Magazine article Clinical Psychiatry News

Estrogen Linked to Atrophy in Women with Diabetes

Magazine article Clinical Psychiatry News

Estrogen Linked to Atrophy in Women with Diabetes

Article excerpt

AT AAIC 2015

WASHINGTON -- Women with type 2 diabetes who take estrogen therapy showed lower total gray matter volume, with atrophy particularly evident in the hippocampus.

A new analysis of the Women s Health Initiative Memory study suggested that these hormone therapy-related decrements in brain volume seem to stabilize in the years after treatment ends. However, said Christina E. Hugenschmidt, Ph.D., the findings also suggested caution when considering a prescription for estrogen therapy for a woman with emerging or frank diabetes.

"The concern is that prescribing estrogen to a woman with diabetes could increase her risk of brain atrophy," she said at the Alzheimer's Association International Conference 2015.

Dr. Hugenschmidt of Wake Forest University, Winston-Salem, N.C., reviewed data from the Women's Health Initiate Memory Study-MRI (WHIMS-MRI).

The parallel placebo-controlled trial randomized women aged 65 years and older to placebo, or 0.625 mg conjugated equine estrogen with or without 2.5 mg progesterone. They were all free of cognitive decline at baseline.

Dr. Hugenschmidt focused on 1,400 women who underwent two magnetic resonance imaging brain scans: one 2.5 years after beginning the study and another about 5 years after that.

At enrollment, the women were a mean age of 70 years old; 124 had type 2 diabetes. About 42% had long-standing disease of 10 years or longer. Not surprisingly, there were some significant differences between the diabetic and nondiabetic groups: Body mass index, waist girth, and waist/hip ratio were all significantly larger in the women with diabetes.

At the first scan, women with diabetes who had been randomized to estrogen therapy had about 18 cc less total brain volume than those without diabetes. The brain volumes of women with diabetes who were taking placebo were nearly identical to those of the nondiabetic women, regardless of what treatment they were taking. …

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