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Physiology

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Endocrinology

Question
4 out of 50
 

Estrogen action on carbohydrate metabolism (AIIMS MAY 2009)



A Worsening of NIDDM

B Increase uptake of glucose through increase in insulin sensitivity

C Glycolysis increase

D Increasing central adipose deposition

Ans. C Glycolysis increase.
  1. A number of studies say that the HRT has no highly deleterious effect in patients with NIDDM or with IGT(Impaired Glucose Tolerance TEST). The data studied do not support the hypothesis of an impaired oestrogen effect in patients with NIDDM. Infact HRT is significantly associated with lower HbA1c levels in NIDDM pateints. In some cases where there was worsening it was associated more with progesterone in OCP.
  2. Estrogen is also shown to modulate insulin sensitivity possibly by altering insulin related gene expression. Infact estrogen α receptor knock out mice shows insulin resistance (Barros et. al. 2006) whereas β receptor decreases insulin sensitivity.
  3. At physiological levels, testosterone and oestradiol are thought to be involved in maintaining normal insulin sensitivity. However, outside this 'physiological window' these steroids may promote insulin resistance. For eg a study stated that intake of Oral Contraceptives for 3 cycles induced glucose intolerance, hyperinsulinaemia and insulin resistance in normal menstruating Chinese women. These changes occurred in association with elevated plasma triglyceride concentrations.
  4. Estrogen-induced growth requires continuous replenishment of energy, predominantly generated by glycolysis. Estrogen-induced changes in glycolysis appeared to be mediated via its regulation of GLUT 1 expression & Glycolytic enzyme induction. Estradiol promotes the energetic capacity of mitochondria by maximizing aerobic glycolysis.
  5. Alterations in the composition of the plasma lipids caused by estrogens are characterized by an increase in the high-density lipoproteinsQ, a slight reduction in the low-density lipoproteinsQand a reduction in plasma cholesterol levelsQ. Plasma triglyceride levels are increasedQdue to lipolysis and increase synthesis of triglyceridesQ.

So, The best answer would be increased glycolysis (Option C) as relation of estrogens with insulin sensitivity is ambivalent (Option B) and most studies show that it does not worsen NIDDM ((Option A).Infact new studies have shown that post-menopausal women who take estrogen replacement therapy (ERT) are less likely to develop diabetes and, if they do have the disease, are better able to maintain good blood sugar control.And question is about carbohydrate metabolism not lipid metabolism where it causes lipolysis (Option D). Estrogen causes fat to be stored in the buttocks, thighs, and hips in women. Men are more likely to have fat stored in the abdomen due to sex hormone differences. When women reach menopause and the estrogen produced by ovaries declines, fat migrates from their buttocks, hips and thighs to their waists; later fat is stored in the abdomen (central obesity).

Endocrinology Flashcard List

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