INFLUENCE OF MENOPAUSE AND LIFE-STYLE FACTORS ON HIGH-DENSITY-LIPOPROTEINS IN MIDDLE-AGED WOMEN

The risk of cardiovascular diseases in women is low until menopause, b ut increases considerably afterward. Data on changes in high density l ipoproteins caused by menopause are controversial. The aim of this inv estigation was to establish the influence of various endogenous (age, body mass index, blood pressure, sex hormones) and exogenous (dietary habits, smoking and drinking behavior, physical activity) factors on v ariables associated with high density lipoprotein metabolism. One thou sand twenty-one working female participants of the DRECAN Study aged b etween 36 and 65 years were investigated. Two-thirds of the study popu lation were premenopausal and one-third were postmenopausal. High dens ity lipoprotein cholesterol and apolipoprotein AI concentrations did n ot correlate with age and did not change significantly as a consequenc e of menopause. Postmenopausal women without hormone replacement thera py showed significantly higher values of age-, body mass index-, and b lood pressure-adjusted ratios of triglycerides/high density lipoprotei n cholesterol, low density lipoprotein cholesterol/high density lipopr otein cholesterol, and apolipoprotein B/apolipoprotein AI as compared with premenopausal women not using oral contraceptives. The current us e of oral contraceptives or of hormone replacement therapy was associa ted with a lower low density lipoprotein cholesterol/high density lipo protein cholesterol ratio. These changes were caused mainly by increas ed serum concentrations of triglycerides, total cholesterol, and apoli poprotein B and not by changes in high density lipoprotein concentrati ons. Cigarette smoking decreased high density lipoprotein cholesterol. Apolipoprotein Al concentration was directly influenced by the amount of daily energy intake. A high caloric diet rich in cholesterol and s aturated fatty acids increased high density lipoprotein 2 cholesterol. There was no influence of higher alcohol intake or physical activity at leisure time on variables of high density lipoprotein metabolism. A higher level of physical activity at the workplace lowered the ratio of triglycerides/high density lipoprotein cholesterol. In premenopausa l women, the use of oral contraceptives increased apolipoprotein Al co ncentrations.