Trajectories of Blood Lipids Profile in Midlife Women: Does Menopause Matter?
Level 3 - non-randomized controlled study
Prospective longitudinal cohort study
PubMed 37947109 · doi:10.1161/JAHA.123.030388
What was done
Researchers analyzed longitudinal data from 2,582 midlife women in the Study of Women's Health Across the Nation (SWAN) to evaluate blood lipid changes across the menopause transition. Latent class growth mixture modeling was used to identify trajectory patterns for total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), high-density lipoprotein cholesterol (HDL-C), log-transformed triglycerides, and apolipoprotein A-I. Multiple linear regression and multinomial logistic regression models were used to assess whether menopause transition-related factors (age at menopause, follicle-stimulating hormone, estradiol, and vasomotor symptoms) predicted lipid levels and trajectory group membership.
What was found
Women were categorized into distinct trajectory patterns for each lipid measure, specifically inverse U-shaped or progressing trajectories. The inverse U-shaped trajectories for total cholesterol, LDL-C, ApoB, HDL-C, log(TG), and apolipoprotein A-I increased prior to menopause and declined postmenopause. Trajectories for total cholesterol, LDL-C, and ApoB began rising 5 years before menopause. Age at menopause, follicle-stimulating hormone, estradiol, and vasomotor symptoms predicted trajectory shapes and lipid levels. The abstract reports no numerical effect sizes, group proportions, or p-values.
Why it matters
This study provides evidence that blood lipid alterations in midlife women are directly influenced by the menopause transition rather than chronological aging alone. It supports initiating lipid monitoring and cardiovascular risk assessment prior to the final menstrual period.
Limits
The abstract provides no quantitative effect sizes, odds ratios, group distributions, or confidence intervals. As an observational cohort study, residual confounding cannot be excluded.
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.