FACTORS ASSOCIATED TO AN ATHEROGENIC LIPI D PROFILE IN PREMENOPAUSAL WOMEN WITHOUT CLINICAL CARDIOVASCULAR-DISEASE

BACKGROUND: TO investigate different factors associated to a non desir able lipid profile in premenopausal women without cardiovascular disea se. To determine the independent factors of lipid profile as a whole o f the sample, for planning preventive studies. PATIENTS AND METHODS: W e study [March 1994 to June 1996) premenopausal women with alcohol con sumption less than 14 g/day and normal serum level of glucose. Group I : women with a non desirable lipid profile (total cholesterol [TCH, mg /dl]/high density lipoprotein cholesterol [HDL-C, mg/dl] greater than or equal to 5). Group II: with a desirable lipid profile (TCH/HDL-C < 5). The following factors were analyzed: age, body mass index (BMI), w aist/hip ratio (W/H), systolic blood pressure [SBP, mmHg], fasting pla sma insulin (fpl, mu U/ml), cigarette smoke [CS) and presence of paren ts with history of non insulin dependent diabetes mellitus (NIDDM) or hypertension. Statistical methods: Mann-Whitney and Student statistics . Contingency-table analysis (chi(2) statistic). Pearson correlation a nd multiple linear regression. RESULTS: We analyzed 126 women (age = 3 0 +/- 8.2; 95% Cl, 29-32; TCH = 197 +/- 36; 95% Cl, 190-203 mg/dl), wi th 20 women (group I] and 106 (group II). Women from group I had highe r values of W/H (0.83 +/- 0.04 vs 0.78 +/- 0.06; p < 0.001), BMI (29.9 +/- 9 vs 24.6 +/- 4.9; p < 0.03), fpl (12.9 +/- 10.4 vs 7.8 +/- 3,5; p < 0.05), SEP (125.9 vs 117; p < 0.02); as well as higher percentage of smokers (75 vs 40%; p < 0.01) and parents with NIDDM (60 vs 26%; p < 0.01) or hypertension (60 vs 49%; NS). No differences of age were de tected (32 +/- 7.3 vs 30 +/- 8.3; NS). BMI (0.32; p < 0.01), W/H (0.50 ; p < 0.01), SEP [0.27; p < 0.01) and fp] (0.33; p < 0.01) were positi vely correlated with TCH/HDL-C ratio (n = 126). In multiple regression analysis (n = 126), W/H (regression coefficient = 6.1; 95% Cl, 3.1-9. 1), fpl (regression coefficient = 0.045; 95% Cl, 0.018-0.072) and CS ( regression coefficient = 0.5; 95% Cl, 0.336-0.667) were the only indep endent predictors (p < 0.01) of the TCH/HDL-C ratio, controlling a 46% of the Variance (R-2 = 0.46). CONCLUSIONS: Our data indicates that ce ntral obesity, hyperinsulinemia and cigarette smoke are independently associated to a high risk cardiovascular lipid profile in premenopausa l women without cardiovascular disease. This study suggests the import ance of these factors in the management of early lipid control in thes e women.