Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. The association of endogenous sex hormones, adiposity, and insulin resistance with incident diabetes in postmenopausal women. Insulin resistance, hemostatic factors, and hormone interactions in pre- and perimenopausal women: SWAN. Increased risk of non-insulin dependent diabetes mellitus, arterial hypertension and coronary artery disease in perimenopausal women with a history of the polycystic ovary syndrome. Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study. Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Intense nonpharmacological intervention in subjects with multiple cardiovascular risk factors: decreased fasting insulin levels but only a minor effect on plasma plasminogen activator inhibitor activity. Association between circulating endogenous androgens and insulin sensitivity changes with exercise training in midlife women Posttraumatic stress disorder and incidence of type-2 diabetes: a prospective twin study. [Impact of weight loss on adipocytokines, C-reactive protein and insulin sensitivity in hypertensive women with central obesity]. Risk of T2DM and impaired fasting glucose among pcos subjects: Results of an 8-year follow-up Adipocytokines, obesity, and insulin resistance during combined androgen blockade for prostate cancer. Insulin resistance, dietary cholesterol, and cholesterol concentration in postmenopausal women. Lifestyle Changes May Reverse Development of the Insulin Resistance Syndrome. The Oslo Diet and Exercise Study: a randomized trial Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer Cardiovascular disease and risk factors in PCOS women of postmenopausal age: a 21-year controlled follow-up study. Clinical and biochemical characterization of women with polycystic ovary syndrome in North Rhine-Westphalia.
OBJECTIVE The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes . A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue ( AT ) and thigh muscle density . RESEARCH DESIGN AND METHODS A total of 28 obese postmenopausal women with type 2 diabetes were r and omly assigned to one of three 16-week treatments : control , aerobic only training ( Ae only ) , or aerobic plus resistance training ( Ae+RT ) . Pre- and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle . RESULTS Glucose infusion rates increased significantly ( P < 0.05 ) in the Ae+RT group . Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density . The Ae+RT training group exhibited a significantly greater increase in muscle density than the Ae only group . Improved glucose disposal was independently associated with changes in subcutaneous AT , visceral AT , and muscle density . Muscle density retained a relationship with glucose disposal after controlling for abdominal AT . CONCLUSIONS Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes . The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density CONTEXT In postmenopausal women , endogenous bioavailable testosterone ( T ) and estradiol ( E2 ) have been positively associated , and SHBG has been negatively associated , with incident type 2 diabetes ( T2DM ) . Previous studies have not explored possible factors explaining these relationships . OBJECTIVE Our objective was to examine the association of endogenous sex hormones with incident T2DM  in postmenopausal women and possible explanatory factors . DESIGN , SETTING , AND PARTICIPANTS The Multi-Ethnic Study of Atherosclerosis ( MESA ) is a prospect i ve study that included 1612 postmenopausal women aged 45 - 84 yr , followed between the years 2000 - 2006 , who were not taking hormone replacement therapy , had no prevalent cardiovascular disease or diabetes , and had complete ascertainment of sex hormones . MAIN OUTCOME MEASURES T2DM was defined based on fasting glucose and /or treatment for diabetes . RESULTS There were 116 incident cases of diabetes during follow-up . Across higher quartiles of bioavailable T and E2 and lower quartiles of SHBG , we found significantly greater hazards of developing incident T2DM ( all P for trend < or=0.001 ) . After adjustment for body mass index and insulin resistance estimated by homeostasis model assessment of insulin resistance , bioavailable T was no longer associated with incident T2DM . The associations of E2 and SHBG with incident T2DM were partially explained by body mass index and insulin resistance but persisted in fully adjusted models ( both P for trend < 0.02 ) . Dehydroepi and rosterone had no relationship with incident T2DM . CONCLUSIONS Adiposity and insulin resistance explained most of the association of bioavailable T but only partially explained the associations of E2 and SHBG with incident T2DM among postmenopausal women We evaluated the association of hemostatic factors with insulin resistance in relation to reproductive hormones including FSH , estradiol , testosterone , and SHBG . SHBG was used to calculate the free estradiol index and free