Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea.
Korea National Institute of Health, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea.
J Korean Med Sci. 2023 Aug 7;38(31):e238. doi: 10.3346/jkms.2023.38.e238.
Adverse lipid profiles are observed in postmenopausal women. However, there is insufficient evidence of the association between lipids and reproductive aging in Korean women. We aimed to characterize lipid changes with respect to timing relative to menopause in Korean middle-aged women.
This study included 1,436 premenopausal women who had a natural menopause during the follow-up period (median = 15.76 years) from the Korean Genome and Epidemiology Study (KoGES) Ansan and Anseong cohort. Lipid levels were measured every 2 years, and the magnitudes of annual lipid changes and differences in the changes by premenopausal body mass index were estimated using piecewise linear mixed-effects models.
All lipid levels increased greatly from 3 or 5 years before menopause to 1 year after menopause in all women, regardless of their premenopausal body mass index. During the period, high-density lipoprotein cholesterol (HDL-C) levels increased at 0.42 mg/dL per year (95% confidence interval [CI], 0.29 to 0.55 mg/dL). Nevertheless, non-HDL-C levels simultaneously increased at 3.42 mg/dL per year (95% CI, 3.11 to 3.72 mg/dL), and an annual change in the non-HDL-C to HDL-C ratio was 0.05 (95% CI, 0.04 to 0.06). One year after menopause, changes in all lipid parameters significantly slowed down, except for the non-HDL-C to HDL-C ratio ( < 0.001 for all). The ratio continued to increase until 3 years after menopause, but thereafter, the change leveled off.
Women experienced remarkable increases in lipid levels during menopausal transition, highlighting the need for early intervention strategies for cardiovascular disease prevention in women.
绝经后女性的血脂谱通常较差。然而，目前缺乏关于韩国女性脂类与生殖衰老之间关系的证据。本研究旨在描述韩国中年女性绝经前后血脂变化与绝经时间的关系。
本研究纳入了韩国基因组与流行病学研究（KoGES）安山和安城队列中的 1436 名自然绝经的绝经前女性（中位随访时间=15.76 年）。每 2 年检测一次血脂水平，采用分段线性混合效应模型估计每年的血脂变化幅度和绝经前体重指数变化的差异。
所有女性的所有血脂水平均在绝经前 3 至 5 年至绝经后 1 年内大幅升高，与绝经前体重指数无关。在此期间，高密度脂蛋白胆固醇（HDL-C）水平每年增加 0.42mg/dL（95%置信区间[CI]，0.29 至 0.55mg/dL）。然而，非高密度脂蛋白胆固醇（non-HDL-C）水平同时每年增加 3.42mg/dL（95%CI，3.11 至 3.72mg/dL），non-HDL-C 与 HDL-C 比值每年增加 0.05（95%CI，0.04 至 0.06）。绝经后 1 年，除了 non-HDL-C 与 HDL-C 比值（所有 P<0.001）外，所有血脂参数的变化均明显减缓。该比值在绝经后 3 年内持续增加，但此后趋于稳定。
女性在绝经过渡期间血脂水平显著升高，这突出表明需要制定早期干预策略，以预防女性心血管疾病。
