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Metabolic Status of Patients with Hypoestrogenic Anovulation on the Long-Term Hormone Replacement Therapy

Abstract

27 patients with hypoestrogenic anovulation (11 - hypogonadotropic hypogonadism (HH) and 16 - premature ovarian failure (POF) have been observed for more than 5 (6.9 ± 1.8) years. The average age at the end of the study HH patients was 28.5 ± 4.9 years, with POF – 36.3 ± 6.4 years. Estradiol/dydrogesterone (E2/D) was used in 11 patients (n=4 – HH; n=7 – POF) Estradiol valerate/levonorgestrel (EV/LNG) – 16 patients (n=7 – HH; n=9 – POF). The prevalence of insulin resistance has increased significantly 26 (92.3%) vs. 20 (74.1%) χ2 A/D p<0.01). Stepwise regression method is carried out to find the most significant predictor of deterioration insulin sensitivity in patients with hypoestrogenism on a long-term hormone replacement therapy (HRT). Analysis of the cumulative effect of each other such factors as: the choice of medicine for HRT, age, BMI at the end of the study, triglyceride levels, family anamnesis of type 2 diabetes (T2D), has determined the leading predictor of increasing index HOMA only family anamnesis of T2D (R=0.92; p=0.00). The frequency of hypertriglyceridemia has also increased significantly (9 (33.3%) vs. 6(22.2%) χ2 A/D p<0.05). The main predictor of growth hypertriglyceridemia recognized age of women at the end of the study (R=0.49; p<0.05), but the choice of the medicine. The number of women with impaired glucose tolerance increased to 14.8% (vs. 0%) χ2 A/D 21.0; p<0.001). Predictors of IGT (T2D) patients with hypoestrogenism on the long-term HRT called HOMA index (R=0.74; p<0.01) and anamnesis for T2D (R=0.76; p<0.001). HRT does not protect the deterioration of insulin sensitivity in patients with a family anamnesis of T2D and is not a means of prevention of this disease.

Chagay NB

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