ASSOCIATION OF HORMONE REPLACEMENT THERAPY AND CAROTID WALL THICKNESSIN WOMEN WITH AND WITHOUT DIABETES

OBJECTIVE - Atherosclerosis is the major underlying cause of death for women with type 2 diabetes. We examined the relationship between use of postmenopausal hormone replacement therapy (HRT) and subclinical at herosclerosis among women with type 2 diabetes, impaired glucose toler ance (IGT), and normal glucose tolerance. RESEARCH DESIGN AND METHODS - A cross-sectional analysis was conducted among 623 postmenopausal wo men in the Insulin Resistance Atherosclerosis Study (IRAS). Current us ers of HRT, n = 200, were compared with 104 former users and 319 never users. Intimal-medial wall thicknesses (IMTs) of the common carotid ( CCA) and internal carotid (ICA) arteries were used as measures of athe rosclerosis.RESULTS - Significant differences between HRT user groups were noted for certain demographic, socioeconomic, and lifestyle facto rs. After adjustment for these and other coronary heart disease risk f actors, current users had a 69 pm thinner ICA IMT than never users (P = 0.06). Former users had a 96 mu m thinner ICA IMT than never users ( P = 0.03). No significant difference was observed for the CCA. Althoug h women with type 2 diabetes had thicker carotid IMT than women withou t diabetes, the association between HRT use and thinner IMT was simila r in both groups. The difference between current and never users was a ttenuated by adjustment for HDL and IDL cholesterol. Neither duration of HRT use nor HRT regimen was associated with IMT in either artery. C ONCLUSIONS - This analysis suggests that current and former use of HRT is associated with reduced atherosclerosis and that women with type 2 diabetes may receive the same benefit from HRT as women without diabe tes.