Serum lipids and lipoproteins in relation to endogenous and exogenous female sex steroids and age: The Women’s Health in the Lund Area (WHILA) study

Abstract

Background: Different studies have presented conflicting results concerning the effect of menopause on lipid levels. Aims: To describe the serum lipid profile and the prevalence of hyperlipidemia in women aged 50–60 and the perceived relation to endogenous and exogenous hormones and age. Methods: Out of a total population of 10,766 women aged 50–59 years, 6908 (64%) participated in a health assessment program, including a lipid profile evaluation. The women were grouped according to hormonal status into pre-menopausal (PM), post-menopausal without hormone replacement therapy (PM0) (HRT) and post-menopausal with hormone replacement therapy (PMT). Age groups used were 50–54, 55–59 and >60 years. Results: Serum cholesterol and triglycerides increased significantly by age in PM0 ( P<0.0001) and triglycerides also in PMT ( P<0.0001). Serum high-density lipoprotein cholesterol (HDL) levels decreased significantly by age in PMT ( P=0.002) and low-density lipoprotein cholesterol (LDL) increased in PM0 ( P<0.0001) and PMT ( P=0.007). The co-prevalence of levels of cholesterol >7 and triglycerides >2 mmol/l decreased by age in PM, but increased by age in PM0 and PMT. The prevalence of high-risk lipid levels and the prevalence of coexisting additional two metabolic risk factors were higher in the PM0 compared to the PMT group. The prevalence of serum triglycerides >1.5 and serum cholesterol >5 mmol/l were increasing by age in each of the hormonal groups. Conclusions: These data suggest that loss of endogenous sex steroids contribute substantially to an increased atherogenic lipid profile. Hormone replacement therapy may partly reverse these differences.