The Severity of Menopausal Symptoms Is Associated With Diabetes and Cardiometabolic Risk Factors in Middle-Aged Women

Abstract

Background: Ovarian senescence is associated with increased cardiovascular disease risk. We aimed to evaluate the association between menopausal symptoms, and cardiometabolic risk factors, in a cohort of apparently healthy middle-aged women. Methods: The cohort included 2,793 peri- and postmenopausal women (menopausal age≤15 years), not on menopausal hormone therapy. Participants were classified into perimenopausal (-3 to +2 years), early- (EM, 2 to 7 years) or late-menopausal (LM, >7 years) after the last menstrual period. Demographic/anthropometric and biochemical/hormonal data were assessed. The severity of menopausal symptoms was evaluated by the Greene Climacteric scale (GCS). Findings: Fitting mixed-effects models, GCS-total score associated with BMI (b=0.12, 95%CI: 0.04 to 0.20), T2DM (b=2.10, 95%CI: 0.06 to 4.15), LM (b=-1.24, 95%CI: -2.17 to -0.33). GCS-psychological score associated with BMI (b=0.06, 95%CI: 0.00 to 0.11). GCS-Physical score associated with BMI (b=0.06, 95%CI: 0.03 to 0.09), central obesity (b=0.18, 95%CI: 0.02 to 0.34), menopausal status (EM and LM vs. perimenopause, b=-0.36, 95%CI: -0.59 to -0.13 and b=-0.65, 95%CI: -0.97 to -0.34, respectively). All previous GCS-scores associated negatively with age. GCS-vasomotor score associated negatively with LM. Fitting poisson mixed models, GCS-sexual score associated positively with EM (incidence rate ratio (IRR)=1.53, 95%CI: 1.21 to 1.94), central obesity (IRR=1.18, 95%CI: 1.00 to 1.39), smoking, diastolic blood pressure, age. Interpretation: The severity of menopausal symptoms is associated with T2DM, obesity and smoking, in a cohort of peri- and postmenopausal women. These associations must be considered on the implementations of primary and secondary prevention strategies. Funding Information: This study did not receive any funding. Declaration of Interests: None to declare. Ethics Approval Statement: All participants signed an informed consent; institutional review board approval was obtained by the Ethics Committee of the Aretaieion Hospital.