High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

Abstract

Lipoprotein(a) is an inherent CVD risk biomarker that varies by race, and the levels of Lp(a) in Saudi women are relatively unexplored. We aimed to examine the effect of age and menopause on Lp(a) and explore the correlation between adiposity and cardiometabolic risk factors with Lp(a) in Saudi women. The third aim was to determine the predictors of elevated Lp(a) in this population. In this cross-sectional study of 229 women, we compared Lp(a) serum levels, adiposity indices, and lipid and glycemic profiles between menopausal groups. We used immunoturbidimetry to measure serum Lp(a) and BIA to assess body composition. We evaluated the relationship between Lp(a) and our parameters using ANOVA and Spearman’s correlations. Regression was used to determine the predictors of high-risk Lp(a) levels. The mean of Lp(a) was 28.37 mg/dL, and the concentration increased significantly in postmenopausal (premenopausal 20.98 ± 12.30; perimenopausal 29.92 ± 9.53; postmenopausal 32.49 ± 9.83 mg/dL; p < 0.001. High-risk levels were 57.1% in postmenopausal and 19.1% in premenopausal. The magnitude of Lp(a) increased significantly after age 50. Lp(a) was significantly associated with age and cholesterol and negatively associated with % FFM. Lp(a) increased by 0.41 units for every year of age, indicating the strongest correlation.

Estimation of Sarcopenia Indices in Women from Saudi Arabia in Relation to Menopause and Obesity: Cross-Sectional Comparative Study

“…Losing ovarian hormones during menopause is associated with changes in adipose tissue distribution from subcutaneous to visceral regions [54].Consistent with our previous study [14],we found that postmenopausal women had higher BMI, percentage of total body fat, and fat mass than premenopausal women, which may be attributed to alterations in endogenous sex hormones as a potential mechanism of action to explain the increase in adiposity in women during menopause [55].…”

“…Premenopausal and postmenopausal women differ in age, making it challenging to separate the effects of aging from those of menopause. As noted in our previous study, age strongly predicts increased cardiovascular risk among women [14]. The mid-40s-to-50s transition to menopause is characterized by a considerable decrease in ovarian follicle counts and a corresponding decrease in estrogen levels [67].…”

“…Although data are limited, it appears that women post menopause present a specific change in body composition with menopause. We recently reported that menopause in Saudi women was associated with changes in body composition; postmenopausal women have lower muscle mass and higher BMI and body fat percentage than premenopausal women [14]. This observation raised two questions: Shall we apply the same cut-off for premenopausal and postmenopausal women to detect low muscle strength?…”

Gender differences in plasma levels of cardiovascular risk markers and severity indices in Saudi patients with angiographic evidence of coronary artery disease

“…These findings are in line with the findings of Nikkila et al who reported a higher TC among 21 elderly females. Our findings are f u r t h e r s t r e n g t h e n e d b y t h e Framingham Study, that revealed high in serum cholesterol levels in women between the premenopausal and postmenopausal stages, with the rise taking place within a short time of the 13,22 onset of the menopause. As the mean age of our female CAD cases was (57.35 years), we also attribute these higher TC and LDL to the effect of hormonal changes during post menopause,…”

Lipoprotein(a) and Atherosclerotic Cardiovascular Disease: Where Do We Stand?

“…Various hormonal changes may also influence Lp(a) levels [ 59 ]. Conditions such as hypothyroidism, growth hormone deficiency in adults, and the depletion of endogenous sex hormones (e.g., menopause, ovariectomy, castration, orchidectomy) have been associated with increased Lp(a) concentration [ 60 , 61 , 62 , 63 ]. Conversely, hormonal replacement therapy with thyroxine or in cases of hyperthyroidism, as well as hormonal replacement treatment in postmenopausal women, have been shown to reduce Lp(a) levels in a case-dependent manner [ 64 , 65 , 66 ].…”