Possibilities to assess insulin resistance as the metabolic syndrome is clustered in women in postmenopause

The formation of the MS cluster starting from insulin resistance (IR), visceral obesity, dyslipidemia, arterial hypertension and carbohydrate metabolism disorders (CMD) against the background of estrogenic deficiency defines postmenopause as a risk factor for type 2 diabetes mellitus (DM2) and increased cardiovascular risk. The TyG index (logarithmic ratio of triglyceride and fasting plasma glucose levels) is proposed for surrogate evaluation of IR, reflecting an integrated approach to metabolic disorders.

Aim: To assess the relationship between the TyG Index and HOMA2-IR and its informativeness in predicting the risk of DM2 in women in postmenopause.

Materials and methods: TyG and HOMA2-IR indices (C-peptide) were determined in 94 postmenopausal women 58.02 ± 5.88 years of age, evaluated according to NCEP ATP III criteria and divided into groups: 1st - DM2, 2nd - prediabetes, 3rd - without CMD (HbAlc 7.3 ± 1.0; 6.2 ± 0.2 and 5.5 ± 0.4%, respectively). By means of SPSS (version 17) we evaluated ME (25-75%); intergroup differences by Mann-Whitney criteria; we performed correlation and ROC-analysis.

Results: TyG correlates with HOMA2IR in group 2 (R = 0.61; p = 0.013) and 3 (R = 0.60; p = 0.001). In the process of ROC-analysis cut-off for TyG was revealed, reflecting the chance of presence of DM2 in groups 2 and 3: 7.5 (sensitivity 0.938 and specificity 0.813) and 8.0 (sensitivity 0.894 and specificity 0.810), respectively.

Conclusion: TyG index allows predicting the development of dysglycemia in women in postmenopause with the signs of MS through the phenomenon of lipoglucotoxicity.

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