title: The association of elective hormone therapy with changes in lipids among glucose intolerant postmenopausal women in the diabetes prevention program.
abstract: OBJECTIVE
  It is unclear how lipids change in response to lifestyle modification or metformin among postmenopausal glucose intolerant women using and not using hormone therapy (HT). We examined the one-year changes in lipids among postmenopausal, prediabetic women in the Diabetes Prevention Program (DPP), and whether changes were mediated by sex hormones.
  
  
  METHODS
  We performed a secondary analysis of a randomized controlled trial of 342 women who used HT at baseline and year 1 and 382 women who did not use HT at either time point. Interventions included intensive lifestyle (ILS) with goals of weight reduction of at least 7% of initial weight and 150 minutes per week of moderate intensity exercise, or metformin or placebo administered 850 mg up to twice a day. Women were not randomized to HT. Main outcome measures were changes between baseline and study year 1 in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides.
  
  
  RESULTS
  Compared to placebo, both ILS and metformin significantly reduced LDL-C and raised HDL-C among HT users, changes partially explained by change in estradiol and testosterone but independent of changes in waist circumference and 1/fasting insulin. In contrast, DPP interventions had no effect on LDL-C and HDL-C among non-HT users. ILS significantly lowered triglycerides among non-users but did not significantly change triglycerides among HT users. Metformin did not significantly change triglycerides among non-users but increased triglycerides among HT users.
  
  
  CONCLUSIONS
  The beneficial effects of ILS and metformin on lowering LDL-C and raising HDL-C differ depending upon concurrent HT use.
authors: Johns Hopkins University, Baltimore, MD, USA. sahill@jhmi.edu
authors: Sherita Hill
authors: SH
authors: Golden
authors: Catherine
authors: C
authors: Kim
authors: Elizabeth
authors: E
authors: Barrett-Connor
authors: Bin
authors: B
authors: Nan
authors: Shengchun
authors: S
authors: Kong
authors: Ronald
authors: R
authors: Goldberg
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000188:drug therapy*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood*; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D017698:Postmenopause; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D012739:Gonadal Steroid Hormones; D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D008687:Metformin
keywords: 5′ adenosine monophosphate-activated protein kinase; AMPK; BMI; DHEA; DPP; Diabetes Prevention Program; E2; FHS; FPG; HDL-C; HOMA-IR; HT; Hormone therapy; ILS; LDL-C; Lifestyle intervention; Lipids; OGTT; SD; SHBG; Sex hormones; T; VLDL; Women; apoB; apolipoprotein B; body mass index; dehydroepiandrosterone; estradiol; fasting plasma glucose; follicle stimulating hormone; high-density lipoprotein cholesterol; homeostatic model assessment of insulin resistance; hormone therapy; intensive lifestyle therapy; low-density lipoprotein cholesterol; oral glucose tolerance test; sex hormone binding globulin; standard deviation; testosterone; very low-density lipoprotein
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