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Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study

¹ Department of Obstetrics and Gynecology, Kuopio University Hospital, FIN-70211 Kuopio, Finland² Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland³ Bone and Cartilage Research Unit, University of Kuopio, Kuopio, Finland⁴ Department of Orthopaedics, Traumatology and Handsurgery, Kuopio University Hospital, Kuopio, Finland⁵ Department of Surgery, Institute of Clinical Medicine, Kuopio University Hospital, Kuopio, Finland⁶ Research Institute of Public Health, University of Kuopio, Kuopio, Finland

(Correspondence should be addressed to K Pentti; Email: kati.pentti{at}fimnet.fi)

Objectives: The purpose of this population-based prospective cohort study was to examine the effect of hormone therapy (HT) on incidence of diabetes mellitus (DM).

Design and methods: Eight thousand four hundred and eighty-three DM-free post-menopausal women aged 52–62 from the population-based Kuopio osteoporosis risk factor and prevention study were followed for 5 years from 1994–1999. Information about the use of HT and health events was obtained from three repeated questionnaires in 1989, 1994, and 1999. DM morbidity before and during the follow-up was obtained from the Registry of Specially Refunded Drugs of the Finnish Social Insurance Institution. Kaplan–Meyer survival curves and Cox's proportional-hazards models were used to estimate the risk of incident DM in relation to the use of HT.

Results: During the follow-up, 40.8% DM-free post-menopausal women had never used HT, 27.3% women were HT past users and 31.9% women had used HT presently during the follow-up. During the follow-up, 162 incident DM cases were recorded. Compared with never users of HT, the adjusted hazard ratio of DM was 0.81 (95% confidence interval (CI) 0.57–1.16) for only past users, 0.53 (95% CI 0.24–1.15) in part-time (during the follow-up <2.5 years) users and 0.31 (95% CI 0.16–0.60) in continuous (during the follow-up 2.5–5.0 years) users of HT.

Conclusions: HT use decreases the incidence of DM in post-menopausal women.