Abstract
Background: Dyslipidemia is highly prevalent among women. The management of dyslipidemia is a cornerstone in the prevention of both primary and secondary cardiovascular events, such as myocardial infarction, ischemic stroke, and coronary death. All major international guidelines on the treatment of dyslipidemia recommend similar approaches to the management of dyslipidemia in both men and women. Women experience a number of hormonal changes throughout their lifetime, including those changes associated with puberty, menarche, pregnancy, and menopause. Each of these hormonal perturbations can alter serum lipoprotein levels. Hence the aim of this study was to assess the lipid profile in pre and post menopausal women.
Materials & Methods: In this hospital based study100 female patients between the age group of 26-70 were included.
The lipid profile was assessed using standard methodologies. Statistical analysis were performed using the SPSS (Version 16; SPSS Inc., Chicago, IL, USA). Quantitative data were expressed as mean ± SD.
Results: In our study population 45% belonged to Grade I obesity, while 19% Grade II obesity and the remaining 36% were found to be non-obese. A statistically significant difference was observed in Triglyceride and HDL cholesterol levels (p <0.05 ).
Conclusion: Therefore, it can be concluded that menopause leads to changes in lipid profile by causing significant alterations in total and LDL cholesterol and by reducing HDL cholesterol. The elevated LDL and the reduction of cardio protective HDL is an indication that menopause is an independent risk factor for developing cardiovascular disease.
Keywords: Cardiovascular disease, Cholesterol, Postmenopausal women.
References
- Bonithon-Kopp C, Scarabin P-Y, Darne B, Malmejac A, Guize L. Menopause-related changes in lipoproteins and some other cardiovascular risk factors. Int J Epidemiol. 1990;19(1):42–48. [PubMed]
- Wu Z, Wu X, Zhang Y. Relationship of menopausal status and sex hormones to serum lipids and blood pressure. Int J Epidemiol. 1990;19(2):297–302 [PubMed]
- Akahoshi M, Soda M, Nakashima E, Shimaoka K, Seto S, Yano K. Effects of menopause on trends of serum cholesterol, blood pressure, and body mass index Circulation. 1996;94(1):61–66. [PubMed]
- Hjortland MC, McNamara PM, Kannel WB. Some atherogenic concomitants of menopause: the Framingham study. Am J Epidemiol. 1976;103(3):304-311. [PubMed]
- Carr MC, Kim KH, Zambon A, et al. Changes in LDL density across the menopausal transition. J Investig Med Off Publ Am Fed Clin Res. 2000;48(4):245–250. [PubMed]
- Matthews KA, Meilahn E, Kuller LH, Kelsey SF, Caggiula AW, Wing RR. Menopause and risk factors for coronary heart disease. N Engl J Med. 1989;321 (10):641–646. [PubMed]
- Lip GY, Blann AD, Jones AF, Beevers DG. Effects of hormone-replacement therapy on hemostatic factors, lipid factors, and endothelial function in women undergoing surgical menopause: implic-ations for prevention of atherosclerosis. Am Heart J. 1997;134 (4):764–771. [PubMed]
- Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004; 364:937-952
- Kannel WB Wilson PW Risk factors that attenuate the female coronary disease advantage. Arch Intern Med. 1995;15557- 61
- Colditz GA Willett WC Stampfer MJ Rosner BSpeizer FE Hennekens CH Menopause and the risk of coronary heart disease in women. N Engl J Med. 1987;3161105- 1110Crossref
- Johnson CLR BMSempos CT et al. Declining serum total cholesterol levels among US adults: the National Health and Nutrition Examination Surveys. 1993;2693002- 3008Crossref
- Welty FK. Cardiovascular disease and dyslipidemia in women. Arch Intern Med 2001;161:514-22.
