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Insulin resistance independently influences arterial stiffness in normoglycemic normotensive postmenopausal women

Park, Jong Suk MD1; Nam, Ji Sun MD1; Cho, Min Ho MD1; Yoo, Jeong Seon MD1; Ahn, Chul Woo MD1; Jee, Sun Ha PhD2; Lee, Hong Soo MD3; Cha, Bong Soo MD1; Kim, Kyung Rae MD1; Lee, Hyun Chul MD1

doi: 10.1097/gme.0b013e3181cd3d60
Articles

Objective: Cardiovascular disease risk increases after menopause, which may be related to insulin resistance, and arterial stiffness is a significant predictor of atherosclerosis. We investigated the relationships among insulin resistance, adiponectin, and arterial stiffness in normoglycemic normotensive postmenopausal women.

Methods: From 9,555 participants who had routine health checkups, 455 normoglycemic normotensive postmenopausal women were enrolled. Serum concentrations of glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Pulse wave velocity (PWV) was evaluated to assess arterial stiffness.

Results: The women were stratified into three groups according to their HOMA-IR values, and comparisons were made among the three groups. There were significant differences in metabolic parameters between the groups. The mean age, body mass index, waist circumference, fasting plasma glucose, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), aortic PWV, and peripheral PWV increased sequentially with the degree of insulin resistance. Meanwhile, HDL-C and adiponectin levels decreased with the worsening of insulin resistance. Age, body mass index, fasting plasma glucose, TG, insulin, SBP, HOMA-IR, aortic PWV, and peripheral PWV were significantly higher in women with central obesity, and HDL-C and adiponectin were significantly lower in women with central obesity. Aortic PWV and peripheral PWV were significantly correlated with age, waist circumference, total cholesterol, SBP, DBP, insulin, and HOMA-IR, but adiponectin was not associated with PWV. The results of multiple regression analysis indicated that SBP, DBP, and insulin resistance were independently correlated with PWV.

Conclusions: Insulin resistance was independently associated with PWV in normoglycemic normotensive postmenopausal women.

Insulin resistance was independently associated with pulse wave velocity in normoglycemic normotensive postmenopausal women.

From the Departments of 1Internal Medicine and 2Epidemiology and Health Promotion, Yonsei University College of Medicine; and 3Department of Family Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Received October 26, 2009; revised and accepted November 24, 2009.

Funding/support: This study was supported by a grant from the Seoul R&BD Program, Republic of Korea (10526).

Financial disclosure/conflicts of interests: None reported.

Address correspondence to: Chul Woo Ahn, MD, Division of Endocrinology, Department of Internal Medicine, Kangnam Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-ku, PO Box 135-720, Seoul, Korea. E-mail: acw@yuhs.ac

©2010The North American Menopause Society