IJCS | Volume 31, Nº3, May/ June 2018

202 Fonseca et al. Metabolic Syndrome and Insulin Resistance International Journal of Cardiovascular Sciences. 2018;31(3)201-208 Original Article TheHomeostasisModelAssessment-InsulinResistance (HOMA-IR) index predicts the level of IR according to the glycemia and basal insulinemia. It has been widely used and represents one of the several alternatives for IR assessment, mainly because it is a simple, fast, easy to apply and low-cost method. 5 The prevalence of MS and its association with IR in menopausal women is still poorly studied in our country. The identification of the main components of MS and their association with IR can be very useful in terms of public health, for instance, by allowing greater specificity for cardiovascular disease primary and secondary prevention actions. The aim of this study was to evaluate the prevalence of MS, its components, and its association with IR in menopause. Methods This was a descriptive study, which evaluated 150 menopausal patients, aged 40 to 65 years, who agreed to participate in the study by signing the Free and Informed Consent form (FICF) at the Gynecology Outpatient Clinic of Hospital Universitário Materno Infantil of Universidade Federal do Maranhão, from May to December 2013. Patients who did not authorize their participation in the study; pregnant women; statin users; those who had undergone coronary angioplasty or myocardial revascularization, or those with a history of previous acute myocardial infarction; those who did not have information on the cause of menopause and the age at which it occurred; or cases of menopause caused by medical interventions (surgeries, radiotherapy or chemotherapy), were not included in the study. The patients were divided into two groups: Group I: premenopausal women and Group II: postmenopausal women. The sociodemographic variables were: age (in full years), ethnicity, family income, schooling, marital status and occupation. Personal history data were also obtained (such as: date of last menstrual period, and time of menopause); comorbidities (Systemic Arterial Hypertension – (SAH), Diabetes Mellitus – (DM) and Cerebrovascular Accident – (CVA); daily use of medications and family history of coronary artery disease before age 60; and Information on social and life habits (regular physical activity, and the reporting of smoking status and alcohol intake). The anthropometric variables were collected through a physical examination, including weight, height and Waist Circumference (WC). The WC measurement was made at the midpoint between the iliac crest and the lowest rib, using a simple fiberglass measuring tape with a latch (manufacturer: Sanny), in the orthostatic position, without clothes covering the chest and at the end of expiration. 6 Blood pressure (BP) was obtained using the mean of two measurements, obtained through the standardized auscultatory method. Patients were classified according to the VI Brazilian Hypertension Guideline (VI Diretriz Brasileira de Hipertensão). 7 Participants who had a previous diagnosis of hypertension and/or used antihypertensive drugs were considered hypertensive, and those with a previous diagnosis of diabetes mellitus or undergoing treatment with hypoglycemic agents were considered diabetic, according to the consensus of the Brazilian Society of Endocrinology. 8 The presence of MS was defined according to the criterion of Albert et al., which requires the presence of three or more of the following components: WC > 80 cm; systolic BP > 130 mmHg and/or diastolic BP > 85 mmHg or undergoing pharmacological treatment for arterial hypertension; fasting triglyceride levels > 150 mg/dL or undergoing pharmacological treatment for hypertriglyceridemia; HDL-cholesterol levels < 50mg/dL orpharmacologicaltreatment;fastingglycemia>100mg/dL or pharmacological treatment for hyperglycemia. The biochemical tests were: fasting glucose, total cholesterol, HDL-cholesterol, triglycerides, urea, creatinine and glycated hemoglobin by the colorimetric method. All examinations were analyzed in the laboratory of Hospital Universitário Materno Infantil of Universidade Federal do Maranhão. HOMA-IR was also calculated using the formula (insulin mUI/L x blood glucose mmol/L/22.5) to evaluate the insulin resistance (IR) of the participants. As reference values, HOMA-IR > 4.65 was used if Body Mass Index (BMI) was >28.9 kg/m 2 andHOMA-IR > 3.60 if BMI > 27.5 kg/m 2 , according to Stern et al. 10 The collection of anthropometric measures and blood samples after a 12-hour fasting was performed at the same time and according to this sequence. Statistical analysis Statistical analysis was performed using Fisher's exact test, Mann-Whitney and chi-square tests. A statistically