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Insulin resistance and weight gain in postmenopausal women of diverse ethnic groups


OBJECTIVE: This study was conducted to examine the influence of insulin resistance on weight change in postmenopausal women of various ethnic groups.

SUBJECTS: Data were obtained from 3389 women (60% White, 20% Black, 12% Hispanic, and 8% Asian/Pacific Islander), ages 50–79, enrolled in either the Women's Health Initiative Clinical trial or Observational Study, whose blood samples were selected randomly from the full cohort of 161 809 women for analyses.

MEASUREMENTS: Glucose, insulin, and lipids were measured on fasting serum samples drawn at baseline and after 3 y of follow-up. Weight, height, waist circumference, and blood pressure were measured. Physical activity and energy intake were assessed via questionnaire. Insulin resistance was estimated using the HOMA (homeostasis model) calculation.

RESULTS: Average age was 62 y, average BMI (body mass index) was 27.4 kg/m2, and average weight change was a gain of 0.4 kg in 3 y. In a multivariate analysis, insulin resistance and insulin concentrations were independent predictors of increases in weight in White women (P=0.002 and 0.004, respectively) and in the combined group (P=0.027 and 0.039). For the whole group, after adjustment for other covariates, those in the highest quartile of insulin resistance gained 0.4 kg in 3 y, whereas those in the lowest quartile lost 0.06 kg. Similar trends were found for insulin resistance and weight gain in Hispanic and Asian/Pacific Islander women, but they did not reach statistical significance. In Black women, no relation was seen between either insulin or insulin resistance and weight change. A significant interaction between obesity and insulin resistance was observed (P=0.002 for White women and 0.032 for the whole group), so that there is weight gain with increasing insulin resistance in the leaner women, but weight loss with increasing insulin resistance in the most obese.

CONCLUSION: Insulin resistance appears to be a predictor of weight gain in postmenopausal women, except for the most obese women. The effect is more pronounced in women who have a lower BMI, and the effect was not seen in the Black women who as a group had a higher BMI.

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Figure 1


  1. Centers for Disease Control and Prevention. Prevalence of overweight and obesity among adults: United States, 1999, Centers for Disease Control and Prevention U.S. Dept. of Health and Human Services: Hyattsville, MD; 1999.

  2. Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the identification, evaluation, and treatment of overweight in adults. Am J Clin Nutr 1998; 68: 899–917.

  3. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP . The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–1522.

    Article  CAS  Google Scholar 

  4. Neel JV . Diabetes mellitus: a ‘thrifty’ genotype rendered detrimental by ‘progress’. Am J Hum Genet 1962; 14: 353–362.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Mayer-Davis EJ, Kirkner GJ, Karter AJ, Zaccaro DJ . Metabolic predictors of five-year change in weight and waist circumference in a tri-ethnic population: the Insulin Resistance Atherosclerosis Study. Am J Epidemiol 2003; 157: 592–601.

    Article  Google Scholar 

  6. Odeleye OE, de Courten M, Pettit DJ, Ravussin E . Fasting hyperinsulinemia is a predictor of increased body weight gain and obesity in Pima Indian children. Diabetes 1997; 46: 1341–1345.

    Article  CAS  Google Scholar 

  7. Srinivasan SR, Myers L, Berenson GS . Temporal association between obesity and hyperinsulinemia in children, adolescents, and young adults: the Bogalusa Heart Study. Metabolism 1999; 48: 928–934.

    Article  CAS  Google Scholar 

  8. The ARIC Investigators. The atherosclerosis risk in communities (ARIC) study: design and objectives. Am J Epidemiol 1989; 129: 687–702.

  9. Lazarus R, Sparrow D, Weiss S . Temporal relations between obesity and insulin: longitudinal data from the normative aging study. Am J Epidemiol 1998; 147: 173–179.

    Article  CAS  Google Scholar 

  10. Hodge AM, Dowse GK, Alberti KG, Gareeboo H, Tuomilehto J, Zimmet PZ . Relationship of insulin resistance to weight gain in nondiabetic Asian Indian, Creol, and Chinese Mauritians. Metabolism 1996; 45: 627–633.

    Article  CAS  Google Scholar 

  11. Swinburn BA, Nyombe BL, Saad MF, Zurlo F, Raz I, Knowler WC, Lillioja S, Bogardus C, Ravussin E . Insulin resistance associated with lower rates of weight gain in Pima Indians. J. Clin. Invest 1991; 88: 168–173.

