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Changes in LDL density across the menopausal transition.

M C Carr1, K H Kim, A Zambon

  • 1Department of Medicine, University of Washington, Seattle 98195-6426, USA. carr@u.washington.edu

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
|August 1, 2000
PubMed
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Menopause increases coronary artery disease risk due to denser LDL particles and higher LDL cholesterol. These changes, linked to BMI, triglyceride, and HDL-C, worsen the lipoprotein profile in postmenopausal women.

Area of Science:

  • Cardiovascular Health
  • Endocrinology
  • Lipid Metabolism

Background:

  • Coronary artery disease (CAD) risk escalates in women post-menopause.
  • Lipid profile alterations, including changes in low-density lipoprotein (LDL) particle size and buoyancy, may underlie this increased risk.
  • Lipoprotein levels and LDL buoyancy across menopausal stages remain under-characterized.

Purpose of the Study:

  • To characterize lipoprotein concentrations and LDL buoyancy across different stages of the menopausal transition.
  • To investigate the relationship between menopausal status, lipid profiles, and LDL particle characteristics.

Main Methods:

  • Cross-sectional study of five groups: premenopausal (n=42), early (n=35), middle (n=19), late (n=20) menopausal transition, and postmenopausal women (n=14).

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  • Measured plasma lipoprotein concentrations, LDL buoyancy, and body mass index (BMI).
  • Excluded women using estrogen therapy.

    • Main Results:

    • Postmenopausal women exhibited significantly higher LDL cholesterol (LDL-C) and total cholesterol than premenopausal women.
    • Women in late menopausal transition showed significantly higher LDL-C and Apo B compared to premenopausal women.
    • All menopausal transition and postmenopausal women displayed denser LDL particles than premenopausal women, with changes explained by triglyceride, HDL-C, and BMI.

    Conclusions:

    • Menopausal transition is linked to denser LDL and elevated LDL-C levels.
    • Denser LDL particle production begins early in the menopausal transition, while LDL-C increases later.
    • Increased triglycerides and decreased HDL, associated with increased BMI, drive the shift to small, dense LDL, potentially increasing atherosclerosis risk.