Risk for metabolic syndrome rises after menopause
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Postmenopausal women are more likely to have metabolic syndrome compared with premenopausal women, putting them at an increased risk for heart disease and stroke, according to a study published in Menopause.
“Independent of the aging process, becoming postmenopausal increases a Canadian woman’s risk of developing impaired glucose tolerance, elevated blood pressure, elevated triglycerides and metabolic syndrome,” Marie K. Christakis, MD, MPH, assistant professor in obstetrics and gynecology at St. Michael’s Hospital and assistant professor at University of Toronto, told Healio. “Metabolic syndrome increases the risk of heart disease and cancer, the two leading causes of death among women.”
Christakis and colleagues analyzed data from 12,611 women aged 45 to 85 years who participated in the Canadian Longitudinal Study on Aging Comprehensive Cohort from 2012 to 2015. The study compared data between women who were postmenopausal (n = 10,035) and premenopausal (n = 2,576).
The researchers used two definitions to determine whether a woman had metabolic syndrome. The first definition was based on a set of unified criteria developed by the International Diabetes Federation, the American Heart Association and the National Heart, Lung, and Blood Institute: elevated waist circumference, triglycerides and BP; low HDL cholesterol; and IGT. In the second definition, the threshold for waist circumference was lowered to 80 cm from the unified criteria’s 88 cm, citing the International Diabetes Federation’s recommendation of an 80-cm waist circumference threshold to define abdominal obesity for women of European origin. Researchers noted 96% of the cohort was of European origin.
The study found a higher prevalence of metabolic syndrome in women who were postmenopausal (32.6%) vs. women who were premenopausal (20.5%) under the unified criteria (P < .001). Under the second definition, the percentage with metabolic syndrome increased to 38.2% for postmenopausal women and 23.2% for premenopausal women (P .001).
When using the unified criteria, menopause was not considered to significantly increase the risk for metabolic syndrome. However, under the second definition, menopause significantly increased the relative risk for metabolic syndrome (adjusted RR = 1.1; 95% CI, 1.01-1.19). Menopause was also associated with certain components of metabolic syndrome, including IGT (aRR = 1.42; 95% CI, 1.26-1.59), elevated BP (aRR = 1.12; 95% CI, 1.03-1.21) and elevated triglycerides (aRR = 1.17; 95% CI, 1.08-1.26).
Women who were premenopausal (19.9%) were more likely to report weight gain in the previous 6 months vs. women who were postmenopausal (15.8%; standardized difference, –0.11). The findings could give providers an opportunity to increase awareness for women about changes in weight during menopause transition and to provide intervention strategies, the researchers wrote.
“Perimenopause may be an important opportunity for clinicians to assess women’s risk factors for metabolic syndrome and provide preventive care to improve their health and longevity,” Christakis said. “Providers can ensure that perimenopausal women are screened for metabolic syndrome and counseled on how metabolic syndrome can impact their future. Lifestyle interventions targeted at women with metabolic syndrome are known to prevent type 2 diabetes and cardiovascular disease.”
Researchers also looked at metabolic syndrome risk in 3,885 postmenopausal women who used menopause hormone therapy vs. women who did not. The study found no significant difference under either definition of metabolic syndrome.
“Future research is needed to explore how the dose, duration and timing of menopause hormone therapy may modulate the risk of metabolic syndrome or its components,” Christakis said.
For more information:
Marie K. Christakis, MD, MPH, can be reached at the Department of Obstetrics and Gynecology, St. Michael’s Hospital, University of Toronto, 61 Queen St. East, Fifth Floor, Toronto, ON M5C 2T2, Canada; email: christakism@smh.ca
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