Predictors of Insulin Resistance in Postmenopausal Women / 대한폐경학회지

ABSTRACT

OBJECTIVES: Insulin resistance plays an important role in cardiovascular diseases, type 2 diabetes, and non-alcoholic fatty liver disease. The objective of this study was to determine the association between obesity and elevated alanine aminotransferase (ALT) with insulin resistance and compare these factors with metabolic syndrome in postmenopausal women. METHODS: We analyzed 606 postmenopausal women who had visited the Health Promotion Center. The medical history and lifestyle data were collected by questionnaire and history taking. Anthropometric parameters and blood pressure were measured. Laboratory tests included fasting glucose and insulin levels, and liver and lipid profiles. Metabolic syndrome was defined based on NCEP-ATP III criteria. As a maker of insulin resistance, the homeostatic model assessment-insulin resistance (HOMA-IR) was calculated. We grouped all subjects into four groups, based on the quartiles of HOMA-IR. The top fourth quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis for the odds ratio of the risk for insulin resistance. RESULTS: The prevalence rates of obesity (body mass index > or = 25 kg/m2) and elevated ALT (> or = 34 U/L) increased with increased HOMA-IR. Obesity and elevated ALT were associated with insulin resistance, after adjusting for age, smoking status, and exercise. Women with co-existing obesity and elevated ALT were at increased risk for insulin resistance (OR = 5.87; 95% CI, 2.93~11.74) compared to women with metabolic syndrome (OR = 3.43; 95% CI, 2.18~5.41). CONCLUSION: Obesity and elevated ALT are associated with insulin resistance in postmenopausal women. A combination of these factors is superior to metabolic syndrome in predicting insulin resistance.