The Emergence of the Metabolic Syndrome with Menopause (original) (raw)
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Emergence of Metabolic Syndrome Out of Menopausal Box!!!
Journal of SAFOMS
Metabolic syndrome is the constellation of risk factors that predisposes to increased risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus that is increasingly coming to light in menopausal females, thereby raising the morbidity and mortality. Declining estrogen levels along with genetic susceptibility and central obesity adversely affect the lipid metabolism, making postmenopausal females vulnerable to metabolic syndrome. Early identification of the various risk factors and appropriate preventive strategies (lifestyle modification and use of statins in selective cases) may decrease the emergence of metabolic syndrome in such females, thereby improving the longevity. Screening of risk factors for metabolic syndrome in postmenopausal females should be routinely done and therefore incorporated and inculcated in every postmenopausal clinic so that suitable candidates can be referred to cardiologists for expert advice and proper intervention if required.
Menopause and the metabolic syndrome
Menopause is the period in a woman's life when she is undergoing hormonal and metabolic changes. Metabolic syndrome or syndrome X comprises of a set of cardiovascular risk factors: obesity, elevated blood pressure, hyperglycemia or insulin resistance and dyslipidemia. Menopause is the point in the timeline of a woman where she is exposed to risk factors for cardiac ill health. The preferential central pattern of fat deposition in obese post-menopausal women is associated with a higher risk of diabetes, hypertriglyceridemia, hypertension and cardiac disease. Hormone therapy improves the altered lipid profile in women with metabolic syndrome and these effects are more pronounced in post-menopausal women. It is important to have more efforts for regular lipid screening and educational programs for a healthy life style for an obese post-menopausal woman.
Prevalence of Metabolic Syndrome and Effect of Hormone Profile in Postmenopausal Patients
Journal of Academic Research in Medicine, 2016
Objective: The purpose of this study was to evaluate the prevalence and connection with hormonal changes of metabolic syndrome and its components in postmenopausal women based on a literature survey. Methods: The medical records of 138 postmenopausal patients were retrospectively reviewed between January 2013 and March 2014. Patients with surgical menopause and those who underwent hormone replacement therapy, chemotherapy, and radiotherapy were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients' demographic data, menopausal status, medical history, and physical examination and clinical laboratory data were analyzed. Data were evaluated statistically. Results: In total, 128 patients were included in this study. The menopausal age of patients in the metabolic syndrome group was 50.06±2.93 and that in the non-metabolic syndrome group was 45.16±4.4 years. The prevalence of metabolic syndrome was observed in 43.4% patients in this study. A statistically significant negative high correlation (p<0.05) was observed between waist circumference and the number of metabolic components with FSH-LH levels. Conclusion: The prevalence of metabolic syndrome among postmenopausal women is high, and abdominal obesity and low HDL levels are strong predictors. These components can lead to an increase in cardiovascular diseases. Thus, it is encouraging to adopt lifestyle changes that reduce the prevalence of metabolic syndrome.
Effect of menopausal hormone therapy on components of the metabolic syndrome
Therapeutic Advances in Cardiovascular Disease, 2016
The world population is aging, and women will spend an increasing share of their lives in a postmenopausal state that predisposes to metabolic dysfunction. Thus, the prevalence of metabolic syndrome (MetS) in women is likely to increase dramatically. This article summarizes the effects of menopause in predisposing to components of MetS including visceral obesity, dyslipidemia, type 2 diabetes (T2D) and hypertension (HTN). We also summarize the effects of menopausal hormone therapy (MHT) in reversing these metabolic alterations and discuss therapeutic advances of novel menopausal treatment on metabolic function.
Maturitas, 1996
The protective effect of estrogen against cardiovascular diseases (CVD) in women disappears after menopause. However, it is not clear whether the change in risk factors after menopause is related to aging or estrogen deprivation. Objective: To assess the risks for CVD and the contribution of aging in estrogen-deprived women. Methods: Forty-one patients with premature ovarian failure (POF) (group 1) and 30 patients with natural menopause (group 2) were investigated with respect to well-known risk factors for CVD. Fifteen young women at reproductive age (group 3) were taken as controls. The median ages (ranges) of the groups were 31 (19-40), 52 (46-67) and 26 (24-29) years, respectively. Family and personal history for CVD, smoking, oral contraceptive usage, physical examination, blood pressure measurement, body mass index (BMI), blood level of fasting insulin, diabetes mellitus, and the levels of lipoprotein proteins were the examined parameters regarding the risks for CVD. Results: The levels of triglycerides and very low density lipoprotein (VLDL) cholesterol were not different in the 3 groups. The levels of fasting insulin (11.3k6.6 vs. 10.2f5.8 W/ml), the ratio of fasting insulin to fasting blood glucose (12.2-&6.3X vs. 10.5+5.40/o), high density lipoprotein (HDL) cholesterol (51.9 + 12.9 vs. 51.6 + 9.7 mg/d), low density lipoprotein (LDL) cholesterol (113 f 47 vs. 127 + 37 mg/dl) and the ratio of HDL to total cholesterol (27.2 f 9.8% vs. 24.1 f 6.9%) were not different in women with POF and natural menopause. These parameters were all better in controls with respect to risk for CVD (respectively, 6.5 f 2.0 IU/ml, 7.4 + 2.2%, 37.9 f 5.3 mg/dl, 80 + 40 mg/dl. P < 0.05). Conclusion: Risk factors for CVD are related to estrogen deprivation. Aging does not have an important impact on CVD within the age range of this study group.
