Does body mass index, smoking, lipoprotein levels, surgically induced menopause, hormone replacement therapy, years since menopause, or age affect hemostasis in postmenopausal women?
BACKGROUND
Controversy still exists as to the relative importance of menopausal status and lifestyle factors for the risk of coronary heart disease in women.


OBJECTIVE
The purpose of this study was to assess the influence of body mass index (BMI), smoking,lipoprotein levels, surgically induced menopause, hormone replacement therapy (HRT), years since menopause, and age on hemostasis in apparently healthy postmenopausal women.


METHODS
Lipoproteins (total cholesterol [TC], low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL-C], triglycerides [TG]), and hemostatic factors (fibrinogen, von Willebrand factor antigen [vWFag], coagulation factors VIIag [FVIlag] and VIIa [FVIIa], plasminogen activator inhibitor 1 [PAI-1]) were each measured once. A forward, stepwise, multiple regression analysis was used to assess variations in hemostatic parameters.


RESULTS
A group of 292 healthy Stockholm women recruited from the census register participated in the Stockholm Female Coronary Risk Study as controls. Of these women, 260 participated in the present study. BMI, smoking, lipoprotein levels, surgically induced menopause, and years since menopause (1-5 y) were found to be associated with a 31% increase in fibrinogen levels. A 7% increase in FVIIa levels was attributed to TC, BMI, and HRT. Years since menopause (1-15 y), TG, TC, BMI, and HRT were associated with an increase of up to 26% in FVIIag levels. A 9% increase in vWFag correlated with HDL-C and years since menopause (1-10, 11-14, and > or =15 y). BMI and TG explained a 21% and 3% increase, respectively, in PAI-1 levels. Neither the use of HRT nor years since menopause had any influence on hemostasis.


CONCLUSIONS
BMI, high levels of TC and TG, and low HDL-C levels appear to be more important than hormonal status in their impact on hemostatic variables in healthy postmenopausal women.
Pripp
Ulla
U
Department of Cardiology, Karolinska University Hospital, Solna, Stockholm, Sweden.
Eriksson-Berg
Margita
M
Orth-Gomér
Kristina
K
Schenck-Gustafsson
Karin
K
Landgren
Britt-Marie
BM
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003327:Coronary Disease / Q000503:physiopathology; D015914:Estrogen Replacement Therapy; D005260:Female; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D017698:Postmenopause / Q000502:physiology*; D012044:Regression Analysis; D012907:Smoking