INFLUENCE OF SPONTANEOUS AND SURGICAL MENOPAUSE ON ATHEROGENIC METABOLIC RISK

We evaluated serum total-, LDL-, HDL-, cholesterol and triglycerides i n 858 women. Sixty-seven were in premenopause, 307 in perimenopause, 3 26 in spontaneous menopause, and 158 women underwent hysterectomy. Of these, 101 had bilateral ovariectomy, 24 with unilateral ovariectomy a nd 33 with retention of both ovaries. After correcting for chronologic al age and body mass index by variance analysis, it was found that tot al-, LDL- and HDL-cholesterol significantly increased during menopause without changes in the total cholesterol/HDL-cholesterol, LDL-cholest erol/HDL-cholesterol and triglycerides/HDL-cholesterol ratio. The chan ges gradually occurred during the months preceding spontaneous cessati on of menses. Atherogenic metabolic risk (as relative risk of high tot al and LDL-cholesterol, estimated by logistic regression analysis) sig nificantly increased in all groups of women in reference to premenopau se. The risk observed in surgical menopause with bilateral ovariectomy was higher than in spontaneous menopause, and conservation of ovaries in hysterectomized women seems to protect only partially against such an increase.