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Can postmenopausal hormone replacement improve plasma lipids in women with diabetes? The Atherosclerosis Risk in Communities Study Investigators.

TitleCan postmenopausal hormone replacement improve plasma lipids in women with diabetes? The Atherosclerosis Risk in Communities Study Investigators.
Publication TypeJournal Article
Year of Publication1996
AuthorsRobinson JC, Folsom AR, Nabulsi AA, Watson R, Brancati FL
Secondary AuthorsCai J
JournalDiabetes Care
Volume19
Issue5
Pagination480-5
Date Published1996 May
ISSN0149-5992
KeywordsAlcohol Drinking, Angina Pectoris, Cardiovascular Diseases, Cholesterol, Cholesterol, HDL, Cholesterol, LDL, Cohort Studies, Continental Population Groups, Cross-Sectional Studies, Diabetes Mellitus, Diabetic Angiopathies, Estrogen Replacement Therapy, Female, Humans, Intermittent Claudication, Lipids, Middle Aged, Postmenopause, Prevalence, Risk Factors, Smoking, Triglycerides, United States
Abstract

OBJECTIVE: to evaluate the association of postmenopausal hormone replacement with plasma lipids in diabetic women.

RESEARCH DESIGN AND METHODS: Cross-sectional data from a multiracial population study were used to evaluate the relationship of hormone replacement status with plasma lipids in diabetic (n = 694) versus nondiabetic (n = 5,321) postmenopausal women.

RESULTS: Although diabetic women who currently used hormone replacement had higher adjusted mean HDL cholesterol levels than those who did not (56.9 vs. 53.6 mg/dl), they had proportionately lower hormone-related increases in HDL, HDL2, and HDL3 cholesterol than did nondiabetic women (HDL cholesterol 64.9 [current users] vs. 55.7 mg/dl [those who never used hormones]). There was a trend toward greater triglyceride values with hormone replacement in diabetic women (156.6 [current users] vs. 125.4 mg/dl [those who never used hormones]) than in nondiabetic women (143.3 [current users] vs. 123.7 mg/dl [those who never used hormones]). LDL cholesterol and apolipoprotein B levels were lower and apolipoprotein A-I levels were higher with hormone replacement, to a similar degree in diabetic and nondiabetic women.

CONCLUSIONS: Diabetic women appear to have a blunted response to the HDL-raising effects of estrogen and an exaggerated hypertriglyceridemic response. This may result in attenuated cardioprotection from postmenopausal hormone replacement therapy and potentially an increased risk of acute pancreatitis from hypertriglyceridemia. The risks and benefits of postmenopausal hormone replacement need to be carefully weighed in diabetic women.

DOI10.2337/diacare.19.5.480
Alternate JournalDiabetes Care
PubMed ID8732713
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States