26.11. Effects of hormone therapy and calcium supplementation on morbidity and mortality in postmenopausal women

Public examination of a doctoral dissertation in the field of medicine

Doctoral candidate: Lic Med Kati Pentti

Time and venue: 26.11.2011 at 12 noon, Mediteknia Auditorium, Kuopio Campus

Language of the public examination: Finnish

Language of the doctoral dissertation: English

Understanding the risks and benefits of HT is critical to clinical decision-making around menopause and beyond. The purpose of this population-based cohort study was to investigate whether HT has an effect on mortality and diabetes morbidity and also to investigate whether calcium or calcium + vitamin D supplementation has an effect on CHD morbidity in ageing women. Agreement analysis was performed to verify the accuracy of self-reported estrogen use versus prescription data. Validity analysis showed that a postal inquiry is a reliable method of recording long-term HT use.

This study is part of the large Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) population-based prospective cohort study. The study population consisted of 11 667 women resident in Kuopio Province and a postmenopausal subgroup of 9354 women who responded to postal inquiries in 1989 and 1994 and whose HT and calcium or calcium + vitamin D supplementation use was verified. A total of 8483 postmenopausal women who were non-diabetic in May 1994 also responded to a third follow-up inquiry in May 1999 which formed the final study population concerning HT and DM morbidity.              

The results showed that a history of HT use does not affect overall or CHD mortality in women. Breast cancer mortality tended to be associated with HT use > 5 years (HR 2.62, 95% CI 0.98–7.00) in the entire study population. In the postmenopausal subgroup, breast cancer mortality was not associated with HT use. The results of this study show that HT has a beneficial (protective) effect on DM morbidity. Postmenopausal women who were past HT users had a 19% (nonsignificant) lower risk of DM than postmenopausal women who had never used HT. HT use during the 5-year follow-up decreased the incidence of DM as follows: part-time use (< 2.5 years) by 47% (HR 0.53, 95% CI 0.24–1.15) and continuous use (2.5−5.0 years) by 69% (HR 0.31, 95% CI 0.16–0.60). In addition, calcium or calcium + vitamin D supplementation appears to be associated with an increased risk of CHD among women aged 52–68. Postmenopausal women who used calcium or calcium + vitamin D supplements had a 26% (HR 1.26, 95% CI 1.01-1.57) increased risk of CHD than nonusers.

The doctoral dissertation of Licenciate of Medicine , Specialist in Obstetrics and Gynaecology,  Specialist in Reproductive Medicine Kati Pentti, entitled Effects of hormone therapy and calcium supplementation on morbidity and mortality in postmenopausal women will be examined at the Faculty of Health Sciences. The opponent in the public examination will be Professor Jorma Heikkinen of Oulu Deaconess Institute and the custos will be Professor Seppo Heinonen of the University of Eastern Finland.

Photo available for download at http://www.uef.fi/vaitoskuvat  

Contact: Kati Pentti, tel. 050 502 0912, kati.pentti(at)fimnet.fi

Publishing year: 2011

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