Highlights
- •Hormone therapy (HT) use was associated with metabolic syndrome (MetS) components among both diabetic and non-diabetic postmenopausal women.
- •‘Ever’ use of hormone therapy was negatively associated with the prevalence of metabolic syndrome among non-diabetic women, and current users of hormone therapy had a lower prevalence of metabolic syndrome than current non-users.
- •Although a longer duration of hormone therapy was associated with a decreasing prevalence of metabolic syndrome, there were no differential associations by age group.
- •There was no differential association of hormone therapy with components of the metabolic syndrome by diabetes status; however, we could not totally exclude the healthy-user bias.
Abstract
A lack of estrogen due to menopause changes metabolic homeostasis, which increases
the risk of metabolic syndrome (MetS) in postmenopausal women. Hormone therapy (HT)
has beneficial effects on chronic diseases as well as on menopause symptoms. The aim
of this study was to investigate the association of HT use with MetS and its components
by diabetes status in middle-aged postmenopausal Korean women. A cross-sectional analysis
was undertaken of a total of 39,295 non-diabetic and 3,359 diabetic postmenopausal
women aged 40 to 69 years from the Health Examinees-Gem (HEXA-G) study (2004–2013).
The mean differences in the MetS components by HT use were assessed using a general
linear model and Tukey’s multiple comparisons tests. The prevalence odds ratio (POR)
and 95% confidence intervals (CIs) were estimated using the logistic regression model.
HT use was associated with lower fasting glucose level, total cholesterol, systolic
blood pressure, body mass index, waist circumference, and waist-to-hip ratio among
both diabetic and non-diabetic women. In non-diabetic women, HT ‘ever’ use was negatively
associated with the prevalence of MetS (POR = 0.80, 95% CI: 0.75-0.85), and current
users had a lower prevalence of MetS (POR = 0.68, 95% CI: 0.60-0.76). A longer duration
of HT use was associated with a decreasing prevalence of MetS. We did not find heterogeneity
by age regarding MetS prevalence. Our results suggest that HT use is negatively associated
with the prevalence of MetS among postmenopausal women. However, further longitudinal
studies are required to investigate the effect of HT on MetS in Korean women.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Trends in the prevalence of metabolic syndrome and its components in South Korea: findings from the Korean National Health Insurance Service Database (2009–2013).PLoS One. 2018; 13e0194490
- Increased cardiovascular mortality in subjects with metabolic syndrome is largely attributable to diabetes and hypertension in 159,971 Korean adults.J. Clin. Endocrinol. Metab. 2015; 100: 2606-2612
- The diabetes epidemic in Korea.Endocrinol. Metab. (Seoul). 2016; 31: 349-353
- Sex differences in metabolic homeostasis, diabetes, and obesity.Biol. Sex Differ. 2015; 6: 14
- The effect of menopause on the metabolic syndrome among Korean women: the Korean National Health and Nutrition Examination Survey, 2001.Diabetes Care. 2007; 30: 701-706
- The emergence of the metabolic syndrome with menopause.J. Clin. Endocrinol. Metab. 2003; 88: 2404-2411
- Estrogen/progestin Replacement, Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial.Ann. Intern. Med. 2003; 138: 1-9
- Effect of oestrogen plus progestin on the incidence of diabetes in postmenopausal women: results from the Women’s Health Initiative Hormone Trial.Diabetologia. 2004; 47: 1175-1187
- Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials.JAMA. 2013; 310: 1353-1368
- Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. The writing Group for the PEPI Trial.JAMA. 1995; 273: 199-208
- Differences in the lipid profile and hormone replacement therapy use in Korean postmenopausal women: the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012.Arch. Gynecol. Obstet. 2016; 294: 165-173
- The effects of hormone therapy on metabolic risk factors in postmenopausal Korean women.Climacteric. 2011; 14: 66-74
- Effect of menopausal hormone therapy on components of the metabolic syndrome.Ther. Adv. Cardiovasc. Dis. 2016;
- Long-term hormone therapy for perimenopausal and postmenopausal women.Cochrane Database Syst. Rev. 2017; 1CD004143
- Hormone replacement therapy and its relationship to lipid and glucose metabolism in diabetic and nondiabetic postmenopausal women: results from the Third National Health and Nutrition Examination Survey (NHANES III).Diabetes Care. 2002; 25: 1675-1680
- The effects of hormone replacement therapy on plasma lipids in type II diabetes.Maturitas. 2000; 34: 239-247
- Menopause, hormone therapy and diabetes.Climacteric. 2017; 20: 11-21
- Associations of postmenopausal hormone therapy with markers of hemostasis and inflammation and lipid profiles in diabetic and nondiabetic American Indian women: the strong heart study.J. Womens Health (Larchmt). 2004; 13: 155-163
- The Health Examinees (HEXA) study: rationale, study design and baseline characteristics.Asian Pac. J. Cancer Prev. 2015; 16: 1591-1597
- Cohort profile: the Korean genome and epidemiology study (KoGES) consortium.Int. J. Epidemiol. 2017; 46: e20
- Trends and correlates of high-risk alcohol consumption and types of alcoholic beverages in middle-aged Korean adults: results from the HEXA-G study.J. Epidemiol. 2018;
- Treatment of high blood cholesterol in, third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report.Circulation. 2002; 106: 3143-3421
- Treatment of symptoms of the menopause: an endocrine society clinical practice guideline.J. Clin. Endocrinol. Metab. 2015; 100: 3975-4011
- Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women.Diabetes Obes. Metab. 2006; 8: 538-554
- Combined estrogen replacement therapy on metabolic control in postmenopausal women with diabetes mellitus.Kaohsiung J. Med. Sci. 2014; 30: 350-361
- Menopausal hormone therapy and type 2 diabetes prevention: evidence, mechanisms, and clinical implications.Endocr. Rev. 2017; 38: 173-188
- Testosterone concentrations in women and men with NIDDM.Diabetes Care. 1994; 17: 405-411
- Menopausal hormone therapy and cardiovascular risk. Where are we now?.Curr. Vasc. Pharmacol. 2018;
- Metabolic syndrome in menopause and associated factors: a meta-analysis.Climacteric. 2017; 20: 583-591
- Cardiovascular health in the menopausal woman: impact of the timing of hormone replacement therapy.Climacteric. 2012; 15: 299-305
Article info
Publication history
Published online: December 19, 2018
Accepted:
December 19,
2018
Received in revised form:
December 10,
2018
Received:
September 7,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
