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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population-based surveys and case-control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one-fifth of the estrogen takers had been freed of their risk through hysterectomies.
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PMID:Characteristics of estrogen-treated women. A descriptive epidemiological study of a Swedish population. Part II. 663 3

411 patients suffering from endometrial carcinoma were seen at the Roswell Park Memorial Institure in Buffalo, New York, between 1970 and 1978. These patients were matched and compared with 338 controls having no neoplastic disease or neoplasms other than of the female genital tract. There was a significantly higher incidence of diabetes, hypertension, and obesity in the uterine cancer patients than in the controls. On the other hand, nulliparity or family history of uterine or other cancer could not be correlated with endometrial cancer in these patients. The control and cancer groups did not differ markedly in the use of estrogens for menopausal or gynecologic reasons. Estrogen use in oral contraceptives (OCs) and for uncertain or unknown reasons was higher in the control than in the cancer group. The uterine cancer group was slightly older (median age 64.2) than the control group (median age 59.7), but this difference is small and believed unlikely to account for the results described.
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PMID:Estrogens and endometrial cancer. 694 29

This is a summary discussion of the 3 types of OCs (oral contraceptives) (combined, sequential, and progestogen-only), their mechanisms of action, their relative effectiveness, and the side effects they cause. It is certainly safer for women to take OCs than to become pregnant, judging from maternal mortality statistics. This is especially true for developing countries. However, hypertension is increased 3-fold, deep venous thrombosis 5-fold, and cerebrovascular disease 4-fold in OC users. The majority of the known side effects are attributed to estrogen, although progestogen is not without blame. The major side effects mentioned, in addition to those listed above, are migraine, diabetes, carcinogenic effects, and possible teratogenic effects. Drug interactions with different drugs may reduce the effectiveness of the OC estrogen, thereby resulting in pregnancy. Estrogen also interacts with other drugs.
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PMID:Oral contraceptives, side effects and drug interactions. 723 87

The association between menopausal estrogen therapy and hip fracture was studied in a retirement community. Ninety-one hip fracture cases during a 5-year period in female residents under age 80 were compared to age-and race-matched community controls. Estrogen use was recorded from the medical records of the outpatient care facility and personal interviews. The estimated risk ratio for use of oral estrogens in excess of 60 months was 0.42. This protective effect was largely limited to oophorectomized women for whom the risk ratio for a comparable duration of use was 0.14; the risk significantly decreased with increased duration, but no such trend existed with increased dosage. Diabetes mellitus, low Quetelet's index, tallness, prolonged immobilization or physical inactivity, use of corticosteroids, early age at menopause, low levels of sunlight exposure, and heavy cigarette smoking were each independent risk factors for hip fracture but none confounded the observed association with estrogen use.
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PMID:Menopausal estrogen therapy and hip fractures. 724 23

The Collaborative Group for the Study of Stroke in Young Women and other similar studies linked oral contraceptives with increased risk of cardiovascular diseases. It is hypothesized that an increased risk for stroke should also be seen among postmenopausal women using estrogens as compared with nonusers. To test this hypothesis, a total of 198 postmenopausal subjects, most of whom were between 50 to 80 years of age, and with a diagnosis of stroke during the period 1972 to 1974, were compared with 396 controls (those who had not had strokes) chosen randomly from the data bank of the Kaiser Foundation Health Plan. The 198 subjects were from the Northern California Kaiser Foundation Hospitals. Both groups were studied for estrogen use and for the associated risk factors of diabetes, hypertension, and coronary artery disease. Of those who had had strokes, 20.7 percent had been taking estrogens, compared to 18.4% in the control group (the difference was insignificant at Chi-Square=0.4396). Relative risk of stroke was calculated by the relative odds method to be 1.16 times as great in estrogen users as nonusers, with 95% confidence limits of 0.75 and 1.77. Estrogen replacement therapy is beneficial for some postmenopausal women. Its risks and benefits must be carefully weighed. This study refutes the association between estrogen use in physiological replacement doses and increased risk of stroke in postmenopausal women.
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PMID:The role of estrogens as a risk factor for stroke in postmenopausal women. 734 44

Clinical and pathologic findings were compared in 43 postmenopausal endometrial carcinoma patients who had received exogenous estrogens prior to diagnosis and 79 similar patients unexposed to estrogens. Estrogen non-users were more likely to manifest lower parity, later menopause, obesity, hypertension, and diabetes, all of which have been considered to be constitutional risk factors for the development of endometrial carcinoma. Although estrogen users and non-users had similar extent of disease as judged by clinical stage, there was a tendency to more myometrial invasion in hysterectomy specimens from non-users, as well as greater frequency of unfavorable histologic types and grades of tumor. At short-term follow-up, more recurrences occurred in non-users, and this tendency appeared to be independent of clinical stage, histologic type, histologic grade, or modality of treatment. The significance of these and other observation to the determination of the risk-benefit ratio for estrogen administration is discussed.
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PMID:Endometrial carcinoma: clinical-pathologic comparison of cases in postmenopausal women receiving and not receiving exogenous estrogens. 738 46

