title: Progression of Metabolic Syndrome Severity During the Menopausal Transition.
abstract: After menopause, women exhibit a higher prevalence of the metabolic syndrome (MetS) and higher risk of cardiovascular disease. However, the timing of changes in MetS severity over the menopausal transition and whether these changes differ by racial/ethnic group remain unclear.
  
  
  
  We assessed data from 1470 women from the Atherosclerosis Risk in Communities cohort who experienced transition in menopausal status over 10 years (visits 1-4). We used linear mixed models to evaluate changes by menopausal status (premenopause, perimenopause, and postmenopause) in a MetS severity Z-score and in the individual MetS components. While there were gradual increases in MetS severity over time across menopause stages, black women in particular exhibited more rapid progression in MetS severity during the premenopausal and perimenopausal periods than during the postmenopausal period. In the postmenopausal period (compared with prior periods), white women exhibited unfavorable decreases in high-density lipoprotein, while black women exhibited favorable alterations in the rate of change for waist circumference, triglycerides, high-density lipoprotein, and glucose, contributing to the slowed progression of MetS severity. These changes were all observed after adjusting for hormone replacement treatment.
  
  
  
  During menopausal transition, women exhibited rapid increases in MetS severity during the premenopausal and perimenopausal periods, with black women having significant reductions in this increase in severity during the postmenopausal period. These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause. These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause.
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gurka
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Vishnu
authors.affiliation: Division of Endocrinology, Department of Medicine, University of Virginia, Charlottesville, VA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Santen
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, VA deboer@virginia.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008593:Menopause / Q000502:physiology*; D024821:Metabolic Syndrome / Q000473:pathology*; D008875:Middle Aged; D047648:Perimenopause / Q000502:physiology; D017698:Postmenopause / Q000502:physiology; D017697:Premenopause / Q000502:physiology; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: cardiovascular disease risk factors; menopause; metabolic syndrome; race and ethnicity; type 2 diabetes mellitus