Insulin resistance and other risk factors of cardiovascular disease amongst women with abnormal uterine bleeding

Abstract

Background: Studies indicate the presence of cardiovascular disease risk amongst patients with uterine fibroids and polycystic ovarian syndrome. Aim: The researchers aimed to examine the prevalence of cardiovascular disease risk factors and independent predictors of insulin resistance (IR) amongst women with abnormal uterine bleeding (AUB). Methods: This observational study examined 77 premenopausal subjects with AUB. Their medical history, body mass index (BMI), waist–hip ratio (WHR), fasting insulin (FI), haemoglobin A1c, creatinine and lipids were evaluated. Subjects were subdivided using insulin levels and compared. Insulin resistance was defined at two FI levels: 10 μU/mL and 15 μU/mL. Results: A total of 91% of participants had smoking history, 62% had a WHR 0.80, 45% were obese and most had dyslipidaemia. In all, 38% – 66% were insulin resistant, depending on cut-off used. At FI 10 μU/mL, subjects were significantly more likely to have a WHR 0.8, be obese and have low HDL. At FI 15 μU/mL, subjects were significantly more likely to have low HDL, elevated triglycerides, a WHR 0.8 and be obese. Univariate analysis showed significant associations between IR in AUB and BMI, WHR and HDL for both FI cut-offs. Multivariate analysis using the lower FI cut-off revealed BMI and WHR were significant independent predictors of IR in AUB. Conclusion: This study reveals the prevalence of IR (66%) and other predictors of cardiovascular disease are greater in AUB in this population than the general US population. Body mass index and WHR are independent predictors of IR in AUB. Low HDL, elevated triglycerides and ethnicity are also significantly associated with IR in AUB depending on the definition used.

Keywords

• insulin
• abnormal uterine bleeding
• heavy menses
• insulin resistance
• gynecology
• metabolic syndrome
• cardiovascular disease