Effect of postmenopausal hormone therapy on glucose and insulin concentrations. PEPI Investigators. Postmenopausal Estrogen/Progestin Interventions.

Academic Article

Abstract

  • OBJECTIVE: To characterize the long-term impact of four hormone therapy regimens on insulin and glucose concentrations measured during a standard oral glucose tolerance test. RESEARCH DESIGN AND METHODS: The Postmenopausal Estrogen/Progestin Intervention Study was a 3-year placebo-controlled randomized trial to assess effects of four hormone regimens on cardiovascular risk factors. This efficacy analysis describes glucose and insulin concentrations from 788 adherent women at baseline and at 1 and 3 years' postrandomization. RESULTS: When compared with women taking placebo, those taking conjugated equine estrogen (CEE) at 0.625 mg/day with or without a progestational agent had mean fasting insulin levels that were 16.1% lower, mean fasting glucose levels 2.2 mg/dl lower, and mean 2-h glucose levels 6.4 mg/dl higher (each nominal P < 0.05). No significant differences were apparent between women taking CEE only versus the three progestin regimens: medroxyprogesterone acetate (MPA) at 2.5 mg daily (continuous MPA), MPA at 10 mg on days 1-12 (cyclical MPA), and micronized progesterone (MP) (cyclical) at 200 mg on days 1-12. The impact of hormone therapy on insulin and glucose depended on baseline levels of fasting insulin and 1-h glucose (P < 0.05). However, the treatment effects on carbohydrate metabolism appeared to be consistent across participant subgroups formed by lifestyle, clinical, and demographic characteristics. CONCLUSIONS: Oral hormone therapy involving 0.625 mg/day of CEE may modestly decrease fasting levels of insulin and glucose. Postchallenge glucose concentrations are increased, however, which may indicate delayed glucose clearance.
  • Authors

    Published In

  • Diabetes Care  Journal
  • Keywords

  • Blood Glucose, Double-Blind Method, Drug Administration Schedule, Drug Therapy, Combination, Estrogen Replacement Therapy, Estrogens, Conjugated (USP), Fasting, Female, Follow-Up Studies, Humans, Insulin, Medroxyprogesterone Acetate, Placebos, Postmenopause, Postprandial Period, Progesterone, Progesterone Congeners, Time Factors
  • Author List

  • Espeland MA; Hogan PE; Fineberg SE; Howard G; Schrott H; Waclawiw MA; Bush TL
  • Start Page

  • 1589
  • End Page

  • 1595
  • Volume

  • 21
  • Issue

  • 10