Associations of postmenopausal hormone therapy with markers of hemostasis and inflammation and lipid profiles in diabetic and nondiabetic american Indian women: the strong heart study.
OBJECTIVE
To examine the associations of postmenopausal hormone therapy (PHT) with indicators of hemostasis and inflammation and with lipid profiles in American Indian women and to determine if diabetes modifies these associations.


METHODS
This report is a cross-sectional analysis of data from 1446 postmenopausal women who were free from cardiovascular disease (CVD) at the second Strong Heart Study examination (1993-1995). Diabetes was diagnosed by WHO criteria. Postmenopausal hormone use was ascertained by review of the medications brought to the examination or by medical record review. Lipoproteins, plasminogen activator inhibitor type 1 (PAI-1), fibrinogen, and C-reactive protein (CRP) were measured in fasting plasma samples.


RESULTS
Among nondiabetic women, current PHT users had lower mean fibrinogen, PAI1, and low-density lipoprotein cholesterol (LDLC) levels than those in never users (38.4 mg/dl, 8.68 ng/ml, and 14.16 mg/dl lower, respectively) but higher CRP and triglyceride levels (1.53 mg/l and 31.43 mg/dl higher, respectively). Multivariate adjustment did not alter any of these associations. In diabetic women, current PHT use was associated only with lower PAI-1 (5.48 ng/ml lower) and higher high-density lipoprotein cholesterol (HDLC) levels (3.33 mg/dl higher) compared with never users.


CONCLUSIONS
In American Indian women without diabetes, PHT was associated with lower levels of hemostatic markers but higher levels of an inflammatory marker. Associations were less marked in women with diabetes. The relation of PHT with lipid profiles also differed in nondiabetic and diabetic women. These data provide an additional rationale for considering diabetes status when deciding whether or not to use PHT.
Zhang
Ying
Y
Center for American Indian Health Research, University of Oklahoma HSC, Oklahoma City, Oklahoma 73190, USA. ying-zhang4@ouhsc.edu
Howard
Barbara V
BV
Cowan
Linda D
LD
Welty
Thomas K
TK
Schaefer
Carl F
CF
Wild
Robert A
RA
Yeh
Jeunliang
J
Lee
Elisa T
ET
D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D015914:Estrogen Replacement Therapy; D005260:Female; D005340:Fibrinogen / Q000187:drug effects / Q000378:metabolism; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007198:Indians, North American; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017698:Postmenopause; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D008074:Lipoproteins; D017395:Plasminogen Activator Inhibitor 1; D014280:Triglycerides; D005340:Fibrinogen; D002097:C-Reactive Protein