TY - JOUR
T1 - Lipid, glucose and homocysteine metabolism in women treated with a GnRH agonist with or without raloxifene
AU - Palomba, Stefano
AU - Russo, Tiziana
AU - Orio, Francesco
AU - Sammartino, Annalidia
AU - Sbano, Francesco Maria
AU - Nappi, Carmine
AU - Colao, Annamaria
AU - Mastrantonio, Pasquale
AU - Lombardi, Gaetano
AU - Zullo, Fulvio
PY - 2004/2
Y1 - 2004/2
N2 - Background: Although GnRH analogues are widely used to treat a variety of sex hormone-related diseases, little is known about their effect on metabolism. Therefore, we have evaluated the effect of a GnRH analogue, administered with or without raloxifene, on serum levels of lipoproteins, glucose, insulin and homocysteine (Hcy). Methods: One hundred premenopausal women with symptomatic uterine leiomyomas were initially enrolled and randomized to receive 3.75 mg/28 days leuprolide acetate depot associated with 60 mg/day raloxifene hydrochloride (group A) or 1 placebo tablet/day (group B) for six cycles of 28 days. At entry and at cycle 6, subjects underwent anthropometric measurements, including body mass index and waist-to-hip ratio measurements, and blood chemistry assays for serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, Hcy, vitamin B12 and folate concentrations. Insulin resistance was evaluated with the homeostasis model assessment (HOMA) score. Results: Baseline parameters were similar in the two groups. At cycle 6, TC, HDL-C, LDL-C and TG levels were significantly increased (P <0.05) in group B. In group A, LDL-C levels were unchanged, and TC, HDL-C and TG levels were increased (P <0.05). Serum TC and LDL-C levels differed (P <0.05) between the groups. Glucose levels were unchanged between and within groups, whereas insulin levels and HOMA scores increased (P <0.05) versus baseline in group B. Post-treatment Hcy levels were higher (P <0.05) versus baseline in group B; they were unchanged in group A. Serum vitamin B12 and folate concentrations were unchanged in both groups. Conclusions: GnRH analogues alter serum lipoprotein and Hcy levels and increase insulin resistance. These acute metabolic changes may be prevented or reduced by raloxifene.
AB - Background: Although GnRH analogues are widely used to treat a variety of sex hormone-related diseases, little is known about their effect on metabolism. Therefore, we have evaluated the effect of a GnRH analogue, administered with or without raloxifene, on serum levels of lipoproteins, glucose, insulin and homocysteine (Hcy). Methods: One hundred premenopausal women with symptomatic uterine leiomyomas were initially enrolled and randomized to receive 3.75 mg/28 days leuprolide acetate depot associated with 60 mg/day raloxifene hydrochloride (group A) or 1 placebo tablet/day (group B) for six cycles of 28 days. At entry and at cycle 6, subjects underwent anthropometric measurements, including body mass index and waist-to-hip ratio measurements, and blood chemistry assays for serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, Hcy, vitamin B12 and folate concentrations. Insulin resistance was evaluated with the homeostasis model assessment (HOMA) score. Results: Baseline parameters were similar in the two groups. At cycle 6, TC, HDL-C, LDL-C and TG levels were significantly increased (P <0.05) in group B. In group A, LDL-C levels were unchanged, and TC, HDL-C and TG levels were increased (P <0.05). Serum TC and LDL-C levels differed (P <0.05) between the groups. Glucose levels were unchanged between and within groups, whereas insulin levels and HOMA scores increased (P <0.05) versus baseline in group B. Post-treatment Hcy levels were higher (P <0.05) versus baseline in group B; they were unchanged in group A. Serum vitamin B12 and folate concentrations were unchanged in both groups. Conclusions: GnRH analogues alter serum lipoprotein and Hcy levels and increase insulin resistance. These acute metabolic changes may be prevented or reduced by raloxifene.
KW - GnRH agonist
KW - Leiomyomas
KW - Metabolism
KW - Raloxifene
KW - Selective estrogen receptor modulators
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UR - http://www.scopus.com/inward/citedby.url?scp=10744220686&partnerID=8YFLogxK
U2 - 10.1093/humrep/deh053
DO - 10.1093/humrep/deh053
M3 - Article
C2 - 14747190
AN - SCOPUS:10744220686
VL - 19
SP - 415
EP - 421
JO - Human Reproduction
JF - Human Reproduction
SN - 0268-1161
IS - 2
ER -