Association between HDL-C levels and menopause: a meta-analysis

Area of Science:

• Cardiovascular Health
• Endocrinology
• Women's Health

Background:

• Menopause is associated with changes in lipid profiles.
• Existing data on high-density lipoprotein-cholesterol (HDL-C) levels in postmenopausal women remain inconclusive.

Purpose of the Study:

• To conduct a systematic review and meta-analysis to clarify HDL-C levels in postmenopausal women.
• To compare lipid profiles, including HDL-C, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), between premenopausal and postmenopausal women.

Main Methods:

• Systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science databases (1987-2020).
• Inclusion of 20 studies (18 cross-sectional, 2 cohort) with 5652 postmenopausal and 7825 premenopausal women.
• Meta-analysis using random effects models to estimate standard mean difference (SMD) and 95% confidence intervals (CI); meta-regression and subgroup analyses were performed.

Main Results:

• No significant difference in HDL-C levels was found between postmenopausal and premenopausal women (SMD = -0.053, 95% CI -0.171 to 0.066).
• Postmenopausal women exhibited significantly higher levels of LDL-C, TC, and TG compared to premenopausal controls.
• Meta-regression analysis indicated no influence of country, publication year, or study quality on HDL-C levels, and no significant publication bias was detected.

Conclusions:

• This meta-analysis indicates that menopause does not alter HDL-C levels, contrary to the increases observed in LDL-C, TC, and TG.
• Further prospective studies with large populations are needed to investigate HDL-C levels and functions across different menopausal statuses.