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. 2010 Dec;95(12):5435-42.
doi: 10.1210/jc.2010-0702. Epub 2010 Sep 15.

Longitudinal study of insulin resistance and sex hormones over the menstrual cycle: the BioCycle Study

Edwina H Yeung  1 , Cuilin Zhang, Sunni L Mumford, Aijun Ye, Maurizio Trevisan, Liwei Chen, Richard W Browne, Jean Wactawski-Wende, Enrique F Schisterman
Affiliations

Longitudinal study of insulin resistance and sex hormones over the menstrual cycle: the BioCycle Study

Edwina H Yeung et al. J Clin Endocrinol Metab. 2010 Dec.

Abstract

Context: Conflicting findings have been reported regarding the effect of menstrual cycle phase and sex hormones on insulin sensitivity.

Objective: The aim was to determine the pattern of insulin resistance over the menstrual cycle and whether variations in sex hormones explain these patterns.

Design: The BioCycle study is a longitudinal study that measured hormones at different phases of the menstrual cycle. Participants had up to eight visits per cycle; each visit was timed using fertility monitors to capture sensitive windows of hormonal changes.

Setting: The study was conducted in the general community of the University at Buffalo (Buffalo, NY).

Participants: A total of 257 healthy, premenopausal women (age, 27±8 yr; body mass index, 24±4 kg/m2) participated in the study.

Main outcome measures: We measured fasting insulin, glucose, and insulin resistance by the homeostasis model of insulin resistance (HOMA-IR).

Results: Significant changes in HOMA-IR were observed over the menstrual cycle; from a midfollicular phase level of 1.35, levels rose to 1.59 during the early luteal phase and decreased to 1.55 in the late-luteal phase. HOMA-IR levels primarily reflected changes in insulin and not glucose. After adjustment for age, race, cycle, and other sex hormones, HOMA-IR was positively associated with estradiol (β=0.082; P<0.001) and progesterone (β=0.025; P<0.001), and inversely associated with FSH (adjusted β=-0.040; P<0.001) and SHBG (β=-0.085; P<0.001). LH was not associated with HOMA-IR. Further adjustment for BMI weakened the association with SHBG (β=-0.057; P=0.06) but did not affect other associations.

Conclusion: Insulin exhibited minor menstrual cycle variability. Estradiol and progesterone were positively associated with insulin resistance and should be considered in studies of insulin resistance among premenopausal women.

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Figures

Figure 1
Figure 1
Geometric mean (95% confidence interval) of insulin, HOMA-IR, and glucose levels over the menstrual cycle in the BioCycle Study (n = 257), adjusted for age, race, and cycle. *, Significantly different from reference visit during menstruation (○).
See this image and copyright information in PMC

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