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- Title
Menopause Per se Is Associated with Coronary Artery Calcium Score: Results from the ELSA-Brasil.
- Authors
Fonseca, Marília I.H.; Almeida-Pititto, Bianca de; Bittencourt, Márcio S.; Bensenor, Isabela M.; Lotufo, Paulo A.; Ferreira, Sandra R.G.
- Abstract
Background: Menopause and aging deteriorate the metabolic profile, but little is known about how they independently contribute to structural changes in coronary arteries. We compared a broad cardiometabolic risk profile of women according to their menopausal status and investigated if menopause per se is associated with presence of coronary artery calcium (CAC) in the ELSA-Brasil. Materials and Methods: All participants, except perimenopausal women, who had menopause <40 years or from non-natural causes or reported use of hormone therapy were included. Sample was stratified according to menopause and age categories (premenopause ≤45 years, premenopause >45 years, and postmenopause); their clinical profile and computed tomography-determined CAC were compared using Kruskal–Wallis and chi squared test for frequencies. Associations of CAC (binary variable) with menopause categories adjusted for traditional and nontraditional covariables were tested using logistic regression. Results: From 2,047 participants 51 ± 9 years of age, 1,175 were premenopausal (702 ≤ 45 years) and 872 were postmenopausal women. Mean values of anthropometric variables, blood pressure, lipid and glucose parameters, branched-chain amino acids (BCAA), and homeosthasis model assessment (HOMA-IR), as well as frequencies of morbidities, were more favorable in premenopausal, particularly in younger ones. In crude analyses, CAC >0 was associated with triglyceride-rich lipoprotein remnants, dense low-density lipoprotein, BCAA, and other variables, but not with HOMA-IR. Menopause was independently associated with CAC >0 (odds ratios 2.37 [95% confidence interval 1.17–4.81]) when compared to the younger premenopausal group. Conclusion: Associations of menopause with CAC, independent of traditional and nontraditional cardiovascular risk factors, suggest that hormonal decline per se may contribute to calcium deposition in coronary arteries.
- Subjects
BRAZIL; CORONARY arterial radiography; KRUSKAL-Wallis Test; BLOOD pressure; PERIMENOPAUSE; TRIGLYCERIDES; LIPOPROTEINS; CARDIOVASCULAR diseases risk factors; CONFIDENCE intervals; BRANCHED chain amino acids; ANTHROPOMETRY; AGE distribution; BLOOD sugar; DISEASES; LOW density lipoproteins; RISK assessment; CORONARY artery disease; CALCINOSIS; CHI-squared test; DESCRIPTIVE statistics; MENOPAUSE; CORONARY arteries; COMPUTED tomography; LOGISTIC regression analysis; ODDS ratio; LIPIDS; DISEASE risk factors
- Publication
Journal of Women's Health (15409996), 2022, Vol 31, Issue 1, p23
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2021.0182