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Insulin Sensitivity, Insulin Secretion, and Glucose Tolerance Versus Intima-Media Thickness in Nondiabetic Postmenopausal Women

Department of Medicine, Lund University (H.L., G.B.), Malmö, Sweden; and Department of Medicine, Lund University (B.A.), SE-221 84 Lund, Sweden

Address all correspondence and requests for reprints to: Dr. Bo Ahrén, Department of Medicine, Lund University, B11 BMC, SE-221 84 Lund, Sweden. E-mail: bo.ahren{at}med.lu.se.

To study the association between insulin sensitivity and secretion vs. early manifestations of atherosclerosis, we performed a 5-yr prospective study in 84 nondiabetic, postmenopausal women, aged 58.7 ± 0.4 yr (mean ± SD). Insulin sensitivity was measured with the euglycemic, hyperinsulinemic clamp, and insulin secretion was measured as the acute response to iv arginine (5 g). Early atherosclerosis was studied by ultrasonography of the right carotid artery. Mean intima-media thickness (IMT), determined 1 cm proximal to the bifurcation, was 0.81 ± 0.14 mm at baseline and increased by 0.012 ± 0.014 mm/yr over the 5 yr (P < 0.001). The maximal IMT, determined in the carotid bifurcation, was 1.42 ± 0.42 mm at baseline and increased by 0.035 ± 0.049 mm/yr (P < 0.001). Neither basal IMT nor the increase in mean or maximal IMT correlated to insulin sensitivity or secretion. In contrast, both baseline IMT and the progression in IMT over the 5-yr follow-up (both mean common carotid artery IMT and maximal bifurcation IMT) correlated with systolic blood pressure and low-density lipoprotein cholesterol. We conclude that carotid intima-media thickness is not related to insulin sensitivity or secretion in nondiabetic, postmenopausal women. Instead, the strongest association is seen with systolic blood pressure and low-density lipoprotein cholesterol levels.

This work was supported by grants from the Swedish Research Council (Grant 6834), the Albert Påhlsson Foundation, the Swedish Diabetes Association, and the Faculty of Medicine, Lund University.

Abbreviations: BG, Blood glucose; BMI, body mass index; CCA, common carotid artery; HOMA, homeostasis model assessment method; IGT, impaired glucose tolerance; IMT, intima-media thickness; LDL, low-density lipoprotein; NGT, normal glucose tolerance; OGTT, oral glucose tolerance test; QUICK1, quantitative insulin sensitivity check index.

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