title: High prevalence of insulin resistance assessed by the glucose clamp technique in hormonal and non-hormonal contraceptive users.
abstract: OBJECTIVE
  To assess the prevalence of insulin resistance (IR) and associated factors in contraceptive users.
  
  
  METHODS
  A total of 47 women 18 to 40 years of age with a body mass index (kg/m(2)) < 30, fasting glucose levels < 100 mg/dl and 2-hour glucose level < 140 mg/dl after a 75-g oral glucose load were submitted to a hyperinsulinemic-euglycemic clamp. The women were distributed in tertiles regarding M-values. The analysed variables were use of combined hormonal/non-hormonal contraception, duration of use, body composition, lipid profile, glucose levels and blood pressure.
  
  
  RESULTS
  IR was detected in 19% of the participants. The women with low M-values presented significantly higher body fat mass, waist-to-hip ratio, fasting insulin, HOMA-IR and were nulligravida, showed > 1 year of contraceptive use and higher triglyceride levels. IR was more frequent among combined oral contraceptive users, however no association was observed after regression analysis.
  
  
  CONCLUSIONS
  The prevalence of IR was high among healthy women attending a family planning clinic independent of the contraceptive method used with possible long-term negative consequences regarding their metabolic and cardiovascular health. Although an association between hormonal contraception and IR could not be found this needs further research. Family planning professionals should be proactive counselling healthy women about the importance of healthy habits.
authors.affiliation: * Human Reproduction Unit, Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP) , Campinas, SP , Brazil.
authors.forename: Vaneska
authors.initials: V
authors.lastname: Melhado-Kimura
authors.forename: Sarah Monte
authors.initials: SM
authors.lastname: Alegre
authors.forename: Elizabeth João
authors.initials: EJ
authors.lastname: Pavin
authors.forename: Priscilla de Nazaré Silva
authors.initials: Pde N
authors.lastname: dos Santos
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
authors.forename: Arlete
authors.initials: A
authors.lastname: Fernandes
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D005215:Fasting / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique / Q000706:statistics & numerical data*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015995:Prevalence; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D003278:Contraceptives, Oral, Hormonal; D007328:Insulin; D014280:Triglycerides
keywords: Combined hormonal contraceptives; Contraceptive methods; Euglycemic clamp; Insulin resistance; Prevalence