Impact of Menstrual Cycle Phase on Insulin Sensitivity Measures and Fasting Lipids

Abstract

There is evidence to suggest that insulin sensitivity may vary in response to changes in sex hormone levels. However, the results of human studies designed to investigate changes in insulin sensitivity through the menstrual cycle have proved inconclusive. The aims of this study were to 1) evaluate the impact of menstrual cycle phase on insulin sensitivity measures and 2) determine the variability of insulin sensitivity measures within the same menstrual cycle phase. A controlled observational study of 13 healthy premenopausal women, not taking any hormone preparation and having regular menstrual cycles, was conducted. Insulin sensitivity (Si) and glucose effectiveness (Sg) were measured using an intravenous glucose tolerance test (IVGTT) with minimal model analysis. Additional surrogate measures of insulin sensitivity were calculated (homoeostasis model for insulin resistance [HOMA IR], quantitative insulin-to-glucose check index [QUICKI] and revised QUICKI [rQUICKI]), as well as plasma lipids. Each woman was tested in the luteal and follicular phases of her menstrual cycle, and duplicate measures were taken in one phase of the cycle. No significant differences in insulin sensitivity (measured by the IVGTT or surrogate markers) or plasma lipids were reported between the two phases of the menstrual cycle or between duplicate measures within the same phase. It was concluded that variability in measures of insulin sensitivity were similar within and between menstrual phases.

insulin sensitivity - menstrual cycle - IVGTT

References

• 1 Wallace TM, Matthews DR. The assessment of insulin resistance in man.  Diabet Med. 2002;  19 527-534
• 2 Stern MP. Do non-insulin-dependent diabetes mellitus and cardiovascular disease share common antecedents?.  Ann Intern Med. 1996;  124 110-116
• 3 Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease.  Diabetes. 1988;  37 1595-1607
• 4 DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance.  Am J Physiol. 1979;  237 E214-E223
• 5 Bergman RN. Lilly lecture 1989. Toward physiological understanding of glucose tolerance. Minimal-model approach.  Diabetes. 1989;  38 1512-1527
• 6 Saad MF, Anderson RL, Laws A, Watanabe RM, Kades WW, Chen YD. et al . A comparison between the minimal model and the glucose clamp in the assessment of insulin sensitivity across the spectrum of glucose tolerance. Insulin Resistance Atherosclerosis Study.  Diabetes. 1994;  43 1114-1121
• 7 Brady LM, Gower BA, Lovegrove SS, Williams CM, Lovegrove JA. Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model.  Int J Obes Relat Metab Disord. 2004;  28 222-227
• 8 Valdes CT, Elkind-Hirsch KE. Intravenous glucose tolerance test-derived insulin sensitivity changes during the menstrual cycle.  J Clin Endocrinol Metab. 1991;  72 642-646
• 9 Escalante-Pulido JM, Alpizar-Salazar M. Changes in insulin sensitivity, secretion and glucose effectiveness during menstrual cycle.  Arch Med Res. 1999;  30 19-22
• 10 Gonzalez-Ortiz M, Martinez-Abundis E, Lifshitz A. Insulin sensitivity and sex steroid hormone levels during the menstrual cycle in healthy women with non-insulin-dependent diabetic parents.  Gynecol Obstet Invest. 1998;  46 187-190
• 11 Trout KK, Rickels MR, Schutta MH, Petrova M, Freeman EW, Tkacs NC. et al . Menstrual cycle effects on insulin sensitivity in women with type 1 diabetes: a pilot study.  Diabetes Technol Ther. 2007;  9 176-182
• 12 Yki-Järvinen H. Insulin sensitivity during the menstrual cycle.  J Clin Endocrinol Metab. 1984;  59 350-353
• 13 Diamond MP, Jacob R, Connolly-Diamond M, DeFronzo RA. Glucose metabolism during the menstrual cycle. Assessment with the euglycemic, hyperinsulinemic clamp.  J Reprod Med. 1993;  38 417-421
• 14 Toth EL, Suthijumroon A, Crockford PM, Ryan EA. Insulin action does not change during the menstrual cycle in normal women.  J Clin Endocrinol Metab. 1987;  64 74-80
• 15 Israel R, Mishell Jr DR, Stone SC, Thorneycroft IH, Moyer DL. Single luteal phase serum progesterone assay as an indicator of ovulation. 1972.  Am J Obstet Gynecol. 1997;  176 490 , , discussion 491
• 16 Pacini G, Bergman RN. MINMOD: a computer program to calculate insulin sensitivity and pancreatic responsivity from the frequently sampled intravenous glucose tolerance test.  Comput Methods Programs Biomed. 1986;  23 113-122
• 17 Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G. et al . Quantitative Insulin Sensitivity Check Index: a simple, accurate method for assessing insulin sensitivity in humans.  J Clin Endocrinol Metab. 2000;  85 2402-2410
• 18 Perseghin G, Caumo A, Caloni M, Testolin G, Luzi L. Incorporation of the fasting plasma FFA concentration into QUICKI improves its association with insulin sensitivity in nonobese individuals.  J Clin Endocrinol Metab. 2001;  86 4776-4781
• 19 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
• 20 Anderson RL, Hamman RF, Savage PJ, Saad MF, Laws A, Kades WW. et al . Exploration of simple insulin sensitivity measures derived from frequently sampled intravenous glucose tolerance (FSIGT) tests: the insulin resistance atherosclerosis study.  Am J Epidemiol. 1995;  142 724-732
• 21 Gill JM, Malkova D, Hardman AE. Reproducibility of an oral fat tolerance test is influenced by phase of menstrual cycle.  Horm Metab Res. 2005;  37 336-341
• 22 Marsden PJ, Murdoch A, Taylor R. Adipocyte insulin action during the normal menstrual cycle.  Hum Reprod. 1996;  11 968-974
• 23 Livingstone C, Collison M. Sex steroids and insulin resistance.  Clin Sci. 2002;  102 151-166
• 24 Schijf CP, Mooren MJ van der, Doesburg WH, Thomas CM, Rolland R. Differences in serum lipids, lipoproteins, sex hormone binding globulin and testosterone between the follicular and the luteal phase of the menstrual cycle.  Acta Endocrinol (Copenh). 1993;  129 130-133
• 25 Jones DY, Judd JT, Taylor PR, Campbell WS, Nair PP. Influence of dietary fat on menstrual cycle and menses length.  Hum Nutr Clin Nutr. 1987;  41 341-345
• 26 Lebech AM, Kjaer A. Lipid metabolism and coagulation during the normal menstrual cycle.  Horm Metab Res. 1989;  21 445-448
• 27 Woods M, Schaefer EJ, Morrill A, Goldin BR, Longcope C, Dwyer JD. et al . Effect of menstrual cycle phase on plasma lipids.  J Clin Endocrinol Metab. 1987;  65 321-323
• 28 Wendler D, Michel E, Kastner P, Schmahl FW. Menstrual cycle exhibits no effect on postprandial lipemia.  Horm Metab Res. 1992;  24 580-581

Correspondence