Postmenopausal women are 2-3 times more likely to have a heart attack than premenopausal women. According to the results of the Framingham study, angina is one of the main manifestations of coronary heart disease in women, whereas myocardial infarction and sudden death are more frequent in men. Cigarette smoking, high blood pressure and hypercholesterolemia are major risk factors for coronary heart disease in both men and women, while diabetes mellitus and hypo-high-density lipoproteinemia are more clearly associated with cardiovascular disease in women than in men. Endogenous and exogenous hormones may be a major determinant of the cardiovascular risk in women. Premenopausal women have a considerably lower incidence of coronary heart disease than postmenopausal women, and estrogen therapy is associated with a reduced risk in the latter. Part of this protective effect seems to be due to the influence of estrogen therapy on lipoprotein metabolism, i.e. a decrease in LDL cholesterol and an increase in HDL cholesterol. Progestins, to an extent which depends on their androgenic potency, have the opposite effects. A large study (the Postmenpausal Estrogen Progestin Intervention Trial) has been launched to test the effect of the estrogen-progestin combination on various cardiovascular risk factors.
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PMID:Estrogens and progestins in postmenopausal women: influence on lipid parameters and cardiovascular risk. 772 Dec 54

Estrogen and progestogen effects on lipid and carbohydrate metabolism are reviewed. Their actions depend on the type and dosage of molecules and their route of administration. Steroid replacement therapy in post menopausal women results in most cases in beneficial effect on lipids without alteration of carbohydrate metabolism. Therapeutic implications in women with metabolic disturbances as hyperlipidemia or diabetes are discussed.
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PMID:[Estrogens, progestins and glucido-lipid metabolism]. 814 62

The effects of streptozotocin-induced (STZ) diabetes on the negative feedback regulation of LH and FSH were evaluated in adult female rats. Rats were injected with STZ (50 mg/kg) or vehicle and ovariectomized 10 days later. Estrogen (EB; 100 micrograms/kg) or oil injections were given on alternate days, starting on the day of ovariectomy. Blood samples for LH, FSH and PRL assay were taken on days 10, 13, 15 and 17. The rats were decapitated on day 17. One hour prior to sacrifice, one half of the animals were injected with alpha-methyl-p-tyrosine for determination of catecholamine turnover rates. Pituitaries were incubated to determine basal secretion rates. Rats treated with STZ exhibited the expected weight loss and elevation of plasma glucose levels. At the time of ovariectomy, FSH, but not LH or PRL, was depressed in the diabetic rats. The postovariectomy rise in LH and FSH was severely attenuated in the diabetic rats. EB treatment was more effective in lowering LH and FSH levels in the diabetic as compared to the control rats. Median eminence (ME) norepinephrine (NE) and dopamine (DA) turnover was higher in the oil-treated diabetic rats than oil-treated controls. EB also caused a greater decrease in ME NE and DA turnover in the diabetic rats. EB was more effective in decreasing in vitro LH secretion and increasing in vitro PRL secretion from pituitaries of control as compared to STZ-treated animals. These results demonstrated that STZ-induced diabetes leads to an attenuation of LH and FSH release after ovariectomy and potentiates the negative feedback effects of EB.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of streptozotocin-induced diabetes on neuroendocrine responses to ovariectomy and estrogen replacement in female rats. 832 21

Clinical and histopathological features of postmenopausal endometrial cancer were studied in 63 patients who had received exogenous estrogens previously and in 76 patients who had never been exposed to estrogens. All treatments were primarily surgical. Estrogen users were younger than nonusers (P < 0.001). Body mass index, age at menarche and menopause, parity, and blood pressure were comparable in the two groups. Prevalence of diabetes mellitus was higher in nonusers (P < 0.01). Tumor stage was earlier (P < 0.001) and the histologic grade was lower (P < 0.001) in estrogen users compared to nonusers, and the frequency of clear cell and adenosquamous carcinoma was lower in estrogen users. Myometrial invasion was less pronounced in estrogen users, independently of grade and stage (P < 0.01). Number of mitoses correlated significantly with grade and with estrogen use. Features such as squamous metaplasia and "foam" cells were not related to tumor grade or use of estrogens. The receptor content correlated inversely with grade but was not related to estrogen use. Duration of estrogen treatment was not associated with tumor stage and grade. Our findings support the theory that endometrial cancer of estrogen users may be less aggressive than cancer of nonusers.
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PMID:Endometrial cancer in postmenopausal women with and without previous estrogen replacement treatment: comparison of clinical and histopathological characteristics. 850 92


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