The independent associations of anti-Müllerian hormone and estradiol levels over the menopause transition with lipids/lipoproteins: The Study of Women's health Across the Nation.
Level 3 - non-randomized controlled study
Prospective longitudinal cohort study without randomization.
PubMed 36517413 · doi:10.1016/j.jacl.2022.11.008
What was done
A longitudinal cohort study evaluated 1,440 women (mean baseline age 47.4 ± 2.6 years) participating in the Study of Women's Health Across the Nation (SWAN) followed across up to 9 visits between 1997 and 2013. Participants were tracked through natural menopause without exogenous hormone use, hysterectomy, or bilateral oophorectomy. The study evaluated independent associations of premenopausal levels and longitudinal changes in anti-Müllerian hormone (AMH) and estradiol (E2) with lipid and lipoprotein profiles (total cholesterol [TC], triglycerides [TG], LDL-C, HDL-C, apolipoprotein B [apoB], and apolipoprotein A-1 [apoA-1]) through the first postmenopausal visit.
What was found
The abstract reports directions of independent associations without numeric effect sizes or confidence intervals: - Lower premenopausal AMH and greater declines in AMH were independently associated with greater TC and HDL-C. - Greater declines in AMH were independently associated with greater apoA-1. - Lower premenopausal E2 and greater declines in E2 were independently associated with greater TG and apoB, and lower HDL-C. - Greater declines in E2 were independently associated with greater TC and LDL-C.
Why it matters
This study shows that AMH and estradiol changes independently and distinctly contribute to midlife lipid remodeling, linking estradiol decline to an atherogenic profile and AMH decline to alterations in HDL-C and apoA-1.
Limits
The abstract reports no numerical estimates, standard errors, or p-values. The observational design cannot establish causality or eliminate residual confounding. Results exclude women who used exogenous hormones or had surgical menopause, and hard clinical cardiovascular outcomes were not assessed.
Cited by
- supports The loss of estrogen during menopause causes adverse changes in lipid and metabolic markers, including increased LDL, ApoB, triglycerides, and decreased HDL.