IJCS | Volume 31, Nº3, May/ June 2018

DOI: 10.5935/2359-4802.20180009 International Journal of Cardiovascular Sciences. 2018;31(3)201-208 ORIGINAL ARTICLES 201 Mailing Address: Érika Joseth Nogueira da Cruz Fonseca • Hospital Universitário Unidade Materno Infantil, Rua Silva Jardim, s/n. Postal Code: 65021-000, Centro, São Luís, MA – Brazil. E-mail: erikajoseth@hotmail.com Metabolic Syndrome and Insulin Resistance by HOMA-IR in Menopause Érika Joseth Nogueira da Cruz Fonseca, Tânia Pavão Oliveira Rocha, Iara Antônia Lustosa Nogueira, Jorgileia Braga de Melo, Bianca Lima e Silva, Elenice Jardim Lopes, Claudiana Batalha Serra, Maria Vaneide Gomes Andrade, Surama Maria Bandeira de Sousa, José Albuquerque de Figueredo Neto Universidade Federal do Maranhão, São Luís, MA – Brazil Manuscript received December 22, 2016, revised manuscript September 20, 2017, accepted September 22, 2017 Abstract Background: Metabolic syndrome is an important cardiovascular risk factor, and its prevalence increases after menopause. However, it is still uncertain whether menopause is an independent risk factor for metabolic syndrome. One of the pathophysiological basis for metabolic syndrome is insulin resistance, which can be calculated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) method, and the association between insulin resistance and menopause is little known. Objective: To evaluate the association between metabolic syndrome and insulin resistance in menopausal women. Method: Descriptive study, which evaluated 150 women, aged 40 to 65, treated at a Gynecology Outpatient Clinic of a tertiary public hospital, fromMay to December of 2013. The sample was divided into two groups: Group I, comprising women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of metabolic syndrome and its components were evaluated, as well as occurrence of insulin resistance in both groups. The association of menopausal status and the assessed variables was assessed using the Mann-Whitney, Chi-square and Fisher's exact tests. The significance level was set at 5%. The statistical analysis was performed using STATA 12.0. Results: Metabolicsyndromeanditscomponentsweremoreprevalentinpostmenopausalwomen.Postmenopausalwomen also had a higher prevalence of insulin resistance, but no statistical association was observed between the findings. Conclusion: Themenopausal statuswas not significantly associatedwithmetabolic syndrome and insulin resistance. Insulin resistance was considered an independent risk factor for the development of metabolic syndrome only in the postmenopausal group. (International Journal of Cardiovascular Sciences. 2018;31(3)201-208) Keywords: Metabolic Syndrome; Insulin Resistance; Menopause; Climacteric; Cardiovascular Diseases. Introduction Approximately 40 million women were menopausal in the United States in 2010 and there was an estimate of 60 million menopausal women by 2020.¹ In Brazil, 28% of the women (24.3 million) are over 40 years of age, and in the city of São Luís, state of Maranhão, the estimated female population in 2010 was 538,138, of which 39%was in the age group between 40 and 59 years. 2 A set of cardiovascular risk factors related to visceral obesity and Insulin Resistance (IR) defines Metabolic Syndrome (MS),³ which is established in the presence of three or more of the following components: glucose intolerance with fasting glycemia ≥ 100 mg/dL; abdominal obesity or greater amount of visceral fat, with waist circumference > 90 cm in men and > 80 cm in women; triglycerides ≥ 150 mg/dL; high-density lipoprotein (HDL) cholesterol < 40 mg/dL for men and < 50mg/dL for women; current antihypertensive therapy or blood pressure >130 x 85 mmHg. IR represents a decrease in the ability of insulin to stimulate glucose use. Pancreatic β -cells increase insulin production and secretion as a compensatorymechanism, while glucose tolerance remains normal. This has been pointed out as a collective health problem, affecting several age groups, especiallymenopausal-agedwomen. 4