Hormone Replacement Therapy and Its Relationship to Lipid and Glucose Metabolism in Diabetic and Nondiabetic Postmenopausal Women

Carlos J. Crespo, DrPH, MS, Ellen Smit, PHD, RD, Anastacia Snelling, PHD, Christopher T. Sempos, PHD and Ross E. Andersen, PHD

Disclosures

Diabetes Care. 2002;25(10) 

In This Article

Results

Table 1 describes selected characteristics according to diabetes status. The percent of women with less than a high-school education was greater among diabetic women (59%) than among nondiabetic women (43%). The percent of current smokers was higher among nondiabetic menopausal women (24%) than among diabetic women (15%). Obesity was more prevalent among diabetic (47%) than nondiabetic (31%) women. Current use of HRT was 60% lower among diabetic women than among nondiabetic women (10 and 16%, respectively). The most common form of HRT administration among women who reported ever taking HRT were pills (90%).

We found a poorer lipid profile and, as expected, glucose metabolism among diabetic women compared with their nondiabetic counterparts. The differences in lipid and glucose profile between diabetic and nondiabetic subjects did not change drastically after adjusting for age, race/ethnicity, BMI, smoking, and educational attainment (data not shown). Of note, fibrinogen and C-reactive protein were also higher in diabetic subjects (336 and 0.81 mg/dl) than among nondiabetic women (310 and 0.48 mg/dl, respectively).

Table 2 (diabetic subjects) and Table 3 (nondiabetic subjects) show indicators of lipid and glucose metabolism according to HRT status. Table 2 shows that among women with diabetes, serum cholesterol levels were significantly lower (225 mg/dl) among those currently taking HRT than among previous or never users of HRT (>240 mg/dl). Non-HDL levels were significantly lower among diabetic as well as nondiabetic women currently taking HRT ( Table 2 and Table 3 ). HDL levels were not significantly different among diabetic women on HRT and previous or never users of HRT ( Table 2 ). In nondiabetic women, however, HDL levels were significantly higher in those taking HRT than in those who have never used HRT or who previously used HRT ( Table 3 ). Similar divergent results were observed for the total cholesterol-to-HDL ratio. Thus, although HDL and total cholesterol-to-HDL ratios were significantly different among nondiabetic women currently taking HRT compared with previous HRT users or never HRT users, these results were not observed in diabetic women.

Diabetic women currently taking HRT had significantly lower fasting glucose levels (112 mg/dl) than previous or never HRT users (>150 mg/dl) ( Table 2 ). Among diabetic and nondiabetic women, however, fasting insulin levels were not significantly different when compared across HRT use category ( Table 2 and Table 3 ). Never users of HRT had higher fibrinogen levels than current users for both diabetic and nondiabetic postmenopausal women ( Table 2 and Table 3 ). Adjustment for age, BMI, smoking, and education did not alter the above findings.

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