title: Lipid Changes Around the Final Menstrual Period Predict Carotid Subclinical Disease in Postmenopausal Women.
abstract: Atherogenic changes in lipids occur among women around the time of the natural menopause, that is, within 1 year of the final menstrual period (FMP). We investigated whether lipid changes around the FMP are related to carotid intima-media thickness, interadventitial diameter, and plaque in postmenopausal women.
  
  
  
  A total of 863 natural postmenopausal women with no history of heart attack or stroke underwent carotid ultrasound scans at follow-up year 12 or 13 of the Study of Women's Health Across the Nation. Estimates of their annual change in lipids were segmented into the year before and after the FMP, before the year before FMP, and 1 year after FMP. Multivariate analyses were adjusted for sociodemographic characteristics, time from FMP to scan, baseline body mass index and systolic blood pressure, and use of medications for hypertension and diabetes mellitus at the scan.
  
  
  
  Smaller increases in high-density lipoprotein cholesterol and apolipoprotein A1 within 1 year of the FMP were related to greater interadventitial diameter, β (SE)=-0.036 (0.015), P=0.02, and β (SE)=-0.035 (0.013), P=0.006, respectively. Greater increases in low-density lipoprotein cholesterol within 1 year of FMP were related to greater likelihood of plaque scores ≥2, odds ratio, 1.071; 95% confidence interval, 1.018-1.127; P=0.009. Magnitude of associations was reduced but remained significant with further adjustment for premenopausal lipid levels. The difference in probability of elevated plaque scores was 50% between those in the highest and lowest low-density lipoprotein cholesterol change tertiles.
  
  
  
  Changes in lipids as women approach the FMP provide useful clinical information for understanding postmenopausal carotid indices.
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.). matthewska@upmc.edu.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Samar R
authors.initials: SR
authors.lastname: El Khoudary
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Maria M
authors.initials: MM
authors.lastname: Brooks
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Siobán D
authors.initials: SD
authors.lastname: Harlow
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Emma J M
authors.initials: EJ
authors.lastname: Barinas-Mitchell
authors.affiliation: From the Departments of Psychiatry and Psychology (K.A.M., R.C.T.) and Department of Epidemiology (K.A.M., S.R.E.K., M.M.B., E.J.M.B.-M., R.C.T.), University of Pittsburgh, PA; Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York (C.A.D.); and Department of Epidemiology, University of Michigan, Ann Arbor (S.D.H.).
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
mesh_terms: D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness / Q000639:trends*; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008137:Longitudinal Studies; D008598:Menstruation / Q000097:blood*; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D011237:Predictive Value of Tests
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL
keywords: atherosclerosis; body mass index; cholesterol; lipids; menopause; race