The effect of menopause on metabolic syndrome: cross-sectional results from the Canadian Longitudinal Study on Aging

Abstract

Objectives: Data were examined from women surveyed in the Canadian Longitudinal Study on Aging to evaluate whether menopause is an independent risk factor for the development of metabolic syndrome (MetS) or its components, including hypertension, central obesity, dyslipidemia, or elevated glycated hemoglobin. Methods: We conducted a cross-sectional analysis of women aged 45-85 years old that participated in the baseline data of the Canadian Longitudinal Study on Aging Comprehensive Cohort collected from 2012 to 2015. Modified Poisson regression with robust error variance was used to estimate the crude and adjusted relative risks (aRRs) of MetS in postmenopausal women compared to premenopausal women. Results: Among 12,611 women analyzed, 10,035 (79.6%) had undergone menopause and 2,576 (20.4%) were premenopausal. Postmenopausal women were more likely to meet criteria for MetS compared to premenopausal women (32.6% vs 20.5%, P < 0.001). Using the MetS criteria with a lower waist circumference threshold, the prevalence of MetS was higher at 38.2% among postmenopausal women and 23.2% among premenopausal women (P < 0.001). After adjusting for age, body mass index, and other covariates, the occurrence of menopause was not associated with a significantly higher relative risk of MetS, using the unified criteria for MetS (aRR 1.09 [95% CI: 0.99-1.19]). Women with menopause had a significantly higher relative risk of MetS when using criteria with a lower waist circumference (aRR 1.10 [95% CI: 1.01-1.19]). Menopause was also associated with a higher risk of impaired glucose tolerance (aRR 1.42 [95% CI: 1.26-1.59]), elevated blood pressure (aRR 1.12 [95% CI: 1.03-1.21]), and elevated triglycerides (aRR 1.17 [95% CI: 1.08-1.26]). Conclusion: Menopause is associated with an increased risk of MetS, independent of age. Lifestyle interventions targeted at women with MetS are known to prevent type 2 diabetes mellitus and cardiovascular risk. Perimenopause may be an important preventative care opportunity to assess metabolic risk factors and improve health and longevity of Canadian women.

Associations of Relative Humidity and Lifestyles with Metabolic Syndrome among the Ecuadorian Adult Population: Ecuador National Health and Nutrition Survey (ENSANUT-ECU) 2012

“…Additionally, menopausal stage increased ORs of MetS, elevated blood pressure, and increased waist circumference in women living in high relative humidity compared to non-menopausal women living at the same humidity levels, indicating sex hormones may explain these differences. Several studies also revealed that menopause is associated with an increased risk of MetS and its components, which supports our outcomes [48][49][50].…”

The Role of Estrogen in Insulin Resistance

“…28 In support of this hypothesis, it has been shown that surgically induced menopause increases the risk of developing insulin resistance and metabolic syndrome. 29 Clinical studies show that post-menopausal women are more susceptible than premenopausal women to develop dyslipidemia, an increase in body weight (evaluated through body mass index and waist circumference), and impaired glucose tolerance (as shown by their levels of hyperinsulinemia and increased fasting glucose levels). 28e31 Metabolic disturbances, such as insulin resistance, tend to dramatically increase with the onset of menopause, and estrogen replacement therapy significantly reduces the risk of metabolic syndrome.…”

The Role of Different Indexes of Adiposity and Body Composition for the Identification of Metabolic Syndrome in Women with Obesity

“…As a consequence of this trend, elderly women, both obese and non-obese, are at higher risk and therefore need to be more closely followed longitudinally. Appropriate interventions targeted at subjects with MetS may be an important preventive care to improve health and longevity, particularly in postmenopausal women [ 3 ].…”