High prevalence of insulin resistance assessed by the glucose clamp technique in hormonal and non-hormonal contraceptive users

Author(s)

Melhado-Kimura, Vaneska ^[1] ; Alegre, Sarah Monte ^[2] ; Pavin, Elizabeth Joao ^[2] ; Silva dos Santos, Priscilla de Nazare ^[1] ; Bahamondes, Luis ^[1] ; Fernandes, Arlete ^[1]

Affiliation

^[1] Univ Campinas UNICAMP, Sch Med Sci, Dept Obstet & Gynaecol, Human Reprod Unit, Campinas, SP - Brazil

^[2] Univ Campinas UNICAMP, Sch Med Sci, Dept Clin Med, Campinas, SP - Brazil

• Document type: Journal article
• Source: EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE; v. 20, n. 2, p. 110-118, APR 2015.
• Web of Science Citations: 3

Abstract

Objective To assess the prevalence of insulin resistance (IR) and associated factors in contraceptive users. Methods A total of 47 women 18 to 40 years of age with a body mass index (kg/m(2)) < 30, fasting glucose levels < 100 mg/dl and 2-hour glucose level < 140 mg/dl after a 75-g oral glucose load were submitted to a hyperinsulinemic-euglycemic clamp. The women were distributed in tertiles regarding M-values. The analysed variables were use of combined hormonal/non-hormonal contraception, duration of use, body composition, lipid profile, glucose levels and blood pressure. Results IR was detected in 19% of the participants. The women with low M-values presented significantly higher body fat mass, waist-to-hip ratio, fasting insulin, HOMA-IR and were nulligravida, showed > 1 year of contraceptive use and higher triglyceride levels. IR was more frequent among combined oral contraceptive users, however no association was observed after regression analysis. Conclusions The prevalence of IR was high among healthy women attending a family planning clinic independent of the contraceptive method used with possible long-term negative consequences regarding their metabolic and cardiovascular health. Although an association between hormonal contraception and IR could not be found this needs further research. Family planning professionals should be proactive counselling healthy women about the importance of healthy habits. (AU)

• FAPESP's process: 09/53293-0 - Prospective study for evaluation of the insulin resistance, lipid metabolism and sub clinical cardiovascular disease in women who initiate the depot-medroxyprogesterone acetate (DMP A) contraceptive method with in follow-up for two years. (Project of scientific research)
• Grantee: Luis Guillermo Bahamondes
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)