Predictors of worsening insulin sensitivity in postmenopausal women.
OBJECTIVE
The purpose of this study was to determine predictors of worsening insulin sensitivity in postmenopausal women.


METHODS
Seventy-one nonobese postmenopausal women were assigned randomly to receive hormone replacement therapy (conjugated estrogens, 0.625 mg, plus medroxyprogesterone acetate, 2.5 mg) or placebo daily for 1 year (34 women received hormone replacement therapy, and 37 women received placebo). At baseline and 12 months, the women received a computed tomography scan at the L4-L5 vertebral disk space, a dual x-ray absorptiometry scan, a euglycemic hyperinsulinemic clamp to measure insulin sensitivity, and a lipid profile. Declining insulin sensitivity was defined as the largest quartile change in insulin sensitivity in the women who received the placebo (-1.42 mg/min/kg lean body mass).


RESULTS
By univariate analysis, we found that significant predictors of worsening insulin sensitivity were the use of hormone replacement therapy, baseline insulin sensitivity, a younger age, and <10 years since menopause. By logistic regression, we determined that hormone replacement therapy use and higher baseline insulin sensitivity were independent predictors of worsening insulin sensitivity.


CONCLUSIONS
The use of hormone replacement therapy and baseline insulin sensitivity are significant independent predictors of the development of worsening insulin sensitivity in postmenopausal women.
Goodrow
Gwen J
GJ
Department of Obstetrics and Gynecology, The University of Vermont College of Medicine, Burlington, VT, USA.
L'Hommedieu
Georgia D
GD
Gannon
Barbara
B
Sites
Cynthia K
CK
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000235:genetics; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose; D004966:Estrogens, Conjugated (USP); D007328:Insulin; D017258:Medroxyprogesterone Acetate