Insulin resistance in postmenopausal women with metabolic syndrome and the measurements of adiponectin, leptin, resistin and ghrelin

Objective: Metabolic syndrome (MBS) is a significant health care problem in postmenopausalwomen and is driven largely by obesity. We wished to assess the prevalence of insulin resistance(IR), diagnosed using practical methods, and whether several adipocyte factors (adiponectin,leptin, resistin) or the gastric peptide ghrelin, associated with cardiovascular risk, might beabnormal and may relate to IR.Study design: We evaluated 37 obese postmenopausal women with MBS and 34 matched obesepremenopausal controls, as well as 14 non-obese premenopausal controls. We measured fastingglucose and insulin, performed 75g 2 hr oral glucose tolerance and intravenous insulin tolerancetests to assess IR, and measured fasting lipids, adiponectin, leptin, resistin and ghrelin.Results: The kinetic decline in glucose after insulin (kITT) as a marker of IR was the mostfrequently abnormal test (abnormal in 81%), with QUICKI, HOMA, and a modification of theMatsuda-DeFronzo index (ISIM) abnormal in 76, 73, and 68%, respectively. The GIR wasabnormal in only 35% of subjects. Leptin and resistin were elevated and adiponectin and ghrelinwere decreased in the postmenopausal women, compared to both groups of premenopausalcontrols. BMI correlated strongly with markers of insulin resistance as well as adipocytokinevalues. After controlling for BMI, only leptin was predictive of ISIM.Conclusion: Being overweight after menopause results in worsening IR and elevations inadipocytokine levels. While BMI is the most important factor, abnormal adipocytokine secretionmay enhance IR and increase cardiovascular risk in postmenopausal women. 2006 Mosby, Inc. All rights reserved.