Influence of menopause on blood cholesterol levels in women: the role of body composition, fat distribution and hormonal milieu

Abstract

Objectives. In this study we investigated the relationships between blood lipids and menopausal status. Setting and subjects. All data were obtained from the first cross-sectional examination of the Virgilio Menopause Health Project in a large cohort of middle-aged women in pre, peri-, and postmenopausal age. The data refer to 426 women without metabolic or endocrine diseases, relevant hepatic, renal and cardiovascular abnormalities, none were dieting or taking medications. Main outcome measures. A precoded questionnaire including full clinical history, socio-economic and personal information, habitual diet, physical activity, drug use and smoking habits, careful recording of gynaecological events and family history for disease was completed. Several anthropometric parameters and the bioelectrical impedance analysis was used to measure free fatty mass. Blood samples for hormones and biochemistry were also obtained. Results. There were no significant differences on body mass index, fatty mass, free fatty mass and parameters of body fat distribution between the three groups. Again, there were no differences in smoking habits, dietary intake or indices of physical activity amongst the groups. There was a significant increase from pre to postmenopause of LH and FSH and a decrease of oestradiol and testosterone, whereas no difference was found in sex hormone-binding globulin. Age-adjusted values of glucose, triglycerides and high density lipoprotein (HDL-) cholesterol were similar in all groups, whereas postmenopausal women had significantly higher values of total and low density lipoprotein (LDL-) cholesterol. On the contrary, there was a significant fall in insulin levels passing from pre to postmenopause. In multiple regression models, total and LDL-cholesterol correlated positively with body mass index, waist-to-hip ratio and age, and negatively with free fatty mass and oestradiol blood levels. Conclusions. These results are consistent with the hypothesis that menopausal status may have a significant and independent effect in determining increased total and LDL-cholesterol concentrations in postmenopausal women.

Relationships of age, menopause and central obesity on cardiovascular disease risk factors in Chinese women

“…The menopausal differences of cardiovascular disease risk factors in our study were also compatible with previous published reports. 18,21,22 Several variables, including age, menopause, general obesity and body fat distribution, had all been used to explain these menopausal differences. 18,21,31 In our regression models, although age and menopause had shown independent effects on the part of the cardiovascular disease risk factors, the effects of central adiposity mediated most of the changes of cardiovascular disease risk factors.…”

“…Although many reports have con®rmed the increase of cardiovascular diseases during menopause, 1 ± 3 only a few have mentioned the effect of menopause-related central obesity on the worsening cardiovascular disease risk factors. 18,21,22 However, some shortcomings associated with these studies include too few study subjects 18 and the use of relatively imprecise anthropometric methods (such as skinfold thickness and bioelectrical impedance analysis measurement). 21 Furthermore, most of the reports were predominantly done in Caucasian women where BMI, body fat distribution and its metabolic signi®cance may be quite different to those in the Chinese population.…”

“…18,21,22 However, some shortcomings associated with these studies include too few study subjects 18 and the use of relatively imprecise anthropometric methods (such as skinfold thickness and bioelectrical impedance analysis measurement). 21 Furthermore, most of the reports were predominantly done in Caucasian women where BMI, body fat distribution and its metabolic signi®cance may be quite different to those in the Chinese population. Given these facts, our second objective was to evaluate the independent effects of age, menopause, general obesity and body fat distribution on the cardiovascular risk factors in a relatively large group of Chinese women.…”

Composição corpórea, distribuição de gordura e metabolismo de repouso em mulheres histerectomizadas no climatério: há diferenças de acordo com a forma da administração do estrogênio?

“…Muitos estudos demonstram que, em mulheres na pré-menopausa, a atividade da lipase lipoprotéica é maior nas regiões glúteo-femural e mamaria do que na região abdominal (13)(14)(15).…”

“…Na menopausa não foi encontrado aumento do depósito de gordura nas regiões glúteo-femural e mamaria, mas sim de depósito de gordura na região abdominal. Este e outros estudos (13)(14)(15)(16) sugerem fortemente que, em decorrência da diminuição dos níveis dos esteróides sexuais no climatério, há diminuição da atividade lipolítica no tecido adiposo abdominal e da ação da lipase lipoprotéica no tecido adiposo fêmuro-gluteal (13)(14)(15)(16)24,50,60).…”