Menopause Clinical Trial
Official title:
Postprandial Lipidemia and Glucose Metabolism After a Meal With Different Types of Fat, Estrogen Treatment, Age and Gender in Healthy Subjects
The study examines the effect of hormone replacement in postmenopausal women compared to men,
55 years of age, and in the elderly without hormone replacement of both sexes. The lipid and
glucose metabolism is evaluated during treatment and placebo with a meal with mashed potatoes
and different types of fat. Glucose, insulin, triglyceride, total cholesterol, LDL and HDL
cholesterol, free fatty acids and coagulation parameters are measured.
During menopause the women reduce their levels of estrogen and their risk of cardiovascular
disease rises to the men's level. This effect on mortality and morbidity can probably be
reduced by hormone therapy.
The experiment illustrates the gender, age and estrogen influence the acute metabolic
responses after meal consisting of mashed potatoes added different types of fat. The reason
is that the distribution of macronutrients are often not equal to the ideal and fat intake in
Western countries is well above the recommended maximum of 30%. A high fat intake -especially
saturated fat -increases the risk of ischemic heart disease significantly and HDL cholesterol
levels are determined by the postprandial lipid response. The negative correlation between
HDL cholesterol and ischemic heart disease can apparently be attributed to a strong positive
correlation between postprandial lipidemia and ischemic heart disease.
Diet has an important role in both the development and treatment of diseases such as type 2
diabetes, elevated blood cholesterol, and obesity. It is recommended today to eat a
high-carbohydrate and low-fat diet with reduced energy in these patients. Postprandial lipid
in the blood after fat meals expected to be gender-specific, since men's total and
LDL-cholesterol and triglycerides are higher than in women of childbearing age. Menopause
reduces women's estrogen levels and increase their risk of cardiovascular disease to men's
level. This effect on morbidity and mortality is influenced probably by hormone replacement.
What influence it has on the postprandial responses is uncertain. The haemostatic system
plays an important role in the development of ischemic heart disease and in acute conditions
such as acute myocardial infarction, unstable angina, and sudden cardiac death. Fat-rich
meals induces an acute activation of coagulation factors and postprandial lipid levels in the
blood are essential to the development of atherosclerosis and coagulation activation 4 to 8
hours after a meal. The influence of gender, age, estrogen and different fat types of these
conditions are not yet fully elucidated. The investigators believe it is important to
investigate the effect of addition of different types of fat to a starchy meal on blood
glucose, insulin and lipid levels in healthy subjects, since the metabolic responses today
considered closely associated to the development of atherosclerosis and type 2 diabetes.
The investigators therefore wish to investigate the effect of hormones in postmenopausal
women compared to men and to assess the effect of age in both sexes of acute metabolic
responses by examining the age groups 45-55 (40 women in total in 5 different hormone
treatments and 8 men) and 65-80 years (16 in total, 8 of each gender).
The effect is assessed on glycemic response, insulin, triglyceride, total cholesterol, LDL
and HDL cholesterol, apo-lipoprotein, free fatty acids and coagulation parameters (von
Willebrand factor, Factor VII, Factor VIIa, Plasminogen activator inhibitor-1, fibrinogen,
tissue thromboplastin, fibrin).
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