FACTORS ASSOCIATED WITH GLUCOSE AND INSULIN LEVELS IN WEALTHY POSTMENOPAUSAL WOMEN

OBJECTIVE - Little is known about the covariates of hyperglycemia and hyperinsulinemia. We examined candidate factors in postmenopausal wome n. RESEARCH DESIGN AND METHODS - We determined the cross-sectional ass ociations of sociodemographic, body size, lifestyle, reproductive, and menopausal factors with pre-trial fasting and postchallenge glucose a nd insulin levels in 869 postmenopausal women aged 45-65 years. Women were participants in the Postmenopausal Estrogen/Progestin Interventio ns study who were not taking estrogen or insulin. RESULTS - Plasma glu cose levels increased significantly with age; serum insulin levels did not. BMI and waist-to-hip ratio (WHR) each showed graded positive and independent associations with glucose and insulin levels. Alcohol int ake, cigarette smoking, physical activity, parity, education, and inco me were also associated with insulin or glucose in age-adjusted models . In multivariable models, BMI and WHR explained 18% of the variabilit y in fasting glucose, 16% in postchallenge glucose, 28% in fasting ins ulin, and 17% in postchallenge insulin. Age and all other factors comb ined accounted for <6% of the variance in glucose or insulin. In multi ply adjusted models, African-American and Hispanic women had higher fa sting and 2-h insulin levels than non-Hispanic white women. CONCLUSION S - Most of the variance in glycemia and insulin is unexplained. Measu res of obesity and fat distribution account for nearly all the explain ed variance.