause Society |
DOI: | 10.1097/gme.0b013e318174f16e |
Published version: | http://dx.doi.org/10.1097/gme.0b013e318174f16e |
Appears in Collections: | Aurora harvest 5 Paediatrics publications |
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