Daily chocolate consumption is inversely associated with insulin resistance and liver enzymes in the Observation of Cardiovascular Risk Factors in Luxembourg study

AbstractThis study examined the association of chocolate consumption with insulin resistance and serum liver enzymes in a national sample of adults in Luxembourg. A random sample of 1153 individuals, aged 18–69 years, was recruited to participate in the cross-sectional Observation of Cardiovascular Risk Factors in Luxembourg study. Chocolate consumption (g/d) was obtained from a semi-quantitative FFQ. Blood glucose and insulin levels were used for the homoeostasis model assessment of insulin resistance (HOMA-IR). Hepatic biomarkers such as serum γ-glutamyl-transpeptidase (γ-GT), serum aspartate transaminase and serum alanine transaminase (ALT) (mg/l) were assessed using standard laboratory assays. Chocolate consumers (81·8 %) were more likely to be younger, physically active, affluent people with higher education levels and fewer chronic co-morbidities. After excluding subjects taking antidiabetic medications, higher chocolate consumption was associated with lower HOMA-IR (β=−0·16, P=0·004), serum insulin levels (β=−0·16, P=0·003) and γ-GT (β=−0·12, P=0·009) and ALT (β=−0·09, P=0·004), after adjustment for age, sex, education, lifestyle and dietary confounding factors, including intakes of fruits and vegetables, alcohol, polyphenol-rich coffee and tea. This study reports an independent inverse relationship between daily chocolate consumption and levels of insulin, HOMA-IR and liver enzymes in adults, suggesting that chocolate consumption may improve liver enzymes and protect against insulin resistance, a well-established risk factor for cardiometabolic disorders. Further observational prospective research and well-designed randomised-controlled studies are needed to confirm this cross-sectional relationship and to comprehend the role and mechanisms that different types of chocolate may play in insulin resistance and cardiometabolic disorders.

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Abstract P142: Daily Chocolate Consumption is Inversely Associated with Insulin Resistance and Liver Enzymes in Adults: The Observation of Cardiovascular Risk Factors Study

Circulation ◽

10.1161/circ.133.suppl_1.p142 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Ala’a Alkerwi ◽

Nicolas Sauvageot ◽

Georgina E. Crichton ◽

Merrill F. Elias ◽

Saverio Stranges ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Sex Education ◽

Liver Enzymes ◽

Smoking Status ◽

Serum Insulin ◽

Model Assessment ◽

Cardiometabolic Disorders

Introduction: Research into the health effects of cocoa has received much attention over the past few years. Several systematic reviews and meta-analyses of existing studies have generally agreed on a potentially beneficial association between chocolate consumption and risk for cardiometabolic disorders. However, evidence regarding a potential role of chocolate consumption in insulin resistance and hepatic biomarkers, from human epidemiological studies, is lacking. Hypothesis: We assessed the hypothesis that daily chocolate consumption would be inversely associated with insulin resistance and hepatic biomarkers in appraently healthy adults. Methods: A random sample of 1153 individuals, aged 18-69 years, was recruited between 2007 and 2009 to participate in the Observation of Cardiovascular Risk Factors (ORISCAV-LUX) study. Chocolate consumption in g/day was obtained from a semi-quantitative food-frequency questionnaire. Blood glucose and insulin were used for the homeostasis model assessment of insulin resistance (HOMA-IR). Hepatic biomarkers, namely serum γ-glutamyl-transpeptidase (γ-GT), serum Aspartate Transaminase (AST) and serum Alanine Transaminase (ALT) in mg/l were assessed using standard laboratory assays. Results: Chocolate consumers (81.8 %) were more likely to be younger, physically active, affluent people with higher education levels and have fewer chronic comorbidities. After exclusion of subjects taking antidiabetic medications, higher chocolate consumption was associated with lower HOMA-IR (β= -0.16, P=0.004), serum insulin levels (β= -0.16, P=0.003), and liver enzymes, including γGT (β= -0.12, P=0.009) and ALT (β= -0.09, P=0.004) after adjustment for age, sex, education, lifestyle (smoking status and physical activity) and dietary confounding factors, including daily energy intake, consumption of fruit and vegetables, alcohol, as well as polyphenol-rich coffee, and tea. Conclusion: This is the first population-based study reporting an independent inverse relationship between daily chocolate consumption and levels of insulin, HOMA-IR and liver enzymes in adults.. Small dietary changes with respect to chocolate consumption may improve liver enzymes and protect against insulin resistance, a well-established risk factor for cardiometabolic disorders.