- Campos HMcNamara JRWilson PWFOrdovas JMSchaefer EJ Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women. J Clin Endocrinol Metab.1988;6730- 35Crossref
- Mosca LManson JE Sutherland SELanger RD Manolio TBarrett-Connor E Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. 1997;962468- 2482Crossref
- Manolio TA Pearson TAWenger NK Barrett-Connor EPayne GHHarlan WR Cholesterol and heart disease in older persons and women: review of an NHLBI workshop. Ann Epidemiol. 1992;2161- 176Crossref
- Walsh JMGrady D Treatment of hyperlipidemia in women. JAMA 1995;2741152- 1158Crossref
- Stevenson JCCrook DGodsland IF Influence of age and menopause on serum lipids and lipoproteins in healthy women 1993;9883- 90Crossref
- Kalavathi L, Dhruvanarayan HR, Zachariah E. Plasma estradiol and lipid profile in perimenopausal women. Indian J Physiol Pharmacol 1991;35:260-2.
- Muzzio ML, Berg G, Zago V, Basilio F, Sanguinetti S, Lopez G, et al.Circulating small dense LDL, endothelial injuring factors and fibronectin in healthy postmenopausal women. Clin Chim Acta 2007;381:157-63.
- Swapnali RK, Kisan R, Jayaprakash Murthy DS. Effect of menopause on lipid profile and apolipoproteins. Al-Ameen J Med Sci 2011;4:221-8.
- Kwiterovich PO, Coresh J, Smith HH, Bachorik PS, Derby CA, Pearson TA. Comparison of the plasma levels of apolipoproteins B and A-I and other risk factors in men and women with premature coronary artery disease. Am J Cardiol 1992;69:1015-21.
- Wakatsuki A, Sagara Y. Lipoprotein metabolism in postmenopausal and oophorectomized women. Obstet Gynecol 1995;85:523-8.
- Kuller LH, Meilahn EN, Cauley JA, Gutai JP, Matthews KA. Epidemiologic studies of menopause: Changes in risk factors and disease. Exp Gerontol 1994;29:495-509.
- Kannel WB. Studies of coronary heart disease risk factors: Perspective from the Framingham study. Am Heart J 1987;114:413-9.
- Swarnalatha PK, Ebrahim NK. A correlative study of estrogen and lipid profile in premenopausal and post-menopausal women. Int J Biomed Adv Res 2012;03:11.
- Padubidri VG, Daftary SN. Howkins and Bourne Shaw’s Textbook of Gynaecology. 13 th ed. New Delhi: Elsevier; 2004. p. 56-8.
- Spencer CP, Godsland H, Stevenson JC. Is there a menopausal metabolic syndrome? Gynecol Endocrinol 1977;11:341-55.
- Adashi EY. The climacteric ovary as a functional gonadotropin driven androgen- producing gland. Fertil Steril 1994;62:20-7.
- Barrett-Connor E, Bush TL. Estrogen and coronary heart disease in women. JAMA 1991;265:1861-7.
- Groedstein F, Stampfer MJ, Manson JE, Colditz GA, Willet WC, Rosner B, et al. Post-menopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med 1996;335:453-61.
- Wild RA, Taylor EL, Knehans A. The gynecologist and the prevention of cardiovascular disease. Am J Obstet Gynecol 1995;172:1-13.
- Arora S, Jain A, Chitra R. Effects of short-term hormone replacement on atherogenic indices in Indian postmenopausal women. Indian J Clin Biochem 2006;21:41-7
- Welty FK. Cardiovascular disease and dyslipidemia in women. Arch Intern Med 2001;161:514-22.
- Tankó LB, Bagger YZ, Qin G, Alexandersen P, Larsen PJ, Christiansen C. Enlarged waist combined with elevated triglycerides is a strong predictor of accelerated atherogenesis and related cardiovascular mortality in postmenopausal women. Circulation 2005;111:1883-90.
- Abbott RD, Wilson PW, Kannel WB, Castelli WP. High density lipoprotein cholesterol, total cholesterol screening, and myocardial infarction. The Framingham Study. Arteriosclerosis 1988;8:207-11.
- Stampfer MJ, Colditz GA. Estrogen replacement therapy and coronary heart disease: A quantitative assessment of the epidemiologic evidence. Prev Med 1991;20:47-63.
- Cheng GS. Cardiac events increased in the first 2 years of HRT. Intern Med News 2000;33:1-2.
Corresponding Author
R.S. Diana
Professor, Department of Nutrition, Sri Balaji College of Nursing
No 7, CLC Works Road, Chromepet, Chennai- 600 044, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.88
