Conference paper
Effect of hormone therapy on insulin resistance in healthy postmenopausal women: A systematic review and meta-analysis of randomized placebo-controlled trials
S-4
The Menopause Society
2024 Annual Meeting of The Menopause Society (Chicago, Illinois, United States, 10 Sep 2024 - 14 Sep 2024)
Sep 2024
Featured in Collection : Drexel's Newest Publications
Abstract
Objective: Menopause is associated with an increased risk of developing insulin resistance and subsequently an increased risk of cardiometabolic diseases. The aim of this study is to summarize the effects of hormone therapy (HT) on insulin resistance in healthy postmenopausal women.
Design: Comprehensive searches of PubMed, MEDLINE, EMBASE, the Cochrane Library, and Google Scholar were performed. We included randomized controlled trials (RCTs) published in English from 1998 to 2024 that evaluated the effect of HT on insulin resistance, measured by homeostasis model assessment of insulin resistance (HOMA-IR), in postmenopausal women without diabetes, hypertension, or cardiovascular diseases. Raw mean differences (RMDs) with 95% CIs were calculated using a random-effects model in Comprehensive Meta Analysis Version 4. Subgroup analysis evaluated the effects of estrogen alone (E) and estrogen plus progestogen (E+P) separately compared to placebo. Heterogeneity was assessed with I2 values.
Results: In total, 17 non-duplicate RCTs reporting fasting insulin, fasting glucose, or HOMA-IR values were included in the analyses. Of the total 29,287 postmenopausal women, 15,350 were randomized to HT including E alone (n=5,553) or E+P (n=9,797), and 13,937 were randomized to placebo. The mean age of the study population ranged from 47 to 75 years. Treatment duration ranged from 8 weeks to 2 years. Types and dosages of HT included oral conjugated equine estrogens (0.3 mg/ day, 0.45 mg/day, 0.625 mg/day), oral 17β-estradiol (1 mg/day, 2 mg/day), transdermal 17β-estradiol (0.05 mg/day), cyclic or continuous use of oral medroxyprogesterone acetate (1.5 mg/day, 2.5 mg/day, 10 mg/day), micronized progesterone (200 mg/day), dydrogesterone (5 mg/day, 10 mg/day), norethisterone acetate (0.5 mg/day, 1 mg/day), drospirenone (2 mg/day), and norethisterone acetate (0.125 mg/day, 0.25 mg/day, 0.5 mg/day, 1 mg/day). Pooled results of 17 trials (3 for E alone, 7 for E+P, 7 for both E and E+P) indicated that HOMA-IR was significantly reduced in the HT group (overall effect: RMD [95% CI] = -0.24 [-0.36 to -0.12], p < .001, I2 = 60.3%) compared to the placebo group at the end of the intervention. In subgroup analysis, HOMA-IR was significantly reduced in both the E alone group (RMD [95% CI] = -0.42 [-0.55 to -0.29], p < .001) and the E+P group (RMD [95% CI] = -0.14 [-0.23 to -0.04], p = .005) compared to placebo (Fig.1).
Conclusion: HT significantly reduced insulin resistance in healthy postmenopausal women. Estrogen alone was associated with a more prominent reduction in insulin resistance compared to combination HT.
Metrics
1 Record Views
Details
- Title
- Effect of hormone therapy on insulin resistance in healthy postmenopausal women: A systematic review and meta-analysis of randomized placebo-controlled trials
- Creators
- Tanya Li - Drexel University, College of MedicineJulia Kaskey - Reading HospitalMatthew Nudy - Pennsylvania State UniversityPeter F Schnatz - Drexel UniversityXuezhi Jiang - Drexel University, Obstetrics and Gynecology
- Publication Details
- S-4
- Conference
- 2024 Annual Meeting of The Menopause Society (Chicago, Illinois, United States, 10 Sep 2024 - 14 Sep 2024)
- Publisher
- The Menopause Society
- Resource Type
- Conference paper
- Language
- English
- Academic Unit
- College of Medicine; Obstetrics and Gynecology
- Identifiers
- 991021903710204721