Issue 124 Item 5 HRT Tied to Better Glycemic Control in Diabetic Women

Diabetic women who receive hormone replacement therapy (HRT) have lower glucose levels and better cholesterol profiles than their counterparts who do not receive HRT That, according to a report published in the October issue of Diabetes Care.

In addition, in non-diabetic women, HRT use is associated with a reduction in non-HDL and a rise in HDL cholesterol levels, the report notes.

The current findings follow recent negative news about HRT. In July, a major US trial was stopped because HRT use appeared to increase the risk of breast cancer and cardiovascular disease. Earlier this month, one drug maker, Wyeth, changed the labels on its HRT products to reflect the safety concerns.

In the current study, Dr. Carlos J. Crespo, from the State University of New York at Buffalo, and colleagues analyzed data from 2,786 postmenopausal women who participated in the Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. All of the women underwent oral glucose tolerance testing, had blood drawn for lipid profiling, and responded to a questionnaire about HRT use.

As a group, diabetic women had worse lipid profiles than their non-diabetic peers, the authors note.

In diabetic women, current HRT use was associated with lower levels of total cholesterol, non-HDL cholesterol, fibrinogen, glucose, insulin, and glycosylated hemoglobin compared with never use. In addition, HRT use was tied to increased apoA levels in diabetic women.

In non-diabetic women, current HRT users had significantly lower non-HDL cholesterol levels and significantly higher HDL cholesterol levels than non-users or previous users.

The study, published in the current issue of Diabetes Care, adds yet another twist to the murky risks-benefits scenario surrounding HRT.

The federal government suspended a nationwide clinical trial of HRT in July, citing, among other concerns, that the combination of estrogen and progesterone used in the trial did not protect against cardiovascular disease as expected.

Yet, the UB researchers found that HRT had a positive effect on two important risk factors for heart disease — blood levels of fats and glucose — in a population-based study of 2,786 diabetic and non-diabetic postmenopausal women between the ages of 40 and 74. Carlos Crespo, Ph.D., associate professor of social and preventive medicine in the UB School of Medicine and Biomedical Sciences and lead author on the study, noted that the national HRT clinical trial did not include women with diabetes and that scientists haven’t researched the benefits or risks of hormone replacement in this group.

"Although there may be some risk in using certain types of HRT among certain women, there might be a segment of women who would be better off using HRT," Dr. Crespo said in a statement. "These findings indicate that diabetic women may be one such segment," he added. Diabetes Care 2002;25:00-00.