Hormone replacement therapy is associated with better glycemic control in women with type 2 diabetes - The Northern California Kaiser Permanente Diabetes Registry
Hormone replacement therapy is associated with better glycemic control in women with type 2 diabetes - The Northern California Kaiser Permanente Diabetes Registry
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DOI：
10.2337/diacare.24.7.1144
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Selby, JV
中科院分区：
文献类型：
--
作者：
Ferrara, A;Karter, AJ;Selby, JV
目的——在患有糖尿病的女性中，伴随更年期的变化可能会进一步削弱血糖控制。关于激素替代疗法 (HRT) 如何影响糖尿病患者的葡萄糖代谢，人们知之甚少。本研究的目的是检查 2 型糖尿病女性的 HbA(1c) 水平是否因当前 HRT 的变化而变化。 研究设计和方法 - 在健康维护组织成员的 15,435 名 2 型糖尿病女性队列中，通过审查健康计划的计算机化实验室和药房系统中的记录来评估 HbA(1c) 和 HRT。通过调查收集社会人口统计学和临床信息。 结果 - 平均年龄为 64.7 岁 (SD +/- 8.7)。研究队列由 55% 的非西班牙裔白人、14% 的非西班牙裔黑人、12% 的西班牙裔、11% 的亚洲人、4% 的“其他”族裔群体以及 4% 的种族数据缺失者组成。目前 HRT 在 25% 的女性中进行了观察。当前使用 HRT 的女性的 HbA(1c) 水平显着低于未使用 HRT 的女性（年龄调整平均值 +/- SE：分别为 7.9 +/- 0.03 与 8.5 +/- 0.02，P = 0.0001）。使用非对抗雌激素的女性和使用对抗雌激素的女性之间没有观察到 HbA(1c) 水平存在差异。在广义估计方程模型中，该模型考虑了医生内的患者聚类，并根据年龄、种族、教育程度、肥胖、降血糖治疗、糖尿病病程、血糖自我监测和运动进行了调整，HRT 与 HbA(1c) 水平下降保持显着且独立的相关性 (P = 0.0001)。结论 - HRT 与 HbA(1c) 水平下降独立相关。需要进行临床试验来了解激素替代疗法是否可以改善糖尿病女性的血糖控制。
OBJECTIVE - In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA(1c) levels varied by current HRT among women with type 2 diabetes.RESEARCH DESIGN AND METHODS - In a cohort of 15,435 women with type 2 diabetes who were members of a health maintenance organization, HbA(1c) and HRT were assessed by reviewing records in the health plan's computerized laboratory and pharmacy systems. Sociodemographic and clinical information were collected by survey.RESULTS - The mean age was 64.7 years (SD +/- 8.7). The study cohort comprised 55% non-Hispanic whites, 14% non-Hispanic blacks, 12% Hispanics, 11% Asians, 4% "other" ethnic groups, and 4% with missing ethnicity data. Current HRT was observed in 25% of women. HbA(1c) levels were significantly lower in women currently using HRT than in women not using HRT (age-adjusted mean +/- SE: 7.9 +/- 0.03 vs. 8.5 +/- 0.02, respectively, P = 0.0001). No differences in HbA(1c) level were observed between women using unopposed estrogens and women using opposed estrogens. In a Generalized Estimating Equation model, which took into account patient clustering within physician and adjusted for age, ethnicity, education, obesity, hypoglycemic therapy, diabetes duration, self-monitoring of blood glucose, and exercise, HRT remained significantly and independently associated with decreased HbA(1c) levels (P = 0.0001).CONCLUSIONS - HRT was independently associated with decreased HbA(1c) level. Clinical trials will be necessary to understand whether HRT may improve glycemic control in women with diabetes.