Metabolic Syndrome and Atherosclerosis in Nondiabetic Postmenopausal Women
The aim of this chapter is to analyse and critically appraise current knowledge regarding the effect of menopause on metabolic syndrome (MetS) and its components, as well as on the risk of atherosclerosis and cardiovascular disease (CVD). Transition to menopause is characterised by a decrease in oestrogen concentrations, relative androgen excess and a decrease in sex hormone-binding globulin concentrations, which are accompanied by changes in fat tissue distribution and increased prevalence of central obesity, insulin resistance and MetS. Some of the individual components of MetS seem to be affected by menopause per se, such as disorders of glucose metabolism, while some others seem to be the result of increased central obesity and insulin resistance, such as hypertension. The lipid profile worsens during the menopausal transition, but whether this phenomenon is irrespective of age, body mass index and central obesity is inconclusive. The presence of MetS appears to increase the risk of CVD after menopause. Surgical menopause is strongly associated with a higher incidence of MetS and increased risk for CVD. Bearing in mind that most women will spend more than one-third of their lifespan in the menopausal status, public health strategies should encourage women to maintain normal body weight during the transition to post-reproductive life, in an attempt to counteract the consequences of both chronological and ovarian ageing.
KeywordsMenopause Metabolic syndrome Obesity Atherosclerosis Cardiovascular disease
None to declare.
- 1.Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.PubMedCrossRefGoogle Scholar
- 9.Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med. 2003;163:427–36.PubMedPubMedCentralCrossRefGoogle Scholar
- 44.Benjamin EJ, Blaha MJ, Chiuve SE, et al.; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135:e146–603.Google Scholar
- 48.Qiuping G, Burt VL, Paulose-Ram R, Charles F. Dillon gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999–2004. Am J Hypertens. 2008;21:789–98.CrossRefGoogle Scholar
- 70.Muka T, Oliver-Williams C, Kunutsor S, et al. Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis. JAMA Cardiol. 2016;1:767–76.PubMedCrossRefGoogle Scholar