HDL biology
CETP rises over time regardless of whether progestogen is added to low-dose estradiol in diabetic women (Diabet Med 2000)
Original title: Lipoproteins and low-dose estradiol replacement therapy in post-menopausal Type 2 diabetic patients: the effect of addition of norethisterone acetate
Thirty-four post-menopausal type 2 diabetic women with moderate glycemic control were treated for six months with low-dose oral estradiol (1 mg) alone or combined with low-dose continuous norethisterone acetate (0.5 mg), with lipoproteins, lipoprotein(a), LDL oxidizability, and CETP measured throughout. Both treatments reduced serum cholesterol and lowered LDL-cholesterol by 17%, with no significant differences between groups in VLDL, HDL, triglycerides, lipoprotein(a) change, or LDL oxidizability. CETP rose with time in both treatment groups, but this increase did not differ significantly between the estradiol-only and estradiol-plus-NETA groups. The authors conclude that adding continuous low-dose norethisterone acetate did not diminish the potentially beneficial effects of low-dose estradiol on atherosclerosis progression in diabetes.
Original abstract
Aims: Low-dose continuous oestrogen/progestogen may increase patient compliance long-term but the cardioprotective effects in diabetes are unknown. The aim of this study was to compare the effect of low-dose oral oestrogen (1 mg, 17-beta-estradiol) treatment with oestrogen (1 mg 17-beta-estradiol) in combination with low-dose (0.5 mg) continuous norethisterone acetate (NETA) on lipoproteins in Type 2 diabetic patients.
Methods: Thirty-four post-menopausal Type 2 diabetic patients in moderate control (mean haemoglobin A1c 7.7%) who had a serum oestradiol level of < 50 pg/ml were examined over a 6-month period. Serum lipids, and lipoprotein composition of very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured. Serum lipoprotein(a) was determined by an ELISA method, LDL fatty acids by gas-liquid chromatography and LDL oxidizability by thiobarbituric acid reactive substances (TBARS assay). Cholesteryl ester transfer protein (CETP), and cell cholesterol were measured.
Results: There was a reduction in serum cholesterol on both treatments but no significant difference between treatment groups. LDL cholesterol decreased by 17% in each group. There was a no significant difference between the groups in serum VLDL or HDL cholesterol or serum triglycerides during the study. The change in lipoprotein(a) during the study was not significantly different between the groups. There was no significant difference in 4 h LDL oxidizability between groups. Although CETP increased with time in both groups there was no significant difference in the change between the groups.
Conclusion: In this small study, the addition of continuous low-dose NETA did not reduce the potentially beneficial effects of low-dose 17-beta-estradiol on the progression of atherosclerosis in diabetes.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.