Objective: In women, cardiovascular (CV) risk increases significantly after the age of 50, i.e., with the onset of menopause, while in men a similar increase occurs approximately ten years earlier. Menopause represents an important life transition and is associated with adverse cardio-kidney-metabolic changes. The aim of this study was to examine changes in lipid status and in newly proposed risk biomarkers in menopause and compare them with men of the same age. Design and method: This cross-sectional analysis was conducted within the nationwide EH-UH 2 project and included a representative sample of non-institutionalized adults. We analysed 624 menopausal women (mean age 64), 308 premenopausal women (mean age 41), and 514 men (mean age 65). Using routine laboratory methods we determined new CV risk biomarkers: total cholesterol (T-Ch), HDL-ch, LDL-Ch, triglycerides (Tg), Lp(a), ApoAI, ApoB and calculated Tg/glucose (G), TgG index, Tg/HDL, atherosclerotic index, Tg*BMI, G/HDL, remnant Ch, and ApoA/ApoB. Results: Compared to premenopausal women, menopausal women had significantly higher all lipid parameters (p<0.001), beside ApoAI, and all new CV risk biomarkers (p<0.01). We observed some gender differences when analyzed menopausal women and men of the same age. Compared to menopausal women, men had higher Tg, Lp(a) TgG index, Tg/HDL, atherosclerotic index, Tg, remnant cholesterol, and ApoA/ApoB, and lower HDL. On contrary, menopausal women compared to men of the same age had higher values of T-Ch, LDL-ch, ApoAI, as well as Tg*BMI index, atherosclerotic index, and G/HDL. There were no gender differences (menopausal vs. men of the same age) in Tg/G, remnant-Ch, and ApoB.Conclusions: We observed important changes in lipid status of menopausal women, the transition from a hormonally protective to a proatherogenic profile (an increased number of atherogenic lipoproteins and loss of the protective HDL fraction) which contribute to higher CV risk in menopause. Observed gender differences points on differences in lipid metabolism between men and women even in menopause. In addition, new risk biomarkers may allow earlier identification of women who lose the cardioprotective effect of oestrogen and enter a high-risk cardiometabolic state.
Bilobrk et al. (Fri,) studied this question.