title: Reductions in glucose among postmenopausal women who use and do not use estrogen therapy.
abstract: OBJECTIVE
  Among postmenopausal women who do not use estrogen therapy (ET), we have previously reported that intensive lifestyle modification (ILS) leads to increases in sex hormone-binding globulin (SHBG) and that such increases are associated with reductions in fasting plasma glucose (FPG) and 2-hour postchallenge glucose (2HG). Oral ET decreases FPG and increases 2HG while increasing both SHBG and estradiol (E2). It is unknown if ILS reduces glucose among ET users, if changes in SHBG and E2 might mediate any glucose decreases in ET users, and if these patterns differ from those in non-ET users.
  
  
  METHODS
  We conducted a secondary analysis of postmenopausal women in the Diabetes Prevention Program who used ET at baseline and 1-year follow-up (n = 324) and who did not use ET at either time point (n = 382). Participants were randomized to ILS, metformin, or placebo administered at 850 mg BID.
  
  
  RESULTS
  ET users were younger, more often white, and more likely to have had bilateral oophorectomy than non-ET users. Among ET users, ILS reduced FPG (P < 0.01) and 2HG (P < 0.01), and metformin reduced FPG (P < 0.01) but not 2HG (P = 0.56), compared with placebo. Associations between SHBG and total E2 with FPG and 2HG were not significant among women randomized to ILS or metformin. These patterns differed from those observed among women who did not use ET.
  
  
  CONCLUSIONS
  We conclude that among glucose-intolerant ET users, interventions to reduce glucose are effective but possibly mediated through different pathways than among women who do not use ET.
authors.affiliation: University of Michigan, Ann Arbor, MI 48109-5429, USA. cathkim@umich.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Kim
authors.forename: Shengchun
authors.initials: S
authors.lastname: Kong
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.forename: Sherita H
authors.initials: SH
authors.lastname: Golden
authors.forename: Kieren J
authors.initials: KJ
authors.lastname: Mather
authors.forename: Bin
authors.initials: B
authors.lastname: Nan
authors.forename: John F
authors.initials: JF
authors.lastname: Randolph
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Edelstein
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Buschur
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
mesh_terms: D001521:Behavior Therapy; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000517:prevention & control; D004958:Estradiol / Q000097:blood; D015914:Estrogen Replacement Therapy; D005215:Fasting; D005260:Female; D005502:Food; D018149:Glucose Intolerance / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010052:Ovariectomy; D010919:Placebos; D017698:Postmenopause / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D010919:Placebos; D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D008687:Metformin