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Submitted on February 2, 2005
Accepted on March 21, 2005
Division of Endocrinology, Diabetes and Clinical Nutrition (CAB, BM, MK, UK, JJP), Division of Gynecological Endocrinology and Reproductive Medicine (CDG), Division of Central Laboratory (PH), Institute for Social and Preventive Medicine (CS), University Hospital, CH-4031 Basel, Switzerland
* To whom correspondence should be addressed. E-mail: Puderj{at}uhbs.ch.
Background: Inflammatory markers and insulin resistance are independent cardiovascular risk factors and are thought to be influenced by sex steroids. We investigated changes of inflammatory markers and estimates of insulin resistance during the menstrual cycle, their variances, their relationship to each other, to sex steroids and to regional body fat distribution.
Methods: Eight normal weight (BMI 21.6 ± 1.9 kg/m2) and nine overweight (BMI 30 ± 2.4 kg/m2) young women with normal ovarian function were assessed 15 times throughout the menstrual cycle. Regional fat distribution was assessed using dual x-ray absorptiometry.
Results: Concentrations of highly sensitive C-reactive protein (hs-CRP) changed significantly during the menstrual cycle and were highest in the early follicular phase (P < 0.00001). Sex hormone-binding globulin (SHBG) concentrations were stable in the follicular phase, but increased in the luteal phase (p< P < 0.00001). During the follicular phase, estimates of insulin resistance had a higher within-subject variance when determined by the homeostasis model assessment index (HOMA-IR, 42%) than when estimated by SHBG concentrations (5%, P < 0.05). During the menstrual cycle, using repeated measurements, hs-CRP correlated inversely to estradiol (
-coefficient -0.23, P < 0.0001) and to SHBG concentrations (-coefficient -0.83, P = 0.004). Central accumulation of body fat correlated to the mean hs-CRP concentration (r = 0.63, P = 0.007) and to the mean HOMA-IR (r = 0.75, P = 0.001).
Conclusion: We demonstrate that serum concentrations of hs-CRP and SHBG significantly change during the menstrual cycle. We reveal a close link between sex steroids, subclinical inflammation, insulin resistance and body fat distribution in regularly menstruating women.
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