Abstract
Background
Studies indicate the presence of cardiovascular disease risk factors among patients with uterine fibroids and polycystic ovarian syndrome. Investigators were interested in examining the prevalence of cardiovascular disease risk factors and the independent predictors of insulin resistance (IR) among women with abnormal uterine bleeding (AUB).
Methods
This observational study examined 77 premenopausal subjects with AUB. Their medical history, body mass index, waist hip ratio, fasting insulin level, hemoglobin A1C, creatinine level, and lipid panel were evaluated. The participants were then subdivided using insulin levels and further compared. IR was defined at two different fasting insulin levels: >10µU/mL and > 15µU/mL.
Results
Of the 77 data sets analyzed, 91% of participants were current or former smokers, 62% had a waist hip ratio > 0.80, 45% were obese, and the majority of participants had dyslipidemia, with high total cholesterol (68%) and elevated LDL (38%) being the most prevalent. 66% of participants were insulin resistant as defined by the lower fasting insulin and 38% were insulin resistant as defined by the upper fasting insulin level. At the lower cutoff, the insulin resistant group was significantly more likely to have a waist hip ratio > 0.8, be obese, and have low HDL levels. At the upper fasting insulin cutoff, the insulin resistant group was significantly more likely to have low HDL levels, elevated triglyceride levels, a waist hip ratio > 0.8, and be obese. Univariate analysis showed statistically significant associations between IR in women with AUB and body mass index, waist hip ratio, and HDL for both fasting insulin cutoffs. Multivariate analysis using the lower fasting insulin cutoff revealed that body mass index and waist hip ratio were significant independent predictors of IR in a woman with AUB.
Conclusions
This study reveals the prevalence of IR and other predictors of cardiovascular disease are greater in women with AUB in this population than the general population. Body mass index and waist hip ratio are independent predictors of IR in women with AUB. Low HDL levels, elevated triglyceride levels, and ethnicity are also significantly associated with IR in women with AUB depending on the definition used.
Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults