The association of elective hormone therapy with changes in lipids among glucose intolerant postmenopausal women in the diabetes prevention program

Publication Description
OBJECTIVE: It is unclear how lipids change in response to lifestyle modification or metformin among postmenopausal glucose intolerant women using and not using hormone therapy (HT). We examined the one-year changes in lipids among postmenopausal, prediabetic women in the Diabetes Prevention Program (DPP), and whether changes were mediated by sex hormones. MATERIALS/METHODS: We performed a secondary analysis of a randomized controlled trial of 342 women who used HT at baseline and year 1 and 382 women who did not use HT at either time point. Interventions included intensive lifestyle (ILS) with goals of weight reduction of at least 7% of initial weight and 150 minutes per week of moderate intensity exercise, or metformin or placebo administered 850 mg up to twice a day. Women were not randomized to HT. Main outcome measures were changes between baseline and study year 1 in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. RESULTS: Compared to placebo, both ILS and metformin significantly reduced LDL-C and raised HDL-C among HT users, changes partially explained by change in estradiol and testosterone but independent of changes in waist circumference and 1/fasting insulin. In contrast, DPP interventions had no effect on LDL-C and HDL-C among non-HT users. ILS significantly lowered triglycerides among non-users but did not significantly change triglycerides among HT users. Metformin did not significantly change triglycerides among non-users but increased triglycerides among HT users. CONCLUSIONS: The beneficial effects of ILS and metformin on lowering LDL-C and raising HDL-C differ depending upon concurrent HT use.

Primary Author
Golden,S. H.
Kim,C.
Barrett-Connor,E.
Nan,B.
Kong,S.
Goldberg,R.
Diabetes Prevention Program Research Group

Author Address
Johns Hopkins University, Baltimore, MD, USA. [email protected]

Volume
62

Issue
9

Start Page
1313

Other Pages
1322

Publisher
Elsevier Inc

Author Address
Johns Hopkins University, Baltimore, MD, USA. [email protected]

PMID
23660512

PMCID
PMC3755098



Reference Type
Journal Article

Periodical Full
Metabolism: clinical and experimental

Publication Year
2013

Publication Date
Sep

Place of Publication
United States

ISSN/ISBN
1532-8600

Document Object Index
10.1016/j.metabol.2013.04.005 [doi]

Accession Number
PMID: 23660512