and rogen index . We studied 3,200 women , aged 42 - 52 yr , in the Study of Women 's Health Across the Nation , a prospect i ve multiethnic study of the menopausal transition . We measured the hemostatic factors , fibrinogen , factor VIIc , tissue plasminogen activator ( t-PA ) , and plasminogen activator inhibitor type 1 ( PAI-1 ) , as well as  glucose and insulin  to calculate insulin resistance . After adjustment for body mass index , site , and ethnicity , SHBG was correlated with PAI-1 ( partial r = -0.30 ) and t-PA ( partial r = -0.12 ) . Although testosterone was associated with t-PA ( partial r = 0.13 ) and PAI-1 ( partial r = 0.07 ) , free and rogen index was strongly correlated with t-PA ( partial r = 0.18 ) and PAI-1 ( partial r = 0.26 ) . SHBG modified the association of hemostatic factors with insulin resistance . Women with greater  insulin resistance had lower SHBG and higher PAI-1 . Estrogen measures were not associated with insulin resistance . The influence of sex hormones on hemostatic factors and insulin resistance is poorly understood . SHBG , which influences the amount of bioavailable hormone , significantly modified the association of PAI-1 and t-PA with insulin resistance . The longitudinal Study of Women 's Health Across the Nation will help us discern whether this interaction contributes to heart disease and diabetes among postmenopausal women The aim of the study was to determine the prevalence of non-insulin dependent diabetes mellitus ( NIDDM ) , arterial hypertension , coronary artery disease and the risk factors for these diseases in perimenopausal women with a history of polycystic ovary syndrome ( PCOS ) treatment . A group of 28 women was selected from a large group of patients who had undergone wedge ovarian resection .  A total of 752 controls was selected by age ( 45 - 59 years ) from a r and om female population sample . There was no difference between the two groups in body mass index , waist circumference or waist-hip ratio . Both groups were found to have identical family histories of NIDDM , hypertension , and coronary artery disease and identical smoking habits . We did not find a difference between the mean concentrations of lipids and fasting glucose . The two groups did not differ in the proportions of women with elevated lipid concentrations . The prevalence of NIDDM and coronary artery disease was significantly higher in PCOS women . In conclusion , women in the general population have the same level of risk factors at perimenopausal age as PCOS women . Patients with markedly expressed clinical symptoms of PCOS made up a subgroup in the general population at high risk for developing NIDDM and coronary artery disease OBJECTIVE Hyperinsulinemia may promote mammary carcinogenesis . Insulin resistance has been linked to an increased risk of breast cancer and is also characteristic of type 2 diabetes . We prospect ively evaluated the association between type 2 diabetes and invasive breast cancer incidence in the Nurses ' Health Study . RESEARCH DESIGN AND METHODS A total of 116,488 female nurses who were 30 - 55 years old and free of cancer in 1976 were followed through 1996 for the occurrence of type 2 diabetes and through 1998 for incident invasive breast cancer , verified by medical records and pathology reports . RESULTS During 2.3 million person-years of follow-up , we identified 6,220 women with type 2 diabetes and 5,189 incident cases of invasive breast cancer . Women with type 2 diabetes had a modestly elevated incidence of breast cancer ( hazard ratio [ HR ] = 1.17 ; 95 % CI 1.01 - 1.35 ) compared with women without diabetes , independent of age , obesity , family history of breast cancer , history of benign breast disease , reproductive factors , physical activity , and alcohol consumption . This association was apparent among postmenopausal women ( 1.16 ; 0.98 - 1.62 ) but not premenopausal women ( 0.83 ; 0.48 - 1.42 ) . The association was predominant among women with estrogen receptor-positive breast cancer ( 1.22 ; 1.01 - 1.47 ) . CONCLUSIONS Women with type 2 diabetes may have a slightly increased risk of breast cancer OBJECTIVE To determine the prevalence of insulin resistance ( IR ) in women with polycystic ovary syndrome ( PCOS ) using baseline fasting blood measurements of glucose and insulin . DESIGN Prospect i ve clinical study . SETTING Academic endocrinology unit in Palermo , Italy . PATIENT(S ) Two hundred and sixty-seven women with PCOS , consecutively evaluated , and 50 consecutively selected ovulating controls . INTERVENTION(S ) Fasting blood was obtained for glucose and insulin measurements from all women . For 60 women with PCOS and 20 controls an insulin tolerance test ( ITT ) was also performed . MAIN OUTCOME MEASURE(S ) Assessment of normal and abnormal values for fasting insulin , glucose/insulin ratio , and the calculated indices of the homeostasis model assessment ( HOMA ) , quantitative