Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized,...

Area of Science:

• Endocrinology and Metabolism
• Cardiovascular Disease
• Hormone Therapy Research

Background:

• Previous randomized trials indicated varied effects of postmenopausal hormone therapy on fasting glucose.
• No prior studies had assessed the impact of hormone therapy on the incidence of diabetes.

Purpose of the Study:

• To investigate the effect of postmenopausal hormone therapy on fasting glucose levels.
• To evaluate the influence of hormone therapy on the occurrence of new-onset diabetes.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 2763 postmenopausal women with coronary heart disease.
• Participants received either conjugated estrogen plus medroxyprogesterone acetate or a placebo daily.
• Fasting glucose was measured at baseline, year 1, and end of trial; incident diabetes was tracked over 4.1 years.

Main Results:

• Hormone therapy did not alter fasting glucose levels, whereas placebo led to significant increases.
• Diabetes incidence was 35% lower in the hormone therapy group compared to placebo (relative hazard, 0.65; P = 0.006).
• The number needed to treat to prevent one case of diabetes was 30; weight changes did not mediate the effect.

Conclusions:

• Postmenopausal hormone therapy demonstrated a 35% reduction in diabetes incidence among women with coronary disease.
• These findings highlight the metabolic effects of postmenopausal hormones.
• The results are insufficient to support hormone use for secondary heart disease prevention.