Patterns of Cardiometabolic Health as Midlife Women Transition to Menopause: A Prospective Multiethnic Study
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Published on: January 28, 2014
Elizabeth Ward1, Ellen B Gold2, Wesley O Johnson1
1Department of Statistics, University of California Irvine, Irvine, California.
Context:
Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women.
Objective:
To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components in multiracial/ethnic women in midlife.
Design:
We conducted a prospective, longitudinal, multiethnic cohort study of 3003 midlife women undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three of five components: high fasting triglyceride (hTG) level, low high-density lipoprotein cholesterol (lHDL-C) level, high fasting plasma glucose (hGluc) level, large waist circumference (abdominal obesity; Ob), and hypertension (HTN). We described the patterns of constellations and estimated hazard ratios (HRs) for constellations at (i) incident MetS and (ii) recovery from MetS, using multivariable-adjusted Cox regression.
Setting:
Seven US sites.
Participants:
In all, 1412 non-Hispanic white, 851 black, 272 Japanese, 237 Hispanic, and 231 Chinese women.
Exposures:
Race/ethnicity, lifestyle factors, and MT stage.
Main Outcomes Measures:
Cardiometabolic constellations, incident MetS, and MetS recovery.
Results:
Central obesity was the most frequent component. Having no components was the most frequent (31%) baseline constellation. Physical activity (HR = 1.68; 95% CI: 1.06, 2.68) and lower caloric intake (HR = 0.96; 95% CI: 0.93, 0.99 per 100 cal/d) were associated with recovery from MetS. Ob/hTG/lHDL-C (18%), Ob/HTN/lHDL-C (16%), and Ob/HTN/hGluc (14%) were frequent incident constellations. Physically active women had 26% to 62% lower hazards of incident MetS than inactive women.
Conclusions:
Modifiable lifestyle behaviors were related to recovery from MetS and decreased risk of the most frequent MetS constellations in midlife women.
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