    Article  CAS  Google Scholar 

  12. Valdez R, Mitchell BD, Haffner SM, Hazuda HP, Morales PA, Monterrosa A, Stern MP . Predictors of weight change in a bi-ethnic population: the San Antonio heart study. Int J Obes 1994; 18: 85–91.

    CAS  Google Scholar 

  13. Hoag S, Marshall JA, Jones RE, Hamman RF . High fasting insulin levels associated with lower rates of weight gain in persons with normal glucose tolerance: the San Luis Valley diabetes study. Int J Obes Relat Metab Disord 1995; 19: 175–180.

    CAS  PubMed  Google Scholar 

  14. Folsom AR, Vitelli LL, Lewis CE et al. Is fasting insulin concentration inversely associated with rate of weight gain? Contrasting findings from the CARDIA and ARIC study cohorts. Int J Obes Relat Metab Disord 1998; 22: 48–54.

    Article  CAS  Google Scholar 

  15. Wedick NM, Mayer-Davis EJ, Wingard DL et al. Insulin resistance precedes weight loss in adults without diabetes: the Rancho Bernardo study. Am J Epidemiol 2001; 153: 1199–1205.

    Article  CAS  Google Scholar 

  16. Howard BV, The Women's Health Initiative Study Group. Design of the Women's Health Initiative clinical trial and observational study. Controlled Clin Trials 1998. 61–109.

  17. Anonymous. Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. Controlled Clin Trials 1998; 19: 61–109.

  18. Howard BV . Diabetes in postmenopausal women. Women's Health Initiative Grant Application. MedStar Research Institute: Washington, DC; 2000.

    Google Scholar 

  19. Schmidt FH In: Bergmeyer Hu (ed). Methods of enzymatic analysis. 2nd edn. Academic Press: New York, NY; 1974. p 1196.

  20. Peterson JI, Young DS . Evaluation of the hexokinase-glucose-6-phosphate dehydrogenase method of determination of glucose in urine. Ann Biochem 1968; 23: 301–316.

    Article  CAS  Google Scholar 

  21. Tietz NW . Fundamentals of clinical chemistry., 3rd edn. Philadelphia, PA: WB Saunders Co.; 1987.

    Google Scholar 

  22. Ivandic A, Prpic-Krizevac I, Bozic D, Barbir A, Peljhan V, Balog Z, Glasnovic M . Insulin resistance and androgens in healthy women with different body fat distributions. Wien Klin Wochenschr 2002; 114: 321–326.

    CAS  PubMed  Google Scholar 

  23. Resnick HE, Bergman RN, Henderson RJ, Nez-Henderson P, Howard BV . Utility of a surrogate measure of insulin resistance in American Indians: the Strong Heart Study. Ethnicity and Disease, in press.

  24. Gould AJ, Williams DEM, Byrne CD, Hales CN, Wareham NJ . Prospective cohort study of the relationship of markers of insulin resistance and secretion with weight gain and changes in regional adiposity. Int J Obes Relat Metab Disord 1999; 23: 1256–1261.

    Article  CAS  Google Scholar 

  25. Boyko EJ, Leonett DL, Bergstrom RW, Newell-Morris L, Fujimoto WY . Low insulin secretion and high fasting insulin and C-peptide levels predict increased visceral adiposity: 5-year follow-up among initially nondiabetic Japanese-American men. Diabetes 1996; 45: 1010–1015.

    Article  CAS  Google Scholar 

  26. Travers SH, Jeffers BW, Eckel RH . Insulin resistance during puberty and future fat accumulation. J Clin Endocrinol Metab 2002; 87: 3814–3818.

    Article  CAS  Google Scholar 

  27. Haffner SM, Howard G, Mayer E, Bergman RN, Savage PJ, Rewers M et al. Insulin sensitivity and acute insulin response in African-Americans, non-Hispanic Whites, and Hispanics with NIDDM. The Insulin Resistance and Atherosclerosis Study. Diabetes 1997; 46: 63–69.

    Article  CAS  Google Scholar 

  28. Cefalu WT, Wang ZQ, Werbel S, Bell-Farrow A, Crouse III JR, Hinson WH, Terry JG, Anderson R . Contribution of visceral fat mass to the insulin resistance of aging. Metabolism 1995; 44: 954–959.

