The effect of menopause on metabolic syndrome: cross-sectional results from the Canadian Longitudinal Study on Aging : Menopause

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The effect of menopause on metabolic syndrome: cross-sectional results from the Canadian Longitudinal Study on Aging

Christakis, Marie K. MD, MPH; Hasan, Haroon BSc, MPH; De Souza, Leanne R. PhD; Shirreff, Lindsay MD, MSc(HQ)

Author Information

1Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Ontario, Canada

2Epi Methods Consulting, Toronto, Ontario, Canada

3Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Address correspondence to: Marie K. Christakis, MD, MPH, Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, 61 Queen St East, 5th Floor; Toronto, ON M5C 2T2, Canada. E-mail: [email protected]

Received 6 February, 2020

Revised 20 March, 2020

Accepted 20 March, 2020

Funding/support: This work was funded by a New Investigator Grant provided by the St. Michael's Hospital Department of Obstetrics and Gynecology. This research was made possible using the data/biospecimens collected by the Canadian Longitudinal Study on Aging (CLSA). Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation. This research has been conducted using the CLSA dataset Baseline Tracking Dataset version 3.4 and Baseline Comprehensive Dataset version 4.0, under Application Number 180103. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland.

The opinions expressed in this manuscript are the author's own and do not reflect the views of the Canadian Longitudinal Study on Aging.

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's Website (www.menopause.org).

Menopause 27(9):p 999-1009, September 2020. | DOI: 10.1097/GME.0000000000001575

Abstract

Objectives: 

Data were examined from women surveyed in the Canadian Longitudinal Study on Aging to evaluate whether menopause is an independent risk factor for the development of metabolic syndrome (MetS) or its components, including hypertension, central obesity, dyslipidemia, or elevated glycated hemoglobin.

Methods: 

We conducted a cross-sectional analysis of women aged 45-85 years old that participated in the baseline data of the Canadian Longitudinal Study on Aging Comprehensive Cohort collected from 2012 to 2015. Modified Poisson regression with robust error variance was used to estimate the crude and adjusted relative risks (aRRs) of MetS in postmenopausal women compared to premenopausal women.

Results: 

Among 12,611 women analyzed, 10,035 (79.6%) had undergone menopause and 2,576 (20.4%) were premenopausal. Postmenopausal women were more likely to meet criteria for MetS compared to premenopausal women (32.6% vs 20.5%, P < 0.001). Using the MetS criteria with a lower waist circumference threshold, the prevalence of MetS was higher at 38.2% among postmenopausal women and 23.2% among premenopausal women (P < 0.001). After adjusting for age, body mass index, and other covariates, the occurrence of menopause was not associated with a significantly higher relative risk of MetS, using the unified criteria for MetS (aRR 1.09 [95% CI: 0.99-1.19]). Women with menopause had a significantly higher relative risk of MetS when using criteria with a lower waist circumference (aRR 1.10 [95% CI: 1.01-1.19]). Menopause was also associated with a higher risk of impaired glucose tolerance (aRR 1.42 [95% CI: 1.26-1.59]), elevated blood pressure (aRR 1.12 [95% CI: 1.03-1.21]), and elevated triglycerides (aRR 1.17 [95% CI: 1.08-1.26]).

Conclusion: 

Menopause is associated with an increased risk of MetS, independent of age. Lifestyle interventions targeted at women with MetS are known to prevent type 2 diabetes mellitus and cardiovascular risk. Perimenopause may be an important preventative care opportunity to assess metabolic risk factors and improve health and longevity of Canadian women.

© 2020 by The North American Menopause Society

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