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Effect of -55CT Polymorphism of UCP3 on Insulin Resistance and Cardiovascular Risk Factors after a High Protein/Low Carbohydrate versus a Standard Hypocaloric Diet

Annals of Nutrition and Metabolism ◽

10.1159/000444150 ◽

2016 ◽

Vol 68 (3) ◽

pp. 157-163 ◽

Cited By ~ 7

Author(s):

Daniel Antonio de Luis ◽

Rocío Aller ◽

Olatz Izaola ◽

Enrique Romero

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Ldl Cholesterol ◽

High Protein ◽

Model Assessment ◽

Wild Genotype ◽

Insulin Levels ◽

Low Carbohydrate

Background: The C/C genotype of a polymorphism in the uncoupling protein3 (UCP3) promoter (-55C->T) (rs1800849) is associated with an increased body mass index. Objective: The aim of our study was to investigate the effect of polymorphism on the UCP3 promoter (-55C->T) on insulin resistance and cardiovascular risk factors secondary to a high protein/low carbohydrate vs. a standard hypocaloric diets (1,000 kcal/day). Design: A population of 283 obese subjects was analyzed in a randomized trial. A nutritional evaluation was performed at the beginning and at the end of a 9-month period in which subjects received 1 of 2 diets (diet HP: high protein/low carbohydrate vs. diet S: standard diet). Results: Weight improvement was higher in non-T carriers. With both diets and only in wild genotype (diet HP vs. diet S), total cholesterol (-9.7 ± 4.0 vs. -11.1 ± 2.0 mg/dl; p > 0.05) and low density lipoprotein (LDL) cholesterol (-8.3 ± 3.0 vs. -5.5 ± 2.7 mg/dl; p > 0.05) decreased. The improvement in these parameters was similar in subjects with diet HP than HS. With diet HP and only in wild genotype, glucose (-5.2 ± 2.2 mg/dl; p < 0.05), triglycerides (-15.5 ± 3.9 mg/dl; p < 0.05), insulin levels (-3.9 ± 3.1 UI/l; p < 0.05) and homeostasis model assessment (HOMA-R; -0.6 ± 0.1 units; p < 0.05) decreased. Conclusion: Carriers of T allele have a different response than non-carrier subjects, with a lack of decrease of LDL cholesterol, glucose, insulin levels and HOMA-R. The weight loss was lower in T carriers. HP diet showed a better metabolic response than S diet in 55CC homozygous.

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Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073388 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3388

Author(s):

Nijole Kazukauskiene ◽

Aurelija Podlipskyte ◽

Giedrius Varoneckas ◽

Narseta Mickuviene

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Thyroid Function ◽

Study Groups ◽

Model Assessment ◽

Psychoemotional State ◽

Study Participants

Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.

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Association between Eating Speed and Classical Cardiovascular Risk Factors: A Cross-Sectional Study

Nutrients ◽

10.3390/nu11010083 ◽

2019 ◽

Vol 11 (1) ◽

pp. 83 ◽

Cited By ~ 10

Author(s):

Indira Paz-Graniel ◽

Nancy Babio ◽

Ignacio Mendez ◽

Jordi Salas-Salvadó

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cox Regression ◽

Cross Sectional Study ◽

Cross Sectional ◽

The Metabolic Syndrome ◽

Cardiometabolic Disorders ◽

Key Factor ◽

Senior Population

Cardiovascular disease (CVD) is one of the main causes of morbidity and mortality around the world. Lifestyle is recognized as a key factor in the development of metabolic disorders and CVD. Recently, eating speed has been of particular interest since some studies have associated it with the development of obesity and other cardiometabolic disorders. We aimed to assess the association between eating speed and various cardiovascular risk factors. We conducted a cross-sectional analysis within the framework of the PREDIMED (Prevención con Dieta Mediterránea) study with 792 participants from the Reus-Tarragona center. Eating speed was self-reported according to participant perception and categorized as slow, medium, or fast. The association between eating speed and cardiovascular risk factors was assessed using Cox regression models with constant time of follow-up for all individuals. Compared to participants in the slow eating speed category, those in the faster eating speed category were 59% more likely to have the hypertriglyceridemia component of the metabolic syndrome (MetS) (Hazard Ratio, (HR) 1.59; 95% Confidence Interval (CI) 1.16–2.17), even after adjustment for potential confounders (HR 1.47; 95% CI 1.08–2.02). No other significant differences were observed. Eating speed was positively associated with the prevalence of the hypertriglyceridemia component of the MetS in a senior population at high cardiovascular risk.

