Low-Grade Inflammation and Estimates of Insulin Resistance during the Menstrual Cycle in Lean and Overweight Women
Claudine A. Blum,
Beat Müller,
Peter Huber,
Marius Kraenzlin,
Christian Schindler,
Christian De Geyter,
Ulrich Keller and
Jardena J. Puder
Divisions of Endocrinology, Diabetes, and Clinical Nutrition (C.A.B., B.M., M.K., U.K., J.J.P.), Gynecological Endocrinology and Reproductive Medicine (C.D.G.), and Central Laboratory (P.H.) and Institute for Social and Preventive Medicine (C.S.), University Hospital, CH-4031 Basel, Switzerland
Address all correspondence to: Jardena J. Puder, Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. E-mail: puderj{at}uhbs.ch.
Background: Inflammatory markers and insulin resistance areindependent cardiovascular risk factors and are thought to beinfluenced by sex steroids. We investigated changes of inflammatorymarkers and estimates of insulin resistance during the menstrualcycle, their variances, and their relationship to each other,sex steroids, and regional body fat distribution.
Methods: Eight normal weight (body mass index, 21.6 ±1.9 kg/m2) and nine overweight (body mass index, 30 ±2.4 kg/m2) young women with normal ovarian function were assessed15 times throughout the menstrual cycle. Regional fat distributionwas assessed using dual x-ray absorptiometry.
Results: Concentrations of highly sensitive C-reactive protein(hs-CRP) changed significantly during the menstrual cycle andwere highest in the early follicular phase (P < 0.00001).SHBG concentrations were stable in the follicular phase butincreased in the luteal phase (P < 0.00001). During the follicularphase, estimates of insulin resistance had a higher within-subjectvariance when determined by the homeostasis model assessmentindex (42%) than when estimated by SHBG concentrations (5%,P < 0.05). During the menstrual cycle, using repeated measurements,hs-CRP correlated inversely to estradiol (ß-coefficient,–0.23, P < 0.0001) and SHBG concentrations (ß-coefficient,–0.83, P = 0.004). Central accumulation of body fat correlatedto the mean hs-CRP concentration (r = 0.63, P = 0.007) and themean homeostasis model assessment index for insulin resistance(r = 0.75, P = 0.001).
Conclusion: We demonstrate that serum concentrations of hs-CRPand SHBG significantly change during the menstrual cycle. Wereveal a close link between sex steroids, subclinical inflammation,insulin resistance, and body fat distribution in regularly menstruatingwomen.
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