Metabolic Syndrome Risk is Elevated in the Years Leading to Menopause
The risk factors related to metabolic syndrome (MetS) increased more rapidly in the years leading up to menopause than following menopause, according to a new study.
“This may mean that the higher cardiovascular risk seen among postmenopausal women could be related to changes in that time before menopause and less so to the changes after menopause has occurred,” said study coauthor Mark D. DeBoer, MD, MSc, MCR, in the Department of Pediatrics at the University of Virginia in Charlottesville. “The reasons for this are unclear.”
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The researchers assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1-4). They used linear mixed models to evaluate changes by menopausal status (pre-, peri-, and postmenopause) in a MetS severity z score and in the individual MetS components.
While the investigators saw gradual increases in MetS severity over time across menopause stages, African American women in particular exhibited more rapid progression in MetS severity during the pre- and perimenopausal periods than during the postmenopausal period. In the postmenopausal period (compared with prior periods), white women exhibited unfavorable decreases in high-density lipoprotein (HDL) cholesterol, while African American women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, HDL cholesterol, and glucose, contributing to the slowed progression of MetS severity. They observed these changes after adjusting for hormone replacement treatment.
“These findings suggest a need to pay attention to cardiovascular risk starting in the years leading up to menopause,” Dr DeBoer said. “Knowing a tendency for rapid worsening of metabolic syndrome may lead to important lifestyle changes. Increases in exercise and an improvement in dietary factors could help to offset these increases in metabolic syndrome severity,” he said.
Dr DeBoer is continuing to evaluate the extent of links between the severity of MetS and risk for cardiovascular disease and type 2 diabetes. In addition, he is investigating the link between the change in MetS severity over time as an indicator of ominous increases in disease risk.
—Mike Bederka
Reference:
Gurka MJ, Vishnu A, Santen RJ, DeBoer MD. Progression of metabolic syndrome severity during the menopausal transition [published online August 3, 2016]. J Am Heart Assoc. doi:10.1161/JAHA.116.003609.