Relationships Between Obesity, Lipids and Fasting Glucose in the Menopause
Maturitas, 2009
Introduction Menopause leads to the development of central adiposity, a more atherogenic lipid profile and increased incidence of metabolic syndrome independent of age and other factors. Objective The aim of the study was to investigate the relationships between anthropometric characteristics, sex hormones, lipids and fasting glucose in menopausal women. Methods The study included 87 menopausal women, who where divided into groups according to two criteria: BMI≥26.7 kg/m 2 and BMI≥25 kg/m 2 . Anthropometric characteristics and blood pressure were measured. Blood was taken at 08.00 h for fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A, apolipoprotein B, lipoprotein(a) (Lp(a)), C-reactive protein, fibrinogen, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). Results Significant differences between groups were found for weight, BMI, waist, hips circumference, waist/hip ratio (WHR), systolic and diastolic blood pressure, Lp(a), FSH, LH, PRL (for systolic blood pressure p<0.05, for the rest p<0.01) and fasting glucose (p<0.05). In obese and overweight women with BMI≥26.7kg/m 2 significant negative correlations were found for FSH and glucose, SHBG and LDL, SHBG and total cholesterol, SHBG and glucose, BMI and HDL, WC and HDL. In obese and overweight women with BMI≥25kg/m 2 significant negative correlations were found for BMI and HDL, waist circumference (WC) and HDL, WHR and HDL, FSH and glucose, SHBG and glucose; significant positive correlations were between BMI and glucose, WC and glucose and WHR with triglycerides. Conclusion Gaining weight and decreased SHBG are related to dyslipidemia and increased fasting glucose confirming increased incidence of metabolic abnormalities in the menopause.
Metabolic syndrome in menopausal transition: Isfahan Healthy Heart Program, a population based study
Diabetology & Metabolic Syndrome, 2010
INTRODUCTION: There is a remarkable increase in cardiovascular disease after menopause. On the other hand, metabolic syndrome as a collection of risk factors has a known effect on cardiovascular diseases. Hormone changes are considered as one of the main relevant factor regarding cardiovascular disease as well as some recognized relationship with metabolic syndrome's components. This study was carried out in
Postmenopausal changes of lipid and glucose metabolism: a review of their main aspects
Maturitas, 1995
In postmenopausal women, partly in relation to advancing age and partly due to oestrogen deficiency, there is a frequent increase in body weight, and more specifically, in android fat distribution. In addition, loss of ovarian function is associated with the development of a more atherogenic profile with increased triglycerides, LDL-cholesterol and its smaller dense subfractions, decreased HDL-and HDLZcholesterol and, potentially, an irregular increase in Lp(a). Not only does oestrogen therapy counteract all these changes towards a definitely less atherogenic profile but oestrogens seem also implicated in reducing LDL oxidative products, in favouring a higher ratio of prostacyclin to thromboxane and, potentially, of endothelium derived relaxing factor to endothelin, and also in acting as a calcium antagonist in the vessel wall. All of these favourable vascular effects are not solely attributable to lipid-related oestrogen effects. Excess weight and central obesity, diet changes and lack of exercise, more frequent with advancing age, all concur to alter glucose tolerance and increase insulin resistance during the postmenopause. Impaired glucose tolerance and diabetes mellitus may be found in nearly 20% of women aged 55 to 65 years. In addition, oestrogen deficiency may be further responsible for decreased pancreatic insulin secretion and alteration of its metabolic clearance rate-changes that can be reversed toward improved insulin secretion and sensitivity by oestrogen treatment in small dosages. By contrast, synthetic androgenic progestins can counteract these effects of oestrogens more than progesterone derivatives do, and they may partly help to promote insulin resistance and hyperinsulinism. Indeed, long lasting hyperinsulinaemia has been linked to an increased risk of cardiovascular morbidity and mortality, maybe in relation to the effects of excess insulin on vascular wall and its adverse impact on lipoprotein metabolism and haemostatic factors. Accordingly, long term administration of androgenic progestins at the menopause should be best avoided.