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HRT and diabetes risk
Title: Hormone replacement therapy and glucose metabolism
Author: R. J. Troisi, et al.
Address: Bethesda, Maryland
Source: Obstetrics and Gynecology 96:665-670 (November) 2000
Summary: Little research has been done to determine the effect of hormone replacement therapy (HRT) on glucose metabolism, despite the increasing prevalence of diabetes in postmenopausal women. Study information was gathered from cross-sectional data from the third National Health and Nutrition Examination Survey. Tests included levels of hemoglobin A1c in women with diagnosed diabetes and levels of hemoglobin A1c fasting and 2-hour glucose, and fasting insulin and C-peptide in women without diagnosed diabetes. They compared mean values for these measures among never, current, and past users of HRT with adjustment for confounders. It was discovered that current users of HRT had lower hemoglobin A1c and fasting plasma glucose levels but higher 2-hour glucose levels compared with never and past users. After adjustment for confounding factors, hemoglobin A1c levels were 0.1% lower, fasting glucose levels were 3 mg/dL lower, and 2-hour glucose levels were 15 mg/dL higher in current users. Fasting serum insulin and C-peptide levels were not associated with HRT use. Duration of HRT use among current users and time since cessation among former users were not associated with measures of glucose metabolism. Researchers concluded that Postmenopausal hormones appear to have no adverse effect on basal glucose metabolism but are associated with slightly elevated postchallenge glucose levels.
Comment: This parallels the studies on oral contraceptives, which are known to marginally alter glucose tolerance. It has been judged that these changes are not clinically significant and that steroid use does not promote development of diabetes. Longitudinal life-table analyses are needed.