sensitivity check index ( QUICKI ) , as well as Kitt ( kinetic disappearance of glucose ) values after ITT . Evaluation was performed of the ability to detect IR using these methods in obese and nonobese women with PCOS . RESULT ( S ) Normal insulin sensitivity was defined by insulin levels < 12 mU/mL , glucose/insulin ratios of > 6.4 , HOMA values of < 47 , and QUICKI values of > 0.333 . In the entire PCOS groups , IR was diagnosed in 65.4 % of women using glucose/insulin ratios and in 77 % and 79.2 % using HOMA and QUICKI . In obese women ( body mass index > 28 in 48 % of group ) , IR was present in 76.7 % as measured by glucose/insulin ratios but was significantly higher ( 95.3 % ) using values of either HOMA or QUICKI ( P<.01 ) . All indices correlated with Kitt values with QUICKI showing the best correlation . CONCLUSION ( S ) Insulin resistance was detected in approximately 80 % of women with PCOS , and in 95 % of obese women . The detection of IR is superior using the calculated indices HOMA and QUICKI Increased plasma levels of insulin and the fibrinolytic inhibitor , plasminogen activator inhibitor type 1 ( PAI-1 ) , are two new cardiovascular risk factors . The extent to which these two risk factors can be affected by nonpharmacological intervention modalities has not been convincingly proven in subjects at high risk for cardiovascular disease . This study assesses the effects on fasting plasma insulin and plasma PAI-1 activity of an intervention program including a low-fat , high-fiber diet and regular daily physical exercise . The intervention was implemented by a 1-month learning and training session in a full-boarding wellness center and included a follow-up evaluation after 12 months . The study was conducted on 108 subjects ( 31 men and 77 women ) referred for multiple risk factor treatment . After 1 month of intense intervention , the physical condition improved significantly , and this effect was maintained during the year . The body mass index ( BMI ) , fasting plasma insulin , and plasma lipids were significantly decreased . In women , PAI-1 activity was significantly reduced . At follow-up study in both sexes , the BMI and fasting insulin were still significantly decreased . In women , PAI-1 activity reverted to the preintervention level . In subjects with multiple risk factors , ie , the insulin resistance syndrome , the plasma insulin level can be reduced by an intense nonpharmacological program . Also , at least in women , plasma PAI-1 activity can be modestly modified . However , the magnitude of the decrease in PAI-1 activity was probably too small to reverse the hypofibrinolytic state characteristic of these subjects Objective Aging induces a shift in circulating hormones in women , accompanied by weight gain during the late reproductive , menopausal transition , and postmenopausal years . Exercise has been shown to counter weight gain ; however , it might increase circulating and rogens . A 6-month aerobic and resistance training exercise regimen was implemented to examine interrelationships between circulating sex hormones , body composition , aerobic capacity , insulin sensitivity , and insulin resistance . Methods Twenty-eight women , aged 42 to 52 years , completed the 6-month intervention study . They were r and omly assigned to either a control ( CON ; n = 10 ) group— and maintained their sedentary lifestyle — or an exercise intervention ( EXE ; n = 18 ) group . The exercise intervention consisted of combined aerobic and resistance workouts scheduled 6 days/week for 60 minutes/day . Body weight , composition , VO2 peak , plasma insulin , glucose , lipid profile , estradiol , testosterone , progesterone , dehydroepi and rosterone , and dehydroepi and rosterone sulfate ( DHEAS ) were measured at baseline and on month 6 . Insulin sensitivity was estimated using the insulin sensitivity index and the quantitative insulin sensitivity check index , whereas insulin resistance was estimated using the homeostatic model for insulin resistance . Results There was a trend toward increased DHEAS in both groups ( P < 0.1 ) , but not as a function of the intervention . Insulin sensitivity index increased in the EXE group compared with the CON group ( P < 0.01 ) . Multiple linear regression indicated that , at 6 months , DHEAS was a negative contributor to insulin sensitivity in the EXE group , but not in the CON group . Conclusions In midlife women , an increase in circulating DHEAS , such as that previously reported during the menopausal transition , is associated with higher insulin resistance , but exercise can mitigate this risk by improving insulin sensitivity , thereby countering the effects of DHEAS Growing evidence has linked posttraumatic stress disorder ( PTSD ) to insulin resistance and type-2 diabetes , but most previous studies were cross-sectional . We examined the association between PTSD and incidence of diabetes in a prospect i ve study of