title: Combined estrogen replacement therapy on metabolic control in postmenopausal women with diabetes mellitus.
abstract: Previous studies have shown that the incidence of diabetes is higher when women come to menopause. This study was carried out to examine the effects of combined estrogen replacement therapy (ERT) on diabetes in postmenopausal women. PubMed/MEDLINE was searched for English-language articles published between January 1997 and June 2011. Studies that examined ERT on the incidence of diabetes and randomized clinical trials that evaluated combined ERT (estrogen plus progesterone) on diabetic indices in postmenopausal women were included. Pooled relative risks were calculated using a random- or a fixed-effects model. Sixteen studies comprising 17,971 cases were included. Based on the pooled data, ERT significantly reduced the incidence of diabetes [odds ratio (OR), 0.61; 95% confidence interval (CI), 0.55-0.68, ERT past/current/continuous use vs. never use; OR, 0.57; 95% CI, 0.51-0.65, ERT current/continuous use vs. past/never use]. Women with combined ERT have significantly lower levels of fasting plasma glucose (mean difference, -1.41 mM/L; 95% CI, -2.49 to -0.33 mM/L) and HbA1c (mean difference, -0.73%; 95% CI, from -1.28 to -0.18%) compared with placebo. Furthermore, combined ERT dramatically reduced plasma total cholesterol (mean difference, -0.34 mM/L; 95% CI, from -0.53 to -0.15 mM/L) and low-density lipoprotein (mean difference, -0.43 mM/L; 95% CI, from -0.71 to -0.14 mM/L) but slightly increased high-density lipoprotein (mean difference, 0.02 mM/L; 95% CI, from -0.07 to 0.12 mM/L) levels as compared with placebo control. This systemic review and meta-analysis provides evidence that postmenopausal women taking low-dose combined ERT have a decreased risk of developing diabetes and have better diabetic control.
authors.affiliation: State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, China. Electronic address: yhxu@must.edu.mo.
authors.forename: Youhua
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Research Center of Natural Medicine, Clinical School of Kunming General Hospital of Chengdu Military Command, Kunming Medical University, Kunming, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, China; Centre for Reproductive Medicine, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Xiong
authors.affiliation: State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhu
mesh_terms: D001786:Blood Glucose; D015992:Body Mass Index; D050260:Carbohydrate Metabolism / Q000187:drug effects; D003920:Diabetes Mellitus / Q000097:blood*; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D017698:Postmenopause; D011372:Progestins / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D004967:Estrogens; D011372:Progestins; D014280:Triglycerides
keywords: Diabetes; Estrogen replacement therapy; Meta-analysis; Systematic review; Women