Common cardiometabolic risk factor constellations for women in mid-life identified by race, ethnicity

SAN DIEGO — The risk for specific constellations of metabolic syndrome components may be related to race/ethnicity and physical activity in women who develop the disorder during the menopausal transition, according to research presented at The Endocrine Society annual meeting.

“Most of the focus of cardiometabolic disease risk in women has been in postmenopausal women, but imagine if we could identify early and prevent the longitudinal accrual of cardiometabolic risk factors in mid-life women,” Jennifer S. Lee, MD, PhD, of Stanford University Medical Center, California told Endocrine Today.

Jennifer S. Lee

Using data from the Study of Women Across the Nation (SWAN), which followed pre-/early peri-menopausal women though the transition, Lee and colleagues looked at data from 2,097 women who did not have metabolic syndrome at baseline.

At least three of five components (triglyceride > 150mg/dL (hTG); HDL cholesterol < 50 mg/dL (lHDL); fasting glucose ≥ 100 mg/dL (hGluc); waist circumference > 88 cm (80 cm for Asians)(Obese); and blood pressure > 130/85 mm Hg (HTN) were required for diagnosis.

The investigators examined the relationships of modifiable and nonmodifiable factors to the common constellations of metabolic syndrome components satisfied during mid-life, with an observation period up to 7 years.

Discrete time Cox regression models were used to identify factors associated with risk; models included age, education, alcohol use, menopausal transition stage (pre-/early peri-menopause, late peri-/post-menopause, or hormone therapy use), race/ethnicity (except Hispanic, due to small sample size), physical activity, smoking status, fiber intake and caloric intake.

During the transition, 163 women developed metabolic syndrome. The three most common constellations at the time of diagnosis were obesity/high triglycerides/low HDL cholesterol; obesity/high blood pressure/low HDL cholesterol; and obesity/high blood pressure/high fasting glucose.

In multivariable models, African Americans demonstrated a lower risk (HR = 0.08, 95% CI 0.01-0.61) of developing the constellation of obesity/high triglycerides/low HDL cholesterol but a higher risk of developing the constellation of obesity/high blood pressure/low HDL cholesterol (HR = 3.75, 1.36-10.34) compared with non-Hispanic whites.

Physical activity was associated with a reduced risk for obesity/high triglycerides/low HDL cholesterol (HR = 0.87, 0.69-1.11).

“This study identified the more common constellations of cardiometabolic risk factors that developed in mid-life women of different races/ethnicities,” Lee said. “It begins to inform about more personalized health care strategies, towards preventing early such constellations and, we hope, cardiometabolic disease outcomes after the mid-life in women” – by Allegra Tiver

Reference:

Lee J. Abstract OR13-3. Presented at: The Endocrine Society Annual Meeting; March 5-8, 2015, San Diego.

Disclosure: Lee reports no relevant financial disclosures.