title: Cross-sectional correlates of fasting hyperinsulinaemia in post-menopausal women of different ethnic origin.
abstract: OBJECTIVE
  In a large ethnically diverse nationwide sample of post-menopausal women we explored the relationship between fasting insulin levels, ethnicity, and a wide range of anthropometric, socio-economic, and lifestyle factors.
  
  
  METHODS
  Subjects were post-menopausal women aged 50-79 years without diagnosed diabetes mellitus comprising a subsample (n = 3500) of the Women's Health Initiative (WHI) Clinical Trial and Observational Study. In a cross-sectional survey at baseline, we analysed the association between ethnicity and fasting insulin using analysis of covariance procedures and identified independent correlates of hyperinsulinaemia, defined by the 75th percentile cut point for each ethnic group.
  
  
  RESULTS
  Fasting insulin levels were higher among African-American and Hispanic women than among non-Hispanic White or Asian women. These differences persisted after adjustment for age, educational attainment, total and central body obesity, adult weight change, family history of diabetes, smoking status, alcohol consumption, use of menopausal hormone therapy and physical activity. Higher levels of body mass index, waist-hip ratio, adult weight gain, and lower levels of total and moderate or strenuous recreational activity were independent correlates of fasting hyperinsulinaemia. Habitual walking was also inversely associated with fasting insulin.
  
  
  CONCLUSIONS
  In this cross-sectional analysis, fasting insulin levels were higher among African-American and Hispanic post-menopausal women as compared with non-Hispanic White and Asian women. In addition, obesity, adult weight gain, and low levels of moderate or strenuous physical activity were independently associated with hyperinsulinaemia.
authors.affiliation: Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. apradhan@partners.org
authors.forename: A D
authors.initials: AD
authors.lastname: Pradhan
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.forename: S L
authors.initials: SL
authors.lastname: Hendrix
authors.forename: K C
authors.initials: KC
authors.lastname: Johnson
authors.forename: L E
authors.initials: LE
authors.lastname: Wagenknecht
authors.forename: M N
authors.initials: MN
authors.lastname: Haan
authors.forename: G
authors.initials: G
authors.lastname: Weidner
authors.forename: A Z
authors.initials: AZ
authors.lastname: Lacroix
authors.forename: N R
authors.initials: NR
authors.lastname: Cook
mesh_terms: D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D004032:Diet; D015444:Exercise / Q000502:physiology; D005215:Fasting / Q000378:metabolism; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology / Q000208:ethnology*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D049629:Waist-Hip Ratio; D015430:Weight Gain / Q000502:physiology; D044465:White People
chemical_list: D007328:Insulin