The effects of the menopause on insulin sensitivity, secretion and elimination in non‐obese, healthy women

Walton, Christopher; Godsland, Ian F.; Proudler, Anthony J.; Wynn, V.; Stevenson, John C.

doi:10.1111/j.1365-2362.1993.tb00792.x

Cited by 182 publications

(111 citation statements)

References 44 publications

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“…However, others have shown no significant difference in insulin sensitivity among post-menopausal women compared to pre-menopausal women. 34,35 In our study, there was no significant difference in fasting plasma glucose, insulin levels, HOMA-IR, and prevalence of hyperglycemia between pre-menopausal and post-menopausal women (Tables 1 and 2).…”

Section: Discussionmentioning

confidence: 48%

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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Section: Discussionmentioning

confidence: 48%

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

et al. 2006

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“…Our study indicated that the potential benefit from consuming tofu and other soy products was primarily confined to postmenopausal women with a low BMI. It has been shown that loss of sex hormones at menopause is associated with reduced insulin sensitivity (Proudler et al, 1992;Walton et al, 1993), while the increased insulin resistance is ameliorated among those using HRT at a relatively low dose (Palin et al, 2001). Phytoestrogens are similar to estrogens in molecular structure and exert weakly estrogenic action under endogenous estrogen-depleted circumstances (Adlercreutz & Mazur, 1997;Bhathena & Velasquez, 2002).…”

Section: Discussionmentioning

confidence: 99%

Soyfood consumption and risk of glycosuria: a cross-sectional study within the Shanghai Women's Health Study

et al. 2004

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Objective: To assess the association between soyfood intake and risk of glycosuria. Design and methods: A cross-sectional study was conducted among participants of the Shanghai Women's Health Study, a population-based cohort study of women aged 40-70 y. Information on usual intake of soyfoods was obtained at baseline survey through an in-person interview using a validated food-frequency questionnaire. Included in this study were 39,385 cohort members screened for diabetes at the baseline survey and free of previously diagnosed diabetes, cardiovascular diseases, kidney diseases, and cancer. There were 323 women who tested positive for urine glucose. Odds ratios (ORs) and 95% confidence intervals (CIs) were employed to measure the association between soyfood intake and glycosuria using unconditional logistic regression. Setting: Urban communities of Shanghai, China. Results: Overall, soyfood intake was not related to the risk of glycosuria. Among postmenopausal women, however, intake of tofu and other soy products was inversely associated with risk of glycosuria after adjustment for potential confounders. The ORs across quintiles of intake were 1.0, 0.75 (95% CI ¼ 0.47-1.20), 0.79 (95% CI ¼ 0.51-1.25), 0.53 (95% CI ¼ 0.32-0.88), and 0.51 (95% CI ¼ 0.26-0.98; P for trend ¼ 0.05). Further analyses showed that the inverse association was primarily confined to postmenopausal women with a body mass index (BMI) of o25 kg/m 2 . The adjusted OR comparing the extreme quintiles was 0.36 (95% CI ¼ 0.13-0.97; P for trend ¼ 0.004). Conclusions: Soyfoods may play a role in the development of glycosuria, an important indicator of diabetes, among postmenopausal women with a low BMI.

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“…In other studies (21), both fasting glucose and insulin increased more in women who became menopausal than in premenopausal women, although the glucose response to OGTT did not differ. The most detailed evaluation to date (22), indicated that the menopause 220 F Cucinelli and others EUROPEAN JOURNAL OF ENDOCRINOLOGY (1999) 140 Figure 3 Left: Plasma C-peptide concentrations expressed as time courses over 240 min after glucose load in the entire study population (All), and the hyperinsulinemic (H) and normoinsulinemic (N) groups of postmenopausal women, before treatment (S), after 12 weeks of unopposed transdermal estrogen therapy (A) and after 12 weeks of added dydrogesterone (K). Data points represent means Ϯ S.E.…”

Section: Discussionmentioning

confidence: 99%

Differential effect of transdermal estrogen plus progestagen replacement therapy on insulin metabolism in postmenopausal women: relation to their insulinemic secretion

Cucinelli¹,

Paparella²,

Soranna³

et al. 1999

European Journal of Endocrinology

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Objective: To evaluate the impact on glucose and insulin metabolism of transdermal estrogen patches before and after the addition of cyclic dydrogesterone in postmenopausal women. Design: We studied 21 postmenopausal women seeking treatment for symptomatic menopause. All patients received transdermal 50 mg/day estradiol for 24 weeks. After 12 weeks of treatment, 10 mg/day dydrogesterone were added. Methods: During both regimens, insulin and C-peptide plasma concentrations were evaluated after an oral glucose tolerance test (OGTT); insulin sensitivity was evaluated by a hyperinsulinemic euglycemic clamp technique. Insulin and C-peptide response to OGTT were expressed as area under the curve (AUC) and as incremental AUC; insulin sensitivity was expressed as mg/kg body weight. Fractional hepatic insulin extraction (FHIE) was estimated by the difference between the incremental AUC of the C-peptide and insulin divided by the incremental AUC of the C-peptide. Plasma hormone and lipid concentrations were assessed at baseline and at 12 and 24 weeks of treatment. Results: Nine patients proved to be hyperinsulinemic and 12 were normoinsulinemic. Transdermal estrogen treatment significantly decreased the insulin AUC (P < 0.05) and the insulin incremental AUC in hyperinsulinemic patients; addition of dydrogesterone further decreased both the AUC and incremental AUC of insulin. Estrogen alone and combined with dydrogesterone evoked a significant increase in C-peptide AUC in hyperinsulinemic (79.2%) and normoinsulinemic (113%) patients. The treatment increased the values for FHIE and insulin sensitivity in all patients (P < 0.04) and in the hyperinsulinemic group (P < 0.01), whereas it did not affect such parameters in normoinsulinemic patients. Conclusions: Transdermal estrogen substitution alone and combined with cyclical dydrogesterone may ameliorate hyperinsulinemia in a selected population of postmenopausal women.

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The effects of the menopause on insulin sensitivity, secretion and elimination in non‐obese, healthy women

Cited by 182 publications

References 44 publications

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

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

Soyfood consumption and risk of glycosuria: a cross-sectional study within the Shanghai Women's Health Study

Differential effect of transdermal estrogen plus progestagen replacement therapy on insulin metabolism in postmenopausal women: relation to their insulinemic secretion

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