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Sex hormone levels at midlife may increase risk for CHD in women
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The quality of a woman’s cholesterol carriers degrades when hormone levels change during the transition to menopause, which may increase the risk for CHD, according to new data from the SWAN study.
Researchers sought to evaluate associations between levels of endogenous sex hormones and the size, distribution and concentration of lipoprotein subclasses as measured by nuclear MR spectroscopy in women transitioning to menopause. The study included 120 women from the Pittsburgh site of the SWAN study (mean age, 50.4 years; 57.5% white). Of those, 68 women were classified as perimenopausal or postmenopausal and 52 were classified as premenopausal or early perimenopausal.
After adjustment for age, race, cycle-day of blood draw, BMI, physical activity and alcohol use, the researchers found a negative correlation between estradiol and medium or small LDL particle concentration (P=.04), and a positive correlation between estradiol HDL particle size (P=.02).
For sex hormone-binding globulin, the researchers observed an independent negative correlation with total small LDL particle concentration, a positive correlation with LDL particle size and a positive correlation with HDL particle size (P<.05 for all).
For free androgen index, the researchers found positive correlations with concentrations of very LDL particles, total LDL particles and total small LDL particles, and negative correlations with large HDL particle concentration, HDL particle size and LDL particle size (P<.05 for all).
“We found that lower levels of estradiol, one of the main hormonal changes that mark menopause, are associated with low-quality cholesterol carriers, which have been found to predict risk for heart disease,” Samar R. El Khoudary, PhD, MPH, from the University of Pittsburgh’s Graduate of School of Public Health, said in a press release. “Our results suggest that there may be value in using advanced testing methods to evaluate changes in cholesterol carriers’ quality in women early in menopause so that doctors can recommend diet and lifestyle changes.
“Higher levels of HDL … may not always be protective, as we have thought before,” El Khoudary said.
Disclosure: The researchers report no relevant financial disclosures.
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