IJCS | Volume 31, Nº3, May/ June 2018

204 Fonseca et al. Metabolic Syndrome and Insulin Resistance International Journal of Cardiovascular Sciences. 2018;31(3)201-208 Original Article 18 participants (24%) had IR, as shown in table 2. In this analysis, the menopausal status was once again not a direct predictor for the IR presence. The study also assessed whether IR alone may be considered an independent risk factor for the development of MS and its components in both groups of assessed women. IR was statistically different from the increase in triglycerides and fasting glucose in the premenopausal group. The study showed the association between the presence of IR andMS in both groups. The IR, calculated by the HOMA-IR index, differed from the statistically significant result in the presence of MS, only in the postmenopausal group, as shown in table 4. Discussion TheprevalenceofMS inwomenofdifferent populations varies considerably. Differences in genetic profile, eating habits, physical activity level, age and lifestyle influence the prevalence of MS. 11 It is postulated that, among the several risk factors for the syndrome development, menopause is a direct predictor. 12 In our study, the prevalence of MSwas 24% in premenopausal women and 44% in the postmenopausal group, with no statistically significant association. Figueiredo Neto et al., 13 in a study carried out in the State of Maranhão, Brazil, using the National Cholesterol Education Program's (NCEP) criteria, found a prevalence of 24% in premenopausal women and 44.4% in postmenopausal ones, also without a statistically significant association. As for the study carried out by Ali et al., 14 in Tunisia, with 2,680 women between 2004 and 2005, using NCEP criteria, they found a prevalence of 25.6% and 45.7% in the pre- and postmenopausal groups, respectively, with the menopausal status being an independent risk factor for the development of MS. In our study, we evaluated the prevalence of MS components and the possible association with menopausal status. Among them, the most frequent in both groups was the increase in triglycerides, with a prevalence of 65.3% and 74.6% in the pre- and postmenopausal groups, respectively. After that, the increase in the waist circumference was the most often observed, with a frequency of 66.6% in the premenopausal period and 70.6% in the postmenopausal one. However, neither showed a statistical association withmenopausal status. Cho et al., 15 in a study carried out in South Korea, with 1,003 women, identified the increase in WC and the reduction in HDL-cholesterol as the most prevalent components of premenopausal MS, reaching 46.1% and 22.5%; respectively. In the postmenopausal period, the increase in WC was the most common (78.9%), followed by an increase in BP (40.6%). 15 Arthur et al., 16 in a study carried out with African women, using the International Diabetes Federation (IDF) criteria, identified as the most prevalent factors in the premenopausal group the increase in WC (79%) and in BP (49.7%). Jouyandesh et al., 17 based on the National Cholesterol Education Program – The Adult Treatment Panel III (NCEP-ATP III), studying 118 postmenopausal women from January 2011 to January 2012 at a clinic for menopause follow-up, found as themost prevalent components, once again, an increase in WC (64.3%) and BP (47.9%). 17 However, the authors suggest that the frequencies observed in the prevalence of MS components may vary among populations due to environmental, nutritional, economic and genetic diversity, characteristic of women in each area. Table 2 – Prevalence of overall insulin resistance and according to the menopausal state in women treated in a Gynecology Outpatient Clinic. São Luís (MA), Brazil, 2015 Insulin resistance General Menopausal status p value Premenopausal Postmenopausal n % n % n % Absent 122 81.33 65 86.67 57 76.00 0.094 Present 28 18.67 10 13.33 18 24.00 * p < 0.05, chi-square test.