title: Body fat distribution, menopausal hormone therapy and incident type 2 diabetes in postmenopausal women of the MESA study.
abstract: OBJECTIVE
  We investigated the association between menopausal hormone therapy (MHT) and incident type 2 diabetes in postmenopausal women, and explored the potential modifying role of body fat distribution on this association.
  
  
  METHODS
  We included 2210 postmenopausal women without prevalent diabetes at recruitment (2000-2002) from the Multiethnic Study of Atherosclerosis. Cox proportional hazards models were used to examine associations of MHT and MHT types with incident diabetes, testing for variation according to body fat distribution.
  
  
  RESULTS
  Over a median follow-up of 11.1 years, there were 226 incident cases of diabetes. There were no significant interactions with central or generalized body fatness. In fully adjusted models, current and past MHT use was associated with a greater risk of incident diabetes [HR: 1.66 (1.18-2.35) and 1.60 (1.11-2.30) respectively]. Estrogen only (ET) and combined progestin and estrogen (PET) formulations were similarly associated with a greater risk of incident diabetes [HR: 1.52 (1.03-2.24) and 1.77 (1.15-2.72) respectively].
  
  
  CONCLUSIONS
  In our observational study of middle-aged and older, non-diabetic postmenopausal women, a current or past use of MHT was independently associated with a greater risk of incident diabetes. ET and PET are associated with similar risks of incident diabetes in postmenopausal women. The association of MHT use with incident diabetes is the same irrespective of body mass index (BMI) or waist circumference.
authors.affiliation: Division of Cardiology, University of Arizona College of Medicine, Tucson, AZ, United States. Electronic address: iebong@shc.arizona.edu.
authors.forename: Imo A
authors.initials: IA
authors.lastname: Ebong
authors.affiliation: Division of Cardiology, University of California Los Angeles School of Medicine, Los Angeles, CA, United States.
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.affiliation: Department of Medicine, Endocrinology and Metabolism, Wake Forest University School of Medicine, Winston Salem, NC, United States.
authors.forename: Kristen G
authors.initials: KG
authors.lastname: Hairston
authors.affiliation: Department of Preventive Medicine, NorthWestern University Feinberg School of Medicine, Chicago, IL, United States.
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.affiliation: Department of Medicine, John Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.affiliation: Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC, United States.
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D050218:Body Fat Distribution; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models
keywords: Body fat; Diabetes; Menopausal hormone therapy