Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil.
Maturitas. 2019 Dec;130:32-37. doi: 10.1016/j.maturitas.2019.09.005. Epub 2019 Sep 12.
It is unclear how aging and menopause-induced lipid changes contribute to the elevated cardiovascular risk in menopausal women. We examined the association between lipid profiles and menopausal status and duration of menopause in the Longitudinal Study of Adult Health (ELSA-Brasil).
This is a cross-sectional analysis of baseline data from women in the ELSA-Brasil, stratified by duration of menopause into 5 groups: pre-menopause, <2 years, 2-5.9 years, 6-9.9 years and ≥10 years of menopause, excluding menopause <40 years or of non-natural cause; also excluded were women using lipid-lowering drugs or hormone replacement. Comparisons were performed using ANOVA with Bonferroni correction. Associations of menopause categories and time since menopause with lipid variables obtained by vertical auto-profile were tested using multiple linear regression.
From 1916 women, postmenopausal groups had unadjusted higher total cholesterol, LDL-c, real LDL-c, IDL-c, VLDL-c, triglycerides, non-HDL-c, VLDL-c, triglyceride-rich lipoprotein remnants (TRL-c) and buoyant LDL-c concentrations than pre-menopausal women, with no difference among postmenopausal groups. In multiple linear regression, duration of menopause <2 years was significantly associated with TRL-c [7.21 mg/dL (95% CI 3.59-10.84)] and VLDL3-c [2.43 mg/dL (95%CI 1.02-3.83)]. No associations of menopausal categories with HDL-c or LDL-c subfractions were found, and nor were associations of time since menopause with lipid subfractions.
In a large sample of Brazilian women, deterioration of the lipid profile following menopause was confirmed, which could contribute to the increased cardiovascular risk. Our findings suggest a postmenopausal elevation in triglyceride-rich lipoprotein remnants. How lipoprotein subfractions change after the onset of menopause warrants investigation in studies with appropriate designs.
尚不清楚衰老和绝经引起的脂质变化如何导致绝经后女性心血管风险增加。我们在巴西成人健康纵向研究（ELSA-Brasil）中检查了血脂谱与绝经状态和绝经持续时间之间的关系。
这是对 ELSA-Brasil 中女性基线数据的横断面分析，根据绝经持续时间分为 5 组：绝经前、<2 年、2-5.9 年、6-9.9 年和≥10 年，排除绝经<40 岁或非自然原因的女性；还排除了使用降脂药物或激素替代治疗的女性。使用方差分析（ANOVA）和 Bonferroni 校正进行比较。使用垂直自动轮廓法获得的血脂变量与绝经类别和绝经后时间的相关性采用多元线性回归进行检验。
在 1916 名女性中，与绝经前女性相比，绝经后组未经调整的总胆固醇、LDL-c、真实 LDL-c、IDL-c、VLDL-c、甘油三酯、非 HDL-c、VLDL-c、富含甘油三酯的脂蛋白残粒（TRL-c）和浮密度 LDL-c 浓度更高，绝经后组之间无差异。在多元线性回归中，绝经<2 年与 TRL-c[7.21mg/dL（95%CI 3.59-10.84）]和 VLDL3-c[2.43mg/dL（95%CI 1.02-3.83）]显著相关。绝经类别的 HDL-c 或 LDL-c 亚组分之间未发现相关性，绝经后时间与脂质亚组分之间也未发现相关性。
在一项巴西女性的大型样本中，绝经后血脂谱恶化得到了证实，这可能导致心血管风险增加。我们的研究结果表明，绝经后甘油三酯富含脂蛋白残粒升高。在适当设计的研究中，需要进一步研究脂蛋白亚组分在绝经后如何变化。