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The associations between plasma adiponectin, ghrelin levels and cardiovascular risk factors

Acta Endocrinologica ◽

10.1530/eje.0.1500715 ◽

2004 ◽

pp. 715-718 ◽

Cited By ~ 39

Author(s):

KM Choi ◽

J Lee ◽

KW Lee ◽

JA Seo ◽

JH Oh ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Central Obesity ◽

Oral Glucose ◽

Model Assessment ◽

Fasting Insulin ◽

Korean Women ◽

Plasma Adiponectin

OBJECTIVE: Ghrelin is a recently discovered peptide, which is produced primarily in the stomach. This orexigenic peptide participates not only in the induction of mealtime hunger but also in long-term body weight regulation and energy homeostasis. Adiponectin is a protein secreted by adipocytes, and has been proposed to mediate obesity-related insulin resistance. Moreover, concentrations of adiponectin are reduced in individuals with obesity, insulin resistance and cardiovascular disease. However, human data are sparse about the direct relationship between adiponectin, ghrelin and cardiovascular risk factors including insulin resistance. DESIGN: Three hundred and thirty-eight elderly Korean women (mean age+/-s.d., 72.3+/-5.5 years) were included in the present study. METHODS: Plasma ghrelin and adiponectin levels were measured by RIA. Anthropometric measurements were taken and a 75 g oral glucose tolerance test performed. Fasting insulin and lipid profile were measured and insulin resistance was determined using the homeostasis model assessment insulin resistance index (HOMA-R) and the quantitative insulin sensitivity check index. RESULTS: Plasma adiponectin levels were negatively correlated with central obesity indices such as waist circumference (r=-0.27, P<0.001) and waist-to-hip ratio (WHR) (r=-0.32, P<0.001), and with insulin resistance indices such as fasting insulin (r=-0.17, P=0.004) and HOMA-R (r=-0.13, P=0.035). Plasma ghrelin levels were negatively correlated with WHR (r=-0.12, P=0.03), but plasma adiponectin and ghrelin levels were not correlated (r=0.03, P=0.66). Multiple regression analysis showed that adiponectin was associated with WHR, fasting insulin and fasting glucose levels. When ghrelin was used as a dependent variable, only WHR remained in the final fitted model. CONCLUSION: Fasting plasma adiponectin and ghrelin levels were found to be associated with central obesity or insulin resistance. However, plasma adiponectin and ghrelin concentrations were not associated with each other in elderly Korean women.

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Metabolic syndrome, insulin resistance and other cardiovascular risk factors in university students

Ciência & Saúde Coletiva ◽

10.1590/1413-81232015214.10472015 ◽

2016 ◽

Vol 21 (4) ◽

pp. 1123-1136 ◽

Cited By ~ 8

Author(s):

José Bonifácio Barbosa ◽

Alcione Miranda dos Santos ◽

Marcelo Mesquita Barbosa ◽

Márcio Mesquita Barbosa ◽

Carolina Abreu de Carvalho ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

University Students ◽

Cardiovascular Risk Factors ◽

Hdl Cholesterol ◽

Blood Collection ◽

Cross Sectional ◽

High Blood Glucose

Abstract A cross-sectional population-based study using questionnaire and anthropometric data was conducted on 968 university students of São Luís, Brazil, from which 590 showed up for blood collection. In the statistical analysis the Student t-test, Mann-Whitney and chi-square tests were used. The prevalence of metabolic syndrome by the Joint Interim Statement (JIS) criteria was 20.5%, almost three times more prevalent in men (32.2%) than in women (13.5%) (P < 0.001). The prevalence of insulin resistance was 7.3% and the prevalence of low HDL-cholesterol was high (61.2%), both with no statistically significant differences by sex. Men showed a higher percentage of smoking, overweight, high blood pressure, high blood glucose and increased fasting hypertriglyceridemia. Women were more sedentary. University students of private institutions had higher prevalences of sedentary lifestyle, obesity, abdominal obesity, elevated triglycerides and metabolic syndrome than students from public institutions. High prevalences of metabolic syndrome, insulin resistance and other cardiovascular risk factors were found in this young population. This suggests that the burden of these diseases in the future will be increased.

