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Diabetes Care 25:1675-1680, 2002
© 2002 by the American Diabetes Association, Inc.


Clinical Care/Education/Nutrition
Original Article

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

Results from the Third National Health and Nutrition Examination Survey (NHANES III)

Carlos J. Crespo, DrPH, MS1, Ellen Smit, PHD, RD1, Anastacia Snelling, PHD2, Christopher T. Sempos, PHD1 and Ross E. Andersen, PHD3

1 Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
2 Department of Health and Fitness, American University, Washington, DC
3 Department of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland

OBJECTIVE—Among postmenopausal women, those with diabetes experience more cardiovascular diseases than those without diabetes. We examine the relationship of hormone replacement therapy (HRT) with indicators of lipid and glucose metabolism using a national sample of diabetic and nondiabetic postmenopausal women.

RESEARCH DESIGN AND METHODS—We used data from the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. A total of 2,786 postmenopausal women aged 40–74 years participated in an oral glucose tolerance test, had blood drawn for lipid assessment, and responded to HRT questions.

RESULTS—Our results show that postmenopausal women with diabetes had increased dyslipidemia compared with nondiabetic women. Among diabetic women, current users of HRT had significant different lipid and glucose control levels than never users of HRT for the following variables: total cholesterol (225 vs. 241 mg/dl), non-HDL (169 vs. 188 mg/dl), apoA (171 vs. 147 mg/dl), fibrinogen (306 vs. 342 mg/dl), glucose (112 vs. 154 mg/dl), insulin (16.81 vs. 22.6 uU/ml), and GHb (6.03 vs. 7.13 mg/dl).

CONCLUSIONS—Diabetic and nondiabetic postmenopausal women currently taking HRT had better lipoprotein profile than never or previous users of HRT. Diabetic women currently taking HRT had better glycemic control than never or previous users of HRT.

Abbreviations: apo, apolipoprotein • HRT, hormone replacement therapy • Lp(a), lipoprotein(a) • NHANES III, Third National Health and Nutrition Examination Survey • OGTT, oral glucose tolerance test


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