Table 1.
Effect of MHT on Type 2 Diabetes Risk
| Name |
Design |
Population |
Age (y) |
Treatment Length |
MHT |
Technique |
Effecta |
|---|---|---|---|---|---|---|---|
| Women Without Diabetes | |||||||
| PEPI (2) | RCT | 788 | 45–64 | 3 y | CE 0.625 mg ± progestin | FG, fasting insulin | IR ↓ |
| HERS (3) | RCT | 2029 | 67 ± 7 | 4.1 y | CE 0.625 mg/MPA 2.5 mg | Incident diabetes FG | Diabetes ↓ 35% |
| WHI (4, 5, 87) | RCT | 15,641 | 50–79 | 5.6 y | CE 0.625 mg/MPA 2.5 mg | Self-report | Diabetes ↓ 19%–21% |
| 10,739 | 50–79 | 7.1 y | CE 0.625 mg | Self-report | Diabetes ↓ 12%–14% | ||
| KEEPS (77) | RCT | 727 | 42–58 | 4 y | CE 0.45 mg/o-P4 200 mg | HOMA-IR | IR ↓ |
| t-E2 50 µg/o-P4 200 mg | HOMA-IR | IR ↓ (ns) | |||||
| Lobo (78) | RCT | 745 | 40–65 | 1 y | CE 0.625 mg/MPA 2.5 mg | FG, OGTT | FG ↓, PG ↑ |
| CE 0.45 mg/MPA 1.5 mg | FG, OGTT | FG ↓, PG ↑ | |||||
| CE 0.3 mg/MPA 1.5 mg | FG, OGTT | FG ←→ PG ←→ | |||||
| Hodis (79) | RCT | 222 | 45+ | 2 y | o-E2 1 mg | HbA1c | HbA1c ↓ 2.4% |
| Salpeter (6) | Meta-analysis | 33,315 | 60 ± 6 | 0.15–5 y | Variable | IR ↓ 13% | |
| RCTs | HOMA-IR | Diabetes ↓ 30% | |||||
| NHS (80) | OS | 21,028 | 30–55 | 12 y | Variable | Self report record | Diabetes ↓ 20% |
| E3N (81) | OS | 63,624 | 40–65 | 10 y | Variable | Self report record | Diabetes ↓ 25% |
| RBS (31) | OS | 785 | 50–97 | 8 y | Variable | FG | FG ↓ |
| Pentti (82) | OS | 8483 | 52–62 | 5 y | Variable | Record | Diabetes ↓ 69% |
| Xu (83) | Meta-analysis | 16,807 | 49–70 | 5–12 y | Variable | HbA1c, FG | FG ↓, HbA1c ↓ |
| Women With Type 2 Diabetes | |||||||
| Friday (84) | RCT | 25 | 50–77 | 8 wk | CE 0.625 mg | HbA1c | HbA1c ↓ |
| FG and insulin | IR ↓ | ||||||
| Anderson (85) | RCT | 27 | 40–65 | 3 mo | o-E2 2 mg | HbA1c | HbA1c ↓ |
| FG and insulin | IR ↓ | ||||||
| Brussaard (86) | RCT | 40 | 61 ± 5 | 6 wk | o-E2 2 mg | HbA1c, euglycemic, hyperinsulinemic clamp | HbA1c ↓ |
| HGP ↓ | |||||||
| Salpeter (6) | Meta-analysis RCTs | 33,315 | 60 ± 6 | 0.15–5 y | Variable | HOMA-IR | IR ↓ 33% |
Abbreviations: FG, fasting glucose; GTT, glucose tolerance test; IR, insulin resistance; NHS, Nurses’ Health Study; ns, nonsignificant; o-E2, oral micronized E2; o-P4, oral micronized progesterone; OS, observational study; PEPI, Postmenopausal Estrogen/Progestin Interventions study; PG, postchallenge glucose; RBS, Rancho Bernardo Study; t-E2, transdermal E2.
a
In the Effect column, up and down arrows indicate increase and decrease, respectively.