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Progression of Metabolic Syndrome Severity During the Menopausal Transition.
J Am Heart Assoc. 2016 08 03; 5(8)JA

Abstract

BACKGROUND

After menopause, women exhibit a higher prevalence of the metabolic syndrome (MetS) and higher risk of cardiovascular disease. However, the timing of changes in MetS severity over the menopausal transition and whether these changes differ by racial/ethnic group remain unclear.

METHODS AND RESULTS

We assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1-4). We used linear mixed models to evaluate changes by menopausal status (premenopause, perimenopause, and postmenopause) in a MetS severity Z-score and in the individual MetS components. While there were gradual increases in MetS severity over time across menopause stages, black women in particular exhibited more rapid progression in MetS severity during the premenopausal 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, while black women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, high-density lipoprotein, and glucose, contributing to the slowed progression of MetS severity. These changes were all observed after adjusting for hormone replacement treatment.

CONCLUSIONS

During menopausal transition, women exhibited rapid increases in MetS severity during the premenopausal and perimenopausal periods, with black women having significant reductions in this increase in severity during the postmenopausal period. These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause. These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause.

Authors+Show Affiliations

Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL.Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL.Division of Endocrinology, Department of Medicine, University of Virginia, Charlottesville, VA.Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, VA deboer@virginia.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27487829

Citation

Gurka, Matthew J., et al. "Progression of Metabolic Syndrome Severity During the Menopausal Transition." Journal of the American Heart Association, vol. 5, no. 8, 2016.
Gurka MJ, Vishnu A, Santen RJ, et al. Progression of Metabolic Syndrome Severity During the Menopausal Transition. J Am Heart Assoc. 2016;5(8).
Gurka, M. J., Vishnu, A., Santen, R. J., & DeBoer, M. D. (2016). Progression of Metabolic Syndrome Severity During the Menopausal Transition. Journal of the American Heart Association, 5(8). https://doi.org/10.1161/JAHA.116.003609
Gurka MJ, et al. Progression of Metabolic Syndrome Severity During the Menopausal Transition. J Am Heart Assoc. 2016 08 3;5(8) PubMed PMID: 27487829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progression of Metabolic Syndrome Severity During the Menopausal Transition. AU - Gurka,Matthew J, AU - Vishnu,Abhishek, AU - Santen,Richard J, AU - DeBoer,Mark D, Y1 - 2016/08/03/ PY - 2016/8/5/entrez PY - 2016/8/5/pubmed PY - 2018/1/9/medline KW - cardiovascular disease risk factors KW - menopause KW - metabolic syndrome KW - race and ethnicity KW - type 2 diabetes mellitus JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 5 IS - 8 N2 - BACKGROUND: After menopause, women exhibit a higher prevalence of the metabolic syndrome (MetS) and higher risk of cardiovascular disease. However, the timing of changes in MetS severity over the menopausal transition and whether these changes differ by racial/ethnic group remain unclear. METHODS AND RESULTS: We assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1-4). We used linear mixed models to evaluate changes by menopausal status (premenopause, perimenopause, and postmenopause) in a MetS severity Z-score and in the individual MetS components. While there were gradual increases in MetS severity over time across menopause stages, black women in particular exhibited more rapid progression in MetS severity during the premenopausal 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, while black women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, high-density lipoprotein, and glucose, contributing to the slowed progression of MetS severity. These changes were all observed after adjusting for hormone replacement treatment. CONCLUSIONS: During menopausal transition, women exhibited rapid increases in MetS severity during the premenopausal and perimenopausal periods, with black women having significant reductions in this increase in severity during the postmenopausal period. These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause. These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/27487829/Progression_of_Metabolic_Syndrome_Severity_During_the_Menopausal_Transition_ L2 - https://www.ahajournals.org/doi/10.1161/JAHA.116.003609?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -