Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA.
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA.
J Lipid Res. 2021;62:100098. doi: 10.1016/j.jlr.2021.100098. Epub 2021 Jul 22.
The cardioprotective association of high-density lipoprotein cholesterol (HDL-C) may vary by menopause stage or estradiol level. We tested whether associations of comprehensive HDL metrics (HDL subclasses, phospholipid and triglyceride content, and HDL cholesterol efflux capacity [HDL-CEC]) with coronary artery calcium (CAC) score and density vary by menopause stage or estradiol level in women transitioning through menopause. Participants (N = 294; mean age [SD]: 51.3 [2.9]) had data on HDL metrics and CAC measures at one or two time points during the menopause transition. Generalized estimating equations were used for analyses. Effect modifications by menopause stage or estradiol level were tested in multivariable models. In adjusted models, menopause stage modified the associations of specific HDL metrics with CAC measures. Higher small HDL particles (HDL-P) concentrations (p-interaction = 0.008) and smaller HDL size (p-interaction = 0.02) were associated with greater odds of CAC presence in late perimenopause than in pre/early perimenopause stage. Women in the highest estradiol tertile, but not the lower tertiles, showed a protective association of small HDL-P with CAC presence (p-interaction = 0.007). Lower large HDL-P concentrations (p-interaction = 0.03) and smaller HDL size (p-interaction = 0.03) were associated with lower CAC density in late perimenopause than in postmenopause stage. Associations of HDL phospholipid and triglyceride content and HDL-CEC with CAC measures did not vary by menopause stage or estradiol level. We concluded that HDL subclasses may impact the likelihood of CAC presence and the stability of coronary plaque differently over the menopause transition. Endogenous estradiol levels may contribute to this observation.
高密度脂蛋白胆固醇 (HDL-C) 的心脏保护作用可能因绝经阶段或雌二醇水平而异。我们测试了综合 HDL 指标（HDL 亚类、磷脂和甘油三酯含量以及 HDL 胆固醇流出能力 [HDL-CEC]）与冠状动脉钙 (CAC) 评分和密度的相关性是否因绝经阶段或绝经过渡期间女性的雌二醇水平而异。参与者（N=294；平均年龄[SD]：51.3[2.9]）在绝经过渡期间的一个或两个时间点有 HDL 指标和 CAC 测量数据。使用广义估计方程进行分析。在多变量模型中测试了绝经阶段或雌二醇水平的效应修饰。在调整后的模型中，绝经阶段改变了特定 HDL 指标与 CAC 测量值的关联。与绝经前期相比，晚期绝经后期的小 HDL 颗粒 (HDL-P) 浓度较高（p 交互作用=0.008）和 HDL 粒径较小（p 交互作用=0.02）与 CAC 存在的可能性更大。处于雌二醇最高三分位的女性，但不是较低三分位的女性，小 HDL-P 与 CAC 存在呈保护性关联（p 交互作用=0.007）。与绝经后期相比，晚期绝经后期的大 HDL-P 浓度较低（p 交互作用=0.03）和 HDL 粒径较小（p 交互作用=0.03）与 CAC 密度较低相关。HDL 磷脂和甘油三酯含量以及 HDL-CEC 与 CAC 测量值的相关性不因绝经阶段或雌二醇水平而异。我们得出的结论是，HDL 亚类可能在绝经过渡期间以不同的方式影响 CAC 存在的可能性和冠状动脉斑块的稳定性。内源性雌二醇水平可能促成了这一观察结果。
