Journal of Clinical Endocrinology & Metabolism, Vol 72, 642-646, Copyright © 1991 by Endocrine Society

ARTICLES

Intravenous glucose tolerance test-derived insulin sensitivity changes during the menstrual cycle

CT Valdes and KE Elkind-Hirsch
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77054.

Using glucose tolerance tests or a glucose clamp some studies report impaired insulin sensitivity during the luteal phase of the menstrual cycle, while others find no change in insulin sensitivity. Tissue sensitivity to insulin and glucose effectiveness can be estimated using the minimal model analysis of an iv glucose tolerance test (IVGTT), but this method has never been applied to evaluate the impact of the menstrual cycle on these parameters. We, therefore, studied eight cycling women using tolbutamide-modified IVGTTs during three different phases of the same menstrual cycle: early follicular, midcycle, and midluteal. Insulin sensitivity (SI) and glucose effectiveness were derived using insulin and glucose levels obtained from tolbutamide- modified IVGTTs and analyzed with the minimal model computer program. The mean SI (x10(-4)/min.microU/mL) decreased in a stepwise fashion from the follicular level of 6.20 +/- 0.91 to a midcycle level of 4.95 +/- 0.73 and was lowest in the luteal phase (3.20 +/- 0.25; P less than 0.007). No change in glucose effectiveness occurred as a function of the menstrual cycle. These findings indicate a significant decrease in insulin sensitivity in the luteal phase of the normal menstrual cycle, but no significant change at midcycle.

This article has been cited by other articles:

				M. J. Toth, B. C. Cooper, R. E. Pratley, A. Mari, D. E. Matthews, and P. R. Casson Effect of ovarian suppression with gonadotropin-releasing hormone agonist on glucose disposal and insulin secretion Am J Physiol Endocrinol Metab, June 1, 2008; 294(6): E1035 - E1045. [Abstract] [Full Text] [PDF]

				R. E. van Genugten, K. M. Utzschneider, J. Tong, F. Gerchman, S. Zraika, J. Udayasankar, E. J. Boyko, W. Y. Fujimoto, S. E. Kahn, and and the American Diabetes Association GENNID Study Effects of Sex and Hormone Replacement Therapy Use on the Prevalence of Isolated Impaired Fasting Glucose and Isolated Impaired Glucose Tolerance in Subjects With a Family History of Type 2 Diabetes Diabetes, December 1, 2006; 55(12): 3529 - 3535. [Abstract] [Full Text] [PDF]

				C. A. Blum, B. Muller, P. Huber, M. Kraenzlin, C. Schindler, C. De Geyter, U. Keller, and J. J. Puder Low-Grade Inflammation and Estimates of Insulin Resistance during the Menstrual Cycle in Lean and Overweight Women J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3230 - 3235. [Abstract] [Full Text] [PDF]

				D. C. Henderson, E. Cagliero, P. M. Copeland, C. P. Borba, E. Evins, D. Hayden, M. T. Weber, E. J. Anderson, D. B. Allison, T. B. Daley, et al. Glucose Metabolism in Patients With Schizophrenia Treated With Atypical Antipsychotic Agents: A Frequently Sampled Intravenous Glucose Tolerance Test and Minimal Model Analysis Arch Gen Psychiatry, January 1, 2005; 62(1): 19 - 28. [Abstract] [Full Text] [PDF]

				S. E. Campbell and M. A. Febbraio Effect of the ovarian hormones on GLUT4 expression and contraction-stimulated glucose uptake Am J Physiol Endocrinol Metab, May 1, 2002; 282(5): E1139 - E1146. [Abstract] [Full Text] [PDF]

				V. Jayagopal, E. S. Kilpatrick, S. Holding, P. E. Jennings, and S. L. Atkin The Biological Variation of Insulin Resistance in Polycystic Ovarian Syndrome J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1560 - 1562. [Abstract] [Full Text] [PDF]

				G. Paradisi, H. O. Steinberg, A. Hempfling, J. Cronin, G. Hook, M. K. Shepard, and A. D. Baron Polycystic Ovary Syndrome Is Associated With Endothelial Dysfunction Circulation, March 13, 2001; 103(10): 1410 - 1415. [Abstract] [Full Text] [PDF]

				D. E. Flanagan, J. C. Vaile, G. W. Petley, V. M. Moore, I. F. Godsland, R. A. Cockington, J. S. Robinson, and D. I. Phillips The Autonomic Control of Heart Rate and Insulin Resistance in Young Adults J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1263 - 1267. [Abstract] [Full Text]

				J. D. Wagner, M. J. Thomas, J. K. Williams, L. Zhang, K. A. Greaves, and W. T. Cefalu Insulin Sensitivity and Cardiovascular Risk Factors in Ovariectomized Monkeys with Estradiol Alone or Combined with Nomegestrol Acetate J. Clin. Endocrinol. Metab., March 1, 1998; 83(3): 896 - 901. [Abstract] [Full Text]

				D. A. Ehrmann, M. K. Cavaghan, J. Imperial, J. Sturis, R. L. Rosenfield, and K. S. Polonsky Effects of Metformin on Insulin Secretion, Insulin Action, and Ovarian Steroidogenesis in Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., February 1, 1997; 82(2): 524 - 530. [Abstract] [Full Text] [PDF]

				S. Franks Polycystic Ovary Syndrome N. Engl. J. Med., September 28, 1995; 333(13): 853 - 861. [Full Text] [PDF]

				K. L. Thornton, R. A. DeFronzo, R. S. Sherwin, and M. P. Diamond Micronized Estradiol and Progesterone: Effects on Carbohydrate Metabolism in Reproductive-Age Women Reproductive Sciences, July 1, 1995; 2(4): 643 - 652. [Abstract] [PDF]

				T. J. Horton, E. K. Miller, D. Glueck, and K. Tench No effect of menstrual cycle phase on glucose kinetics and fuel oxidation during moderate-intensity exercise Am J Physiol Endocrinol Metab, April 1, 2002; 282(4): E752 - E762. [Abstract] [Full Text] [PDF]