Association between hyperinsulinemia and endogenous androgen levels in peri- and postmenopausal women

We evaluated the relationship between hyperinsulinemia and anthropometric, metabolic, and hormonal parameters that might contribute to the risk for coronary heart disease (CHD) in 104 peri- and postmenopausal women. Plasma glucose, insulin, luteinizing hormone (LH), follicle-stimulating hormone (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 microIU/mg. Mean age was 54.8 years. Mean age at menopause was 47.7 years. Body mass index (BMI) was greater than 25 in 46 patients, and 28 (26.9%) were hyperinsulinemic. BMI, waist circumference, triglycerides, and 2-hour postglucose insulin levels were significantly higher in hyperinsulinemic patients. Hyperinsulinemic patients had higher TT levels (P =.02), FAI (P =.0001), and lower SHBG levels (P =.003). Positive correlations were observed between IGR and BMI, waist-to-hip ratio (WHR), waist circumference, and triglycerides. IGR and high-density lipoprotein-cholesterol (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 risk factors for cardiovascular diseases in peri- and postmenopausal women. However, this observation should be confirmed by longitudinal studies.