middle-aged male twins from the Vietnam Era Twin Registry . Lifetime PTSD was diagnosed at baseline with the Diagnostic Interview Schedule ( DIS ) according to DSM-III-R criteria . Subthreshold PTSD was defined by meeting some , but not all , criteria for PTSD . A total of 4340 respondents without self-reported diabetes at baseline were included . Of these , 658 reported a new diagnosis of treated diabetes over a median of 19.4 years of follow-up . At baseline , twins with PTSD showed more behavioral and metabolic risk factors such as overweight and hypertension . The age-adjusted cumulative incidence of diabetes was significantly higher in twins with PTSD ( 18.9 % ) than those without PTSD ( 14.4 % ) , [ odds ratio ( OR ) = 1.4 , 95 % confidence interval ( CI ) 1.03 - 1.8 ] , and intermediate in those with subthreshold PTSD ( 16.4 % ) ( OR = 1.2 , 95 % CI 0.9 - 1.5 , p for trend = 0.03 ) . Adjustment for military , lifestyle and metabolic factors diminished the association . No significant association was found comparing twin pairs discordant for PTSD . In conclusion , PTSD was prospect ively associated with a 40 % increased risk of new-onset type-2 diabetes which was partially explained by a cluster of metabolic and behavioral risk factors known to influence insulin resistance . Shared biological or behavioral precursors which occur within families may lead to both PTSD and insulin resistance/diabetes . Thus , PTSD could be a marker of neuroendocrine and metabolic dysregulation which may lead to type-2 diabetes OBJECTIVE To assess the impact of weight reduction on serum adipocytokines , C-reactive protein ( CRP ) , and insulin sensitivity in hypertensive female patients with central obesity . METHODS This study was performed using the data base and stored serum sample s of female patients who had participated in an intervention study focused on weight loss . Thirty hypertensive women aged 18 to 65 , body mass index ( BMI ) > 27 kg/m2 , and central obesity were selected . They were r and omly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks . Patients who experienced weight loss greater than 5 % ( n = 24 ) were assessed for blood pressure , anthropometric parameters , visceral fat , insulin resistance ( HOMA-R - homeostasis model assessment of insulin resistance ) and sensitivity ( ISI - Insulin Sensitivity Index ) indices , plus serum lipids , adipocytokines ( adiponectin , leptin , IL-6 , and TNF-alpha ) and CRP levels . RESULTS After BMI had been reduced by approximately 5 % in both groups , visceral fat , fasting glucose , triglycerides , and TNF-alpha decreased . Only the orlistat group , which was more insulin resistant at baseline , showed a significant reduction in blood glucose after oral glucose load , in addition to increased insulin sensitivity . CONCLUSION This study 's findings indicate that a weight loss greater than 5 % is associated with improved inflammatory status and decreased insulin resistance , regardless of changes in adiponectin and TNF-a levels . The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group Women with polycystic ovary syndrome ( PCOS ) often develop type 2 diabetes mellitus ( T2DM ) . To determine the magnitude of risk of developing T2DM among women with PCOS , development of T2DM was prospect ively assessed among women who had T2DM ( n = 97 ) and controls ( n = 95 ) using Kaplan-Meier survival analysis and Cox proportional hazards modeling . The women with T2DM had higher baseline weight ( body mass index , P < 0.01 ) and lower insulin sensitivity ( homeostasis assessment model of insulin resistance , P < 0.01 ) . The 8-year incidence rate among cases and controls was 13.4 % and 5.8 % , respectively ( relative risk = 2.3 ) . Obese cases had a fivefold risk of T2DM developing ( P < 0.01 ) compared with age-adjusted obese controls , indicating significant interaction between PCOS and obesity to effect T2DM risk OBJECTIVES Gonadotropin-releasing hormone agonists increase fat mass , decrease insulin sensitivity , and increase serum triglycerides . To better characterize the metabolic effects of gonadotropin-releasing hormone agonist treatment , we prospect ively evaluated the changes in body composition , insulin sensitivity , and levels of adiponectin , resistin , C-reactive protein ( CRP ) , and plasminogen activator inhibitor type 1 ( PAI-1 ) . We also assessed the relationships among changes in adipocytokines , body composition , and insulin sensitivity . METHODS In this prospect i ve , 12-week study , 25 nondiabetic men with locally advanced or recurrent prostate cancer and no radiographic evidence of metastases were treated with leuprolide depot and bicalutamide . The outcomes studied included changes from baseline to week 12 in body composition , insulin sensitivity , and levels of adiponectin , resistin , CRP , and PAI-1 . RESULTS The mean + /- st and ard error percentage of fat body mass increased by 4.3 % + /- 1.3 % from baseline to week 12 ( P = 0.002 ) . The insulin sensitivity index decreased by 12.9 % + /- 7.6 % ( P = 0.02 ) . The serum adiponectin levels increased by 37.4 % + /- 7.2 % from baseline to week 12 ( P < 0.001 ) . In contrast , the resistin , CRP , and PAI-1 levels did not change significantly . Changes in body composition tended to be associated with changes in adiponectin , but not insulin sensitivity . CONCLUSIONS Combined and rogen blockade with leuprolide and bicalutamide significantly increased fat mass and adiponectin levels and decreased insulin sensitivity but did not alter the resistin , CRP , or PAI-1 levels . This pattern of metabolic changes appears distinct from the classic metabolic syndrome Questions remain concerning the effect of variations in cholesterol intake on plasma cholesterol concentration , as well as on the role of factors modulating the metabolic impact of this dietary intervention . To define the impact of wide variations in dietary cholesterol intake on plasma total and low-density lipoprotein ( LDL ) cholesterol concentrations , as well as testing the hypothesis that resistance to insulin-mediated glucose disposal would accentuate the increase in plasma total and LDL cholesterol concentrations in response to a given increment in dietary cholesterol intake , we performed a prospect i ve , r and omized study comparing diets varying in cholesterol content in 65 healthy , postmenopausal women , 31 defined as insulin-resistant and 34 as insulin-sensitive . The changes in total and LDL cholesterol in response to increments in dietary cholesterol of up to approximately 800 mg/day were modest in magnitude , without evidence of a statistically significant diet-induced increase in cholesterol concentration , or of any difference in the responses of insulin-resistant as compared with insulin-sensitive women . These results indicate that relatively large increments in dietary cholesterol intake had little effect on total or LDL cholesterol concentrations in healthy , postmenopausal women , irrespective of whether they were insulin-resistant or insulin-sensitive OBJECTIVE To compare and assess the single and joint effect of diet and exercise intervention for 1 year on insulin resistance and the development leading toward the insulin resistance syndrome . RESEARCH DESIGN AND METHODS An unmasked , r and omized 2 × 2 factorial intervention trial was applied with a duration of 1 year for each participant . The trial comprised 219 men and women with diastolic blood pressure of 86–99 mmHg , HDL cholesterol < 1.20 mmol/l , triglycerides > 1.4 mmol/l , total cholesterol of 5.20–7.74 mmol/l , and BMI > 24 kg/m2 . Participants were r and omly allocated to diet group ( n = 35 ) , diet and exercise group ( n = 67 ) , exercise group ( n = 54 ) , and control group ( n = 43 ) . The diet included increased intake of fish and reduced total fat intake . The exercise program entailed supervised endurance exercise three times a week . Baseline cross-sectional changes and 1-year changes in insulin resistance , fasting serum levels of insulin , C-peptide , proinsulin , glucose , and lipids as well as weight , mean blood pressure , and plasminogen activator inhibitor 1 ( PAI-1 ) values were recorded . RESULTS The cross-sectional results at baseline showed significant correlations between the calculated insulin resistance and BMI ( r = 0.54 ) and correlations between the mean blood pressure ( mBP ) ( r = 0.26 ) and PAI-1 ( r = 0.40 ) . The 1-year diet intervention gave a significant decrease in the calculated insulin resistance from 4.6 to 4.2 and a positive correlation between the changes in insulin resistance and changes in BMI ( r = 0.40 ) . The diet and exercise intervention also led to significantly decreased insulin resistance ( from 5.0 to 4.0 ) . The exercise intervention did not significantly change insulin resistance . CONCLUSIONS The cross-sectional and 1-year intervention results supported each other and underscored the important connection between increased BMI and the development leading toward the insulin resistance syndrome Experimental and epidemiological evidence suggests that circulating glucose and insulin may play a role in breast carcinogenesis . However , few cohort studies have examined breast cancer risk in association with glucose and insulin levels , and studies to date have had only baseline measurements of exposure . We conducted a longitudinal study of postmenopausal breast cancer risk using the 6 % r and om sample of women in the Women 's Health Initiative clinical trials whose fasting blood sample s , provided at baseline and at years 1 , 3 and 6 , were analyzed for glucose and insulin . In addition , a 1 % sample of women in the observational study , who had glucose and insulin measured in fasting blood sample s drawn at baseline and in year 3 , were included in the analysis . We used Cox proportional hazards models to estimate hazard ratios