Key result
Hormone replacement therapy is linked to significantly higher CRP levels in post-menopausal diabetic women.
Why the study?
The effect of hormone replacement therapy on C-reactive protein levels in women with Type 2 diabetes is not well documented and has conflicting conclusions.
Does hormone replacement therapy increase C-reactive protein levels in post-menopausal women with Type 2 diabetes?
Cross-Sectional (n=327)
Does hormone replacement therapy increase C-reactive protein levels in post-menopausal women with Type 2 diabetes?
p-value: p=0.0045 to 0.010
Hormone replacement therapy is associated with increased circulating C-reactive protein levels in post-menopausal women with Type 2 diabetes, suggesting a potential inflammatory mechanism for adverse cardiovascular effects.
AIMS: Increased levels of inflammatory biomarkers, especially C-reactive protein (CRP), are associated with increased risk for cardiovascular disease (CVD) events, such as myocardial infarction, stroke, peripheral vascular disease, and sudden cardiac death. Medical interventions that increase CRP levels, such as hormone replacement therapy (HRT) in post-menopausal women, are under increasing scrutiny. The effect of HRT on CRP levels in women with Type 2 diabetes (T2DM) is not well documented, and conflicting conclusions have been reported. The aim of this study was to determine the influence of HRT on women with diabetes in a large cross-sectional study. METHODS: Three hundred and twenty-seven post-menopausal women with T2DM from the Diabetes Heart Study participated. Current use of HRT was determined and serum CRP levels were measured using a high-sensitivity ELISA kit. Generalized estimating equation methods were used to assess the relationship of multiple clinical and lifestyle (e.g. smoking) measures on CRP levels including differences between women taking HRT (HRT+) and not taking HRT (HRT-). RESULTS: Overall serum CRP levels were strongly associated with body mass index (P < 0.0001) and age (P < 0.0001). Of the women, 243 were not using HRT and 84 were using HRT. HRT+ and HRT- women did not differ significantly in measures of clinical traits, with the exception of higher mean low-density lipoprotein cholesterol in HRT- women (P = 0.004). In all models tested, HRT+ women had significantly higher circulating CRP levels, with P-values ranging from 0.0045 to 0.010. CONCLUSIONS: In this study of serum CRP concentration as a function of HRT in women with Type 2 diabetes, there was consistent evidence for increased circulating CRP levels in women receiving oestrogen-containing HRT. Whether HRT-induced increases in CRP can account for the adverse cardiovascular effects of HRT remains to be established; however, based on these data, there is little reason to believe that diabetic women would be spared from such an effect.
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Bowden et al. (2006) conducted a cross-sectional in Type 2 diabetes (n=327). Hormone replacement therapy vs. No hormone replacement therapy was evaluated on Circulating C-reactive protein (CRP) levels (p=0.0045 to 0.010). In post-menopausal women with Type 2 diabetes, hormone replacement therapy was associated with significantly higher circulating CRP levels (P=0.0045 to 0.010).
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