    Article  CAS  Google Scholar 

  29. Porte D, Seeley RJ, Woods SC, Baskin DG, Figlewicz DP, Schwartz MW . Obesity, diabetes and the central nervous system. Diabetologia 1998; 41: 863–881.

    Article  CAS  Google Scholar 

  30. Schwartz MW, Boyko EJ, Kahn SE, Ravussin E, Bogardus C . Reduced insulin secretion: an independent predictor of body weight gain. J Clin Endocrinol Metab 1995; 80: 1571–1576.

    CAS  Google Scholar 

  31. Duncan BB, Schmidt MI, Chambless LE, Folsom AR, Carpenter M, Heiss G . Fibrinogen, other putative markers of inflammation, and weight gain in middle-aged adults—the ARIC study. Obes Res 2000; 4: 279–286.

    Article  Google Scholar 

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The Women's Health Initiative program is funded by the National Heart, Lung and Blood Institute, U.S. Department of Health and Human Services.

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Correspondence to B V Howard.

Appendix A: Long list of WHI investigators

Appendix A: Long list of WHI investigators

Program Office: (National Heart, Lung, and Blood Institute, Bethesda, MD)

Barbara Alving, Jacques Rossouw, Linda Pottern, Shari Ludlam, Joan McGowan.

Clinical Coordinating Center: (Fred Hutchinson Cancer Research Center, Seattle, WA) Ross Prentice, Garnet Anderson, Andrea LaCroix, Ruth Patterson, Anne McTiernan, Barbara Cochrane, Julie Hunt, Lesley Tinker, Charles Kooperberg, Martin McIntosh, C. Y. Wang, Chu Chen, Deborah Bowen, Alan Kristal, Janet Stanford, Nicole Urban, Noel Weiss, Emily White; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker, Pentti Rautaharju, Ronald Prineas, Michelle Naughton; (Medical Research Labs, Highland Heights, KY) Evan Stein, Peter Laskarzewski (University of California at San Francisco, San Francisco, CA) Steven Cummings, Michael Nevitt, Maurice Dockrell (University of Minnesota, Minneapolis, MN) Lisa Harnack; (McKesson BioServices, Rockville, MD) Frank Cammarata, Steve Lindenfelser (University of Washington, Seattle, WA) Bruce Psaty, Susan Heckbert.

