Original ArticlesComparison of Estimates of Insulin Sensitivity in Pre- and Postmenopausal Women Using the Insulin Tolerance Test and the Frequently Sampled Intravenous Glucose Tolerance Test

Lindheim, Steven R.; Buchanan, Thomas A.; Duffy, Daniel M.; Vijod, Marcela A.; Kojima, Tetsuya; Stanczyk, Frank Z.; Løbo, Rogerio A.

doi:10.1177/107155769400100210

Cited by 121 publications

(67 citation statements)

References 17 publications

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“…An increment in visceral adipose tissue deposition and worsening insulin-stimulated glucose disposal has been observed during the menopause transition. 35,36 We did not observe differences in any of the measured parameters before as compared with 4 months after surgical menopause among the SS women who remained SS, the salt resistant who became SS, or the salt resistant who remained salt resistant (Table 3). These findings suggest that, although salt-resistant women developed SS within 4 months after surgical menopause, elevation of blood pressure and changes in metabolic profile do not occur within this time frame.…”

Section: Discussionmentioning

confidence: 88%

Surgical Menopause Increases Salt Sensitivity of Blood Pressure

et al. 2006

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Abstract-Salt sensitivity of blood pressure is associated with an elevated risk of developing hypertension (HTN) and is an independent risk factor for cardiovascular disease. The prevalence of HTN increases after menopause. The aim of this study was to investigate prospectively whether the loss of ovarian hormones increases the occurrence of salt sensitivity among healthy premenopausal women. We enrolled 40 normotensive, nondiabetic women (age 47.2Ϯ3.5), undergoing hysterectomy-oophorectomy for nonneoplastic processes and not on hormone replacement, to determine the effect of changes in sodium intake on blood pressure the day before and subsequently 4 months after surgical menopause. Salt loading was achieved using a 2-L normal saline infusion and salt depletion produced by 40 mg of intravenous furosemide. A decrease Ͼ10 mm Hg in systolic blood pressure between salt loading and salt depletion was used to define salt sensitivity. Before and after menopause, salt-sensitive women exhibited higher waist/hip and waist/thigh ratios (PϽ0.01). Although all of the women remained normotensive, the prevalence of salt sensitivity was significantly higher after surgical menopause (21 women; 52.5%) than before (9 women; 22.5%; Pϭ0.01), because 12 (38.7%) salt-resistant women developed salt sensitivity after menopause. In summary, we demonstrated that the prevalence of salt sensitivity doubled as early as 4 months after surgical menopause, without an associated increase in blood pressure. Epidemiological studies indicate that development of HTN may not occur until 5 to 10 years after menopause. The loss of ovarian hormones may unmask a population of women prone to salt sensitivity who, with aging, would be at higher risk for the subsequent development of HTN and cardiovascular disease.

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Section: Discussionmentioning

confidence: 88%

Surgical Menopause Increases Salt Sensitivity of Blood Pressure

et al. 2006

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“…Lindheim et al, 33 for example, have found reduced insulin sensitivity (i.e. higher insulin resistance) in post-menopausal women, compared with BMI-matched pre-menopausal women.…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance, obesity, and metabolic syndrome among non-diabetic pre- and post-menopausal women in North Taiwan

et al. 2006

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Objective: To investigate the relationship between the metabolic syndrome and its related factors among non-diabetic pre-and post-menopausal women in North Taiwan. Design: A cross-sectional study in a medical center in North Taiwan. Subjects: Five hundred and ninety-four, non-diabetic middle-aged women (age range ¼ 40-64 years, mean ¼ 48.975.4 years) were recruited. Measurements: The fasting plasma glucose, insulin, lipids levels and anthropometric indices were measured. The homeostasis model assessment was applied to estimate the degree of insulin resistance (HOMA-IR). Metabolic syndrome was defined by using the National Cholesterol Education Panel (NCEP) criteria and modified NCEP criteria (waist circumference 480 cm). Results: The prevalence of metabolic syndrome was 6.2% using NCEP criteria, and 8.9% using modified NCEP criteria. Postmenopausal women had a higher prevalence of metabolic syndrome and its individual components compared to premenopausal women except hyperglycemia and low HDL-C. In multiple logistic regression analysis with adjustment for age and menopausal status, both BMI and HOMA-IR were independently associated with the metabolic syndrome. Conclusion: The prevalence of metabolic syndrome was higher in post-menopausal than pre-menopausal women. Both obesity and insulin resistance may play an important role in the development of metabolic syndrome among the middle-aged women in North Taiwan.

