title: Insulin resistance in postmenopausal women: concurrent effects of hormone replacement therapy and coffee.
abstract: BACKGROUND
  In postmenopausal women, an increase in insulin resistance is associated with an increased risk of diabetes, cardiovascular disease and breast cancer. Hormone replacement therapy (HRT) can reduce insulin resistance and coffee use is reported to decrease the incidence of diabetes. The aim of our study was to assess possible concurrent effects of HRT and espresso coffee intake on insulin resistance and on interdependent nutritional and clinical features.
  
  
  METHODS
  A total of 478 healthy postmenopausal, non-diabetic women (aged 54.5 +/- 4.2 years) were studied: 360 had been on HRT for at least 2 years and 118 were not treated. Insulin resistance was assessed by a conventional homeostasis model (HOMA-IR).
  
  
  RESULTS
  Insulin resistance is directly related to body mass index (p < 0.0001), and not with age and blood pressure; hypertensive menopausal women have a slightly higher body mass index but the same degree of insulin resistance as normotensive women. Women on HRT show lower insulin resistance, but not lower prevalence of arterial hypertension. Coffee use is associated with a decrease in insulin resistance in non-obese women receiving HRT, but not in other subsets.
  
  
  CONCLUSIONS
  The combination of coffee consumption and HRT could lower insulin resistance in postmenopausal women. In overweight women, greater insulin sensitivity is associated with intake of espresso coffee and not with HRT; in normal weight women, only HRT is associated with lower insulin resistance.
authors.affiliation: Department of Internal Medicine, Institute of Internal Medicine and Medical Therapy, University of Catania, Catania.
authors.forename: D
authors.initials: D
authors.lastname: Catalano
authors.forename: G M
authors.initials: GM
authors.lastname: Trovato
authors.forename: D
authors.initials: D
authors.lastname: Spadaro
authors.forename: G F
authors.initials: GF
authors.lastname: Martines
authors.forename: G
authors.initials: G
authors.lastname: Garufi
authors.forename: A
authors.initials: A
authors.lastname: Tonzuso
authors.forename: D
authors.initials: D
authors.lastname: Grasso
authors.forename: S G
authors.initials: SG
authors.lastname: Sciacchitano
mesh_terms: D015992:Body Mass Index; D003069:Coffee; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D008535:Megestrol / Q000008:administration & dosage / Q000031:analogs & derivatives; D008875:Middle Aged; D017698:Postmenopause
chemical_list: D003069:Coffee; D003280:Contraceptives, Oral, Synthetic; D004967:Estrogens; C047637:nomegestrol; D004958:Estradiol; D008535:Megestrol