Clinical Centers: (Albert Einstein College of Medicine, Bronx, NY) Sylvia Wassertheil-Smoller, William Frishman, Judith Wylie-Rosett, David Barad, Ruth Freeman; (Baylor College of Medicine, Houston, TX) Jennifer Hays, Ronald Young, Jill Anderson, Sandy Lithgow, Paul Bray; (Brigham and Women's Hospital, Harvard Medical School, Boston, MA) JoAnn Manson, Julie Buring, J. Michael Gaziano, Kathryn Rexrode, Claudia Chae; (Brown University, Providence, RI) Annlouise R. Assaf, Carol Wheeler, Charles Eaton, Michelle Cyr; (Emory University, Atlanta, GA) Lawrence Phillips, Margaret Pedersen, Ora Strickland, Margaret Huber, Vivian Porter; (Fred Hutchinson Cancer Research Center, Seattle, WA) Shirley A.A. Beresford, Vicky M. Taylor, Nancy F. Woods, Maureen Henderson, Mark Kestin; (George Washington University, Washington, DC) Judith Hsia, Nancy Gaba, Joao Ascensao; (Harbor-UCLA Research and Education Institute, Torrance, CA) Rowan Chlebowski, Robert Detrano, Anita Nelson, James Heiner, John Marshall; (Kaiser Permanente Center for Health Research, Portland, OR) Cheryl Ritenbaugh, Barbara Valanis, Patricia Elmer, Victor Stevens, Njeri Karanja; (Kaiser Permanente Division of Research, Oakland, CA) Bette Caan, Stephen Sidney, Geri Bailey Jane Hirata; (Medical College of Wisconsin, Milwaukee, WI) Jane Morley Kotchen, Vanessa Barnabei, Theodore A. Kotchen, Mary Ann C. Gilligan, Joan Neuner; (MedStar Research Institute/Howard University, Washington, DC) Barbara V. Howard, Lucile Adams-Campbell, Maureen Passaro, Monique Rainford, Tanya Agurs-Collins; (Northwestern University, Chicago/Evanston, IL) Linda Van Horn, Philip Greenland, Janardan Khandekar, Kiang Liu, Carol Rosenberg; (Rush-Presbyterian St. Luke's Medical Center, Chicago, IL) Henry Black, Lynda Powell, Ellen Mason; (Stanford Center for Research in Disease Prevention, Stanford University, Stanford, CA) Marcia L. Stefanick, Mark A. Hlatky, Bertha Chen, Randall S. Stafford, Linda C. Giudice; (State University of New York at Stony Brook, Stony Brook, NY) Dorothy Lane, Iris Granek, William Lawson, Gabriel San Roman, Catherine Messina; (The Ohio State University, Columbus, OH) Rebecca Jackson, Randall Harris, Electra Paskett, W. Jerry Mysiw, Michael Blumenfeld; (University of Alabama at Birmingham, Birmingham, AL) Cora E. Lewis, Albert Oberman, James M. Shikany, Monika Safford, Brian K. Britt; (University of Arizona, Tucson/Phoenix, AZ) Tamsen Bassford, John Mattox, Marcia Ko, Timothy Lohman; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende, Maurizio Trevisan, Ellen Smit, Susan Graham, June Chang; (University of California at Davis, Sacramento, CA) John Robbins, S. Yasmeen, Karen Lindfors, Judith Stern; (University of California at Irvine, Orange, CA) Allan Hubbell, Gail Frank, Nathan Wong, Nancy Greep, Bradley Monk; (University of California at Los Angeles, Los Angeles, CA) Howard Judd, David Heber, Robert Elashoff; (University of California at San Diego, LaJolla/Chula Vista, CA) Robert D. Langer, Michael H. Criqui, Gregory T. Talavera, Cedric F. Garland, R. Elaine Hanson; (University of Cincinnati, Cincinnati, OH) Margery Gass, Suzanne Wernke, Nelson Watts; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher, Michael Perri, Andrew Kaunitz, R. Stan Williams, Yvonne Brinson; (University of Hawaii, Honolulu, HI) David Curb, Helen Petrovitch, Beatriz Rodriguez, Kamal Masaki, Santosh Sharma; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace, James Torner, Susan Johnson, Linda Snetselaar, Bradley VanVoorhis; (University of Massachusetts/Fallon Clinic, Worcester, MA) Judith Ockene, Milagros Rosal, Ira Ockene, Robert Yood, Patricia Aronson; (University of Medicine and Dentistry of New Jersey, Newark, NJ) Norman Lasser, Bali Singh, Vera Lasser, John Kostis; (University of Miami, Miami, FL) Mary Jo O'Sullivan, Linda Parker, R. Estape, Diann Fernandez; (University of Minnesota, Minneapolis, MN) Karen L. Margolis, Richard H. Grimm, Donald B. Hunninghake, June LaValleur, Sarah Kempainen; (University of Nevada, Reno, NV) Robert Brunner, William Graettinger, Vicki Oujevolk; (University of North Carolina, Chapel Hill, NC) Gerardo Heiss, Pamela Haines, David Ontjes, Carla Sueta, Ellen Wells; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller, Jane Cauley, N. Carole Milas; (University of Tennessee, Memphis, TN) Karen C. Johnson, Suzanne Satterfield, Raymond W. Ke, Jere Vile, Fran Tylavsky; (University of Texas Health Science Center, San Antonio, TX) Robert Brzyski, Robert Schenken, Jose Trabal, Mercedes Rodriguez-Sifuentes, Charles Mouton; (University of Wisconsin, Madison, WI) Gloria Sarto, Douglas Laube, Patrick McBride, Julie Mares-Perlman, Barbara Loevinger; (Wake Forest University School of Medicine, Winston-Salem, NC) Denise Bonds, Greg Burke, Robin Crouse, Lynne Parsons, Mara Vitolins; (Wayne State University School of Medicine/Hutzel Hospital, Detroit, MI) Susan Hendrix, Michael Simon, Gene McNeeley, Pamela Gordon, Paul Makela.

Former WHI Investigators: Catherine Allen (University of Wisconsin, Madison, WI) *, Sandy Dougherty* (University of Nevada, Reno, NV), Richard Carleton*(Brown University, Providence, RI).

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Howard, B., Adams-Campbell, L., Allen, C. et al. Insulin resistance and weight gain in postmenopausal women of diverse ethnic groups. Int J Obes 28, 1039–1047 (2004).

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