Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis.

IF 2.9 4区医学 Q1 OBSTETRICS & GYNECOLOGY

Climacteric Pub Date : 2025-06-18 DOI:10.1080/13697137.2025.2509844

Tanya Li, Nathan S Jiang, Julia Kaskey, Peter F Schnatz, Matthew Nudy

{"title":"Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis.","authors":"Tanya Li, Nathan S Jiang, Julia Kaskey, Peter F Schnatz, Matthew Nudy","doi":"10.1080/13697137.2025.2509844","DOIUrl":null,"url":null,"abstract":"Objective: Menopause increases the risk of insulin resistance and cardiometabolic diseases. This study summarizes the effects of hormone therapy (HT) on insulin resistance in non-diabetic postmenopausal women.Method: The study analyzed randomized controlled trials (1998-2024) that assessed the impact of HT on insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) in non-diabetic postmenopausal women. Raw mean differences (RMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analysis compared estrogen alone (E alone) and estrogen plus progestogen (E + P) to placebo.Results: Seventeen randomized controlled trials with 5772 women (3644 on HT: E alone [n = 1259] or E + P [n = 2385]; 2128 on placebo) were included. The weighted mean (standard deviation) age was 56.91 (5.95) years, with treatment lasting 8 weeks to 3 years. HT significantly reduced HOMA-IR (RMD = -0.24 [-0.32 to -0.16], p < 0.001, I2 = 60.3%). Subgroup analysis showed reductions in both E alone (RMD = -0.42 [-0.55 to -0.29], p < 0.001, I2 = 35%) and E + P (RMD= -0.14 [-0.23 to -0.04], p = 0.005, I2 = 13.7%) compared to placebo.Conclusion: HT significantly lowers insulin resistance in healthy, non-diabetic postmenopausal women, with E alone yielding greater reductions than combination therapy.","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Climacteric","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13697137.2025.2509844","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Menopause increases the risk of insulin resistance and cardiometabolic diseases. This study summarizes the effects of hormone therapy (HT) on insulin resistance in non-diabetic postmenopausal women.

Method: The study analyzed randomized controlled trials (1998-2024) that assessed the impact of HT on insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) in non-diabetic postmenopausal women. Raw mean differences (RMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analysis compared estrogen alone (E alone) and estrogen plus progestogen (E + P) to placebo.

Results: Seventeen randomized controlled trials with 5772 women (3644 on HT: E alone [n = 1259] or E + P [n = 2385]; 2128 on placebo) were included. The weighted mean (standard deviation) age was 56.91 (5.95) years, with treatment lasting 8 weeks to 3 years. HT significantly reduced HOMA-IR (RMD = -0.24 [-0.32 to -0.16], p < 0.001, I² = 60.3%). Subgroup analysis showed reductions in both E alone (RMD = -0.42 [-0.55 to -0.29], p < 0.001, I² = 35%) and E + P (RMD= -0.14 [-0.23 to -0.04], p = 0.005, I² = 13.7%) compared to placebo.

Conclusion: HT significantly lowers insulin resistance in healthy, non-diabetic postmenopausal women, with E alone yielding greater reductions than combination therapy.

查看原文本刊更多论文

非糖尿病绝经后妇女的激素治疗和胰岛素抵抗：一项系统回顾和荟萃分析。

目的：绝经增加胰岛素抵抗和心脏代谢疾病的风险。本研究总结了激素治疗（HT）对非糖尿病绝经后妇女胰岛素抵抗的影响。方法：本研究分析了1998-2024年的随机对照试验，这些试验使用胰岛素抵抗稳态模型评估非糖尿病绝经后妇女的胰岛素抵抗（HOMA-IR），评估了激素对胰岛素抵抗的影响。使用随机效应模型计算95%置信区间（ci）的原始平均差异（rmd）。亚组分析比较单独雌激素（E单独）和雌激素加孕激素（E + P）与安慰剂。结果：17项随机对照试验，涉及5772名女性(其中3644名接受HT: E单独治疗[n = 1259]或E + P治疗[n = 2385]；包括2128名安慰剂组)。加权平均（标准差）年龄56.91（5.95）岁，治疗时间8周~ 3年。HT显著降低HOMA-IR （RMD = -0.24[-0.32至-0.16],p 2 = 60.3%）。亚组分析显示，与安慰剂相比，E单独（RMD= -0.42[-0.55至-0.29],p 2 = 35%）和E + p （RMD= -0.14[-0.23至-0.04],p = 0.005, p 2 = 13.7%）均有所降低。结论：激素治疗可显著降低健康、非糖尿病绝经后妇女的胰岛素抵抗，单独雌激素治疗比联合治疗效果更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Climacteric 医学-妇产科学

CiteScore

1.70

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.