Сarbohydrate Metabolism Disorders and Metabolic Syndrome Components in Patients with Essential Hypertension Associated with Physiological and Postsurgical Menopause

Abstract

The objective — to compare the characteristics of carbohydrate metabolism, and the presence of other components of metabolic syndrome (MS) associated with physiological and postsurgical menopause, as well as the assessment of possible impact of hormone replacement therapy (HRT) intended to prevent postcastration climacteric symptoms in women with essential hypertension (EH) from relevant clinical groups. Material and methods. 112 women with EH degree II, whose average age was 46.14 ± 1.60 years, were examined: I group — 37 patients (average age 45.70 ± 1.45 years) with EH degree II and postsurgical menopause in reproductive age without HRT; II group — 37 patients (average age 44.90 ± 1.82 years) with EH degree II and postsurgical menopause, who received combined HRT; III group — 38 patients (average age 47.83 ± 1.70 years) with EH degree II on the background of physiological menopause without HRT. MS has been detected in accordance with the International Diabetes Federation Consensus (2009). Results. Women of childbearing age with postsurgical menopause on the background of symptomatic hypoestrogenism without HRT have carbohydrate metabolism disorders manifested in significant (p < 0.01) higher levels of fasting glucose, in glycemic profile, characteristics of insulin resistance (IR) by HOMA index and glycated hemoglobin, associated with the minimum percentage of normoglycemia (37.8 %), the highest levels of IR (89.2 %) and diabetes mellitus (DM) (29.7 %) as against significantly higher level of normoglycemia in patients receiving HRT (83.7 %) and with early physiological menopause (63.1 %), lower levels of IR (70.3 and 65.8 %) and DM (2.7 and 0 %) in the last two groups of patients. Administration of HRT to the women of reproductive age with postsurgical menopause optimizes carbohydrate and lipid metabolism, manifested in almost twice smaller detection rate (45.9 vs. 81.1 %) of MS and significantly (p < 0.01) lower number of revealed components of MS. Conclusions. Women with both postsurgical and early physiological menopause following hypoestrogenism have significant disorders of carbohydrate metabolism as hyperglycemia, IR, DM associated with various cardiometabolic symptoms that form menopausal MS. All the above changes most manifest in patients with postsurgical menopause without HRT, administration of which in the second group enabled to prevent hypoestrogenism and to slow the course of prediabetogenic changes in carbohydrate metabolism.

Keywords

• carbohydrate metabolism
• insulin resistance
• menopause
• hormone replacement therapy