Findings from recent publications have suggested that early menopause occurring younger than age 45 years is a risk factor for type 2 diabetes, ischemic heart disease, and all-cause mortality; however, the correlation of age at natural menopause (ANM) with cardiovascular risk factors (CVRFs; i.e., blood pressure, blood lipids, glucose metabolism markers) is not fully understood. In a recent publication in the journal Menopause, researchers sought to examine the cross-sectional and longitudinal correlation of early natural menopause with changes in CVRFs.
The authors wrote, “Understanding whether ANM is associated with postmenopausal changes in CVRFs, such as lipids, inflammatory biomarkers, and glucose metabolism, might help to understand factors that could accelerate cardiovascular aging in women.”
The study involved 981 eligible postmenopausal women from the Swiss CoLaus study who reported ANM. All participants had measurements of CVRFs—blood lipids, blood pressure, glucose, homeostatic model assessment for insulin resistance (HOMA-IR), and inflammatory markers such as high-sensitivity C-reactive protein—at baseline between 2003 and 2006 and at first follow-up between 2009 and 2012.
ANM was examined as a continuous variable and in categories (ANM <45 and ≥45 years), and linear regression analysis and linear mixed models were employed to measure whether ANM is associated cross-sectionally and longitudinally with changes in CVRFs. With regard to demographic characteristics, lifestyle-related factors, time since menopause, medication, and clinical conditions models were adjusted. The researchers evaluated ANM as a continuous variable and as menopause at younger than age 45 years (n = 99) and at age 45 years and older (n = 882).
The results revealed that in the cross-sectional analysis, women with ANM <45 years had lower diastolic blood pressure (β = –3.76 mmHg; 95% CI, –5.86 to –1.65) compared with women whose ANM ≥45 (76 mmHg vs. 79 mmHg, respectively). In the longitudinal analysis, ANM <45 years was linked with changes in log insulin (β = .26; 95% CI, 0.08-0.45) and log HOMA-IR levels (β = .28; 95% CI, 0.08-0.48), and there were no correlations discovered between ANM and other CVRFs.
Based on their findings, the authors wrote, “In general, our study showed no consistent associations between ANM and changes in CVRFs. However, our results indicated potential adverse changes in glucose metabolism related to early ANM. Our study found an association between early menopause and changes in insulin and HOMA-IR levels.”
The authors concluded that their findings imply that ANM is not steadily correlated with changes in CVRFs in the postmenopausal years; however, early ANM may be linked with adverse changes in insulin and HOMA-IR in postmenopausal women. They also noted that more extensive studies with validated menopause status and ANM are necessary to replicate their findings and examine whether ANM has short- or long-term effects on CVRFs.
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Published July 11, 2023