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“…This increased CVD risk after menopause has been partly attributed to the increment in visceral adipose tissue (AT) deposition and worsening insulin-stimulated glucose disposal observed during the menopause transition (1,2). There is also evidence indicating that there is an increase in insulin resistance (IR) with aging (3).…”

mentioning

confidence: 95%

Contribution of Abdominal Visceral Obesity and Insulin Resistance to the Cardiovascular Risk Profile of Postmenopausal Women

Piché

Corneau

et al. 2005

Diabetes

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The aim of this study was to determine the respective contribution of abdominal visceral adipose tissue (AT) accumulation and insulin resistance (IR) to the determination of a comprehensive cardiovascular metabolic risk profile in 108 postmenopausal women not receiving hormone therapy. Insulin sensitivity (M/I) was determined by a hyperinsulinemic-euglycemic clamp, and visceral AT area was measured by computed tomography. Median values of visceral AT (133.9 cm 2 ) and insulin sensitivity (0.010189 mg ⅐ kg ؊1 ⅐ min ؊1 ⅐ pmol ؊1 ) were used to form four subgroups: 1) low visceral AT-low IR (n ‫؍‬ 35), 2) low visceral AT-high IR (n ‫؍‬ 19), 3) high visceral AT-low IR (n ‫؍‬ 19), and 4) high visceral AT-high IR (n ‫؍‬ 35). Women with isolated IR (low visceral AT and high IR) were characterized by significantly higher fasting and 2-h glycemia and higher fibrinogen, triglyceride, and VLDL-apolipoprotein (apo)B concentrations than women with low visceral AT and low IR (P < 0.05). The plasma lipid-lipoprotein profile and inflammatory markers were not significantly different between women with high visceral AT and low IR and women with low visceral AT and low IR. Women with high visceral AT and high IR had higher fasting and 2-h glycemia, triglyceride, and VLDL-apoB levels; lower apoAI and HDL 2 cholesterol levels; as well as higher C-reactive protein and interleukin-6 concentrations than women with low visceral AT and low IR (P < 0.05). In addition, 15 of the 35 women (42.9%) in the high visceral AT and high IR group were newly diagnosed with type 2 diabetes, whereas no women were diagnosed with type 2 diabetes in the group of women with low visceral AT and low IR. These results show that although the presence of high IR in its isolated form is associated with some metabolic alterations, it is the combination of both high visceral AT and high IR that is the most detrimental for the metabolic health in postmenopausal women. Diabetes 54:770 -777, 2005 P ostmenopausal women are at higher risk of cardiovascular disease (CVD) than premenopausal women. This increased CVD risk after menopause has been partly attributed to the increment in visceral adipose tissue (AT) deposition and worsening insulin-stimulated glucose disposal observed during the menopause transition (1,2). There is also evidence indicating that there is an increase in insulin resistance (IR) with aging (3). Insulin resistance has been suggested as an important risk factor in the development of the metabolic syndrome, a cluster of abnormalities comprising glucose intolerance, dyslipidemia, high blood pressure, and impaired fibrinolysis activity that is associated with increased risk of developing type 2 diabetes and CVD (4). It is well demonstrated that obesity is a risk factor for type 2 diabetes and CVD (5). In addition, body fat distribution is also related to the risk of type 2 diabetes and CVD, and studies have shown that individuals with increased accumulation of visceral AT appear to develop the metabolic syndrome more frequently than those with an incr...

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Original ArticlesComparison of Estimates of Insulin Sensitivity in Pre- and Postmenopausal Women Using the Insulin Tolerance Test and the Frequently Sampled Intravenous Glucose Tolerance Test

Cited by 121 publications

References 17 publications

Surgical Menopause Increases Salt Sensitivity of Blood Pressure

Surgical Menopause Increases Salt Sensitivity of Blood Pressure

Insulin resistance, obesity, and metabolic syndrome among non-diabetic pre- and post-menopausal women in North Taiwan

Contribution of Abdominal Visceral Obesity and Insulin Resistance to the Cardiovascular Risk Profile of Postmenopausal Women

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