HRT will protect against diabetes
Epidemiological data indicate an increase in the incidence of type 2 diabetes mellitus among women in the postmenopausal period, when there is a natural extinction of the synthesis of estrogens – female sex hormones. This indirectly proves the protective role of estrogens. It is known that hormone replacement therapy, consisting in the constant intake of hormonal drugs, reduces the risk of diabetes by 35% compared to the absence of treatment.
Scientists from the University of Geneva in Switzerland conducted a study of the effect of estrogens on two hormones (glucagon and glucagon-like peptide-1, GPP1) responsible for maintaining normal blood glucose levels.
A number of laboratories are studying the effect of estrogens on the beta cells of the pancreas that produce insulin. The role of other hormones regulating glucose in blood and tissues is being investigated for the first time.
Glucagon is a hormone that is synthesized by alpha cells of the pancreas and through complex transformations leads to an increase in blood glucose levels. GPP1 is a peptide hormone that is synthesized in the L–cells of the small intestine in response to food intake. It suppresses the synthesis of glucagon and stimulates the release of insulin into the blood. Some authors believe that the first link in the pathogenesis of diabetes mellitus is a violation of the synthesis of GPP1.
The administration of estrogen to female mice in a state of surgical menopause (after removal of the ovaries) increased glucose tolerance and reduced the risk of diabetes. It has been proven that alpha cells react to the estrogen content in the body by reducing the production of glucagon. In addition, intestinal L-cells, which in their structure are very close to the alpha cells of the pancreas, actively released HPP1 in response to the intake of estrogen. He, in turn, stimulated the synthesis of insulin, suppressed the synthesis of glucagon and participated in the formation of a feeling of satiety. The authors suggested that HPP1 plays a key role in carbohydrate metabolism in women after menopause.
Hormone replacement therapy (HRT) is currently being actively discussed – more often on the negative side due to the large number of side effects. The main undesirable effect of estrogens is to increase thrombosis and the associated risk of cardiovascular diseases (heart attack, stroke, thromboembolism and others). The authors emphasize that timely HRT does not carry risks. If the intake of sex hormones begins 10 years after menopause or later, then the risk of increased thrombosis is really high.
Given the effect of estrogens on carbohydrate metabolism, controlled HRT will help reduce the risk of type 2 diabetes.
The authors found that of the three estrogens (estradiol, estriol and estrone), estradiol increased the production of HPP1, thus reducing the risk of diabetes, by activating the ERß receptor. The administration of WAY20070, an experimental selective agonist (stimulator) ERß, to mice led to the same effects as the administration of estradiol.
The results of the study were confirmed on human cell culture.
Thus, there is a prospect of developing a drug that would not have the side effects of HRT and which could be prescribed for the treatment of type 2 diabetes not only for women, but also for men.
The article by S. Handgraaf et al. 17-β Estradiol regulates proglucagon-derived peptide secretion in mouse and human α- and L cells is published in the journal JCI Insight.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of the University of Geneva: Diabetes: a new insight of the protective role of oestrogens.