Associação entre hiperinsulinemia e níveis de androgênios endógenos em mulheres na peri e pós-menopausa

Abstract

We evaluated the relationship between hyperinsulinemia and anthropometric, metabolic, and hormonal parameters that might contribute to risk for coronary heart disease in 104 peri and postmenopausal women. Plasma glucose, insulin, LH, FSH, sex hormone binding globulin (SHBG), and total testosterone (TT) were determined. Free androgen index (FAI) and fasting insulin to glucose ratio (IGR) were calculated. The cut-off point to define hyperinsulinemia was established at 23 mIU/mg. Mean age was 54.8 years. Mean age at menopause was 47.7 years. Body mass index (BMI) was >25 in 46 patients, and 28 (26.9%) were hyperinsulinemic. BMI, waist circumference, triglycerides, and 2-hour post-glucose insulin levels were significantly higher in hyperinsulinemic patients. Hyperinsulinemic patients had higher TT levels (p=0.02), FAI (p=0.0001), and lower SHBG levels (p=0.003). Positive correlations were observed between IGR and BMI, waist to hip ratio, waist circumference, and triglycerides. IGR and HDL-C were negatively correlated. IGR presented a positive association with TT and FAI, and a negative association with SHBG. FAI contributed positively to IGR, independently of BMI, age, or time since menopause. In conclusion, androgen levels may be important determinants of cardiovascular risk in peri and postmenopausal women. However, this observation should be confirmed by longitudinal studies.