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High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors

Public Health Nutrition ◽

10.1017/s1368980015001585 ◽

2015 ◽

Vol 19 (3) ◽

pp. 486-493 ◽

Cited By ~ 25

Author(s):

Raquel Burrows ◽

Paulina Correa-Burrows ◽

Marcela Reyes ◽

Estela Blanco ◽

Cecilia Albala ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Abdominal Obesity ◽

Hdl Cholesterol ◽

Lifestyle Factors ◽

School Level ◽

Model Assessment ◽

Fasting Hyperglycaemia

AbstractObjectiveTo analyse the prevalence of cardiovascular risk factors in healthy adolescents of low to middle socio-economic status and to study the influence of anthropometric, biological and lifestyle factors on the risk of metabolic syndrome (MetS).DesignCross-sectional study. BMI, waist circumference, blood pressure, fat and lean mass (by dual-energy X-ray absorptiometry), TAG, HDL-cholesterol, glucose, insulin, homeostatic model assessment–insulin resistance index (HOMA-IR), food intake and physical activity were measured. Cardiovascular risk factors were defined using the International Diabetes Federation criteria and insulin resistance using HOMA-IR ≥2·6. Bivariate and multivariate regressions examined the associations between MetS and anthropometric, biological and lifestyle factors.SettingObservational cohort study including Chilean adolescents, who were part of a follow-up study beginning in infancy.SubjectsAdolescents aged 16–17 years (n 667).ResultsIn the sample, 16·2 % had obesity and 9·5 % had MetS. Low HDL-cholesterol (69·9 %), abdominal obesity (33·3 %) and fasting hyperglycaemia (8·7 %) were the most prevalent cardiovascular risk factors. In males, obesity (OR=3·7; 95 % CI 1·2, 10·8), insulin resistance (OR=3·0; 95 % CI 1·1, 8·2), physical inactivity (OR=2·9; 95 % CI 1·1, 7·7) and sarcopenia (OR=21·2; 95 % CI 4·2, 107·5) significantly increased the risk of MetS. In females, insulin resistance (OR=4·9; 95 % CI 1·9, 12·6) and sarcopenia (OR=3·6; 95 % CI 1·1, 11·9) were significantly associated with MetS.ConclusionsHigh prevalences of obesity, abdominal obesity, dyslipidaemia, fasting hyperglycaemia and MetS were found in healthy adolescents. In both sexes, sarcopenia and insulin resistance were important risk factors of MetS. Promotion of active lifestyles at the school level and regulation of the sale of energy-dense foods are needed.

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The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000690 ◽

2020 ◽

pp. 1-9

Author(s):

Habib Yarizadeh ◽

Alireza Bahiraee ◽

Sara Asadi ◽

Niloofar Sadat Maddahi ◽

Leila Setayesh ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Model Assessment ◽

Iranian Women ◽

Cvd Risk ◽

Dash Diet ◽

Melanocortin 4 Receptor Gene ◽

Significant Difference ◽

High Adherence

Abstract. Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25–40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

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Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0597 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Güzin Özden ◽

Ayşe Esin Kibar Gül ◽

Eda Mengen ◽

Ahmet Ucaktürk ◽

Hazım Alper Gürsu ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Left Ventricular ◽

Atherogenic Index ◽

Volume Index ◽

Common Component

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.

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Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study

Acta Endocrinologica ◽

10.1530/eje.1.02065 ◽

2006 ◽

Vol 154 (1) ◽

pp. 131-139 ◽

Cited By ~ 18

Author(s):

Lenora M Camarate S M Leão ◽

Mônica Peres C Duarte ◽

Dalva Margareth B Silva ◽

Paulo Roberto V Bahia ◽

Cláudia Medina Coeli ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Postmenopausal Women ◽

Fat Mass ◽

Visceral Fat ◽

Increased Risk

Background: There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease. Objective: We aimed to assess the effects of androgen replacement on cardiovascular risk factors. Design: Thirty-seven postmenopausal women aged 42–62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo. Methods: Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography. Results: A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance. Conclusion: This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.

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