and 95 % confidence intervals for the association of baseline and follow‐up measurements of serum glucose and insulin  with breast cancer risk . All statistical tests were 2‐sided . Among 5,450 women with baseline serum glucose and  insulin values , 190 incident cases of breast cancer were ascertained over a median of 8.0 years of follow‐up . The highest tertile of  baseline insulin , relative to the lowest , was associated with a 2‐fold increase in risk in the total population ( multivariable hazard ratio 2.22 , 95 % confidence interval 1.39–3.53 ) and with a 3‐fold increase in risk in women who were not enrolled in the intervention arm of any clinical trial ( multivariable hazard ratio 3.15 , 95 % confidence interval 1.61–6.17 ) . Glucose levels showed no association with risk . Analysis of the repeated measurements supported the results of the baseline analysis . These data suggest that elevated serum insulin levels may be a risk factor for postmenopausal breast cancer . © 2009 CONTEXT Polycystic ovary syndrome ( PCOS ) is associated with the metabolic syndrome and , consequently , with a potentially increased risk of cardiovascular disease ( CVD ) and related mortality later in life . Studies regarding CVD and mortality in PCOS women well into the postmenopausal age are lacking . OBJECTIVE Our objective was to examine whether postmenopausal PCOS women differ from controls regarding cardiovascular risk factors , myocardial infa rct ion ( MI ) , stroke and mortality . DESIGN AND SETTING We conducted , at a university hospital , a prospect i ve study of 35 PCOS women ( 61 - 79 yr ) and 120 age-matched controls . The study was performed 21 yr after the initial study . PARTICIPANTS Twenty-five PCOS women ( Rotterdam criteria ) and 68 controls participated in all examinations . Data on morbidity were based on 32 of 34 PCOS women and on 95 of 119 controls . INTERVENTIONS INTERVENTIONS included reexamination , interviews , and data from the National Board of Health and Welfare and from the Hospital Discharge Registry . MAIN OUTCOME MEASURES Blood pressure , glucose , insulin , triglycerides , total cholesterol , high- and low-density lipoprotein , apolipoprotein A1 and B , fibrinogen , and plasminogen activator inhibitor antigen were studied . Incidences of MI , stroke , hypertension , diabetes , cancer , cause of death , and age at death were recorded . RESULTS PCOS women had a higher prevalence of hypertension ( P = 0.008 ) and higher triglyceride levels ( P = 0.012 ) than controls . MI , stroke , diabetes , cancer , and mortality prevalence was similar in the two cohorts with similar body mass index . CONCLUSIONS The well-described cardiovascular/metabolic risk profile in pre- and perimenopausal PCOS women does not entail an evident increase in cardiovascular events during the postmenopausal period Polycystic ovary syndrome ( PCOS ) , defined as the combination of oligoanovulation and hyper and rogenism , affects more than 5 % of women of reproductive age . Insulin resistance and hyperinsulinemia appear to play an important role in its pathogenesis . Here , we will present a characterization of a PCOS cohort from North Rhine-Westphalia in Germany . Clinical features , family history as well as endocrine and metabolic parameters were prospect ively recorded from 200 successive patients . All patients were evaluated for insulin resistance and beta-cell-function by oral glucose tolerance test .  Patient data were compared with those of 98 age-matched control women . PCOS patients showed significantly higher BMI , body fat mass and and rogen levels as well as impaired glucose and insulin metabolism . A positive family history of PCOS and diabetes was more frequent in PCOS patients . Insulin resistance ( 71 % ) was the most common metabolic abnormality in PCOS patients followed by obesity ( 52 % ) and dyslipidemia ( 46.3 % ) , with an incidence of 31.5 % for the metabolic syndrome . C-reactive protein and other cardiovascular risk factors were frequently elevated even in young PCOS patients . While the clinical characteristics and endocrine parameters of this German PCOS cohort were heterogeneous , they were comparable to those from other Caucasian population
Because of the heterogeneity and the limited number of studies , there is no sufficient evidence on the potential role of vasomotor symptoms in metabolic health .
However , both high- quality cohort studies , with large study population s and adjustment for multiple confounding variables showed positive associations between vasomotor symptoms and insulin resistance and type 2 diabetes mellitus .
These findings suggest that there is an association between vasomotor symptoms and metabolic health outcomes .
The objective of this study was to systematic ally review studies describing the association between vasomotor symptoms and metabolic syndrome , type 2 diabetes and insulin resistance in peri- and postmenopausal women .