Influence of menopause and lifestyle factors on high density lipoproteins in middle-aged women

The risk of cardiovascular diseases in women is low until menopause, but increases considerably afterward. Data on changes in high density lipoproteins caused by menopause are controversial. The aim of this investigation 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 variables associated with high density lipoprotein metabolism. One thousand twenty-one working female participants of the DRECAN Study aged between 36 and 65 years were investigated. Two-thirds of the study population were premenopausal and one-third were postmenopausal. High density lipoprotein cholesterol and apolipoprotein AI concentrations did not correlate with age and did not change significantly as a consequence of menopause. Postmenopausal women without hormone replacement therapy showed significantly higher values of age-, body mass index-, and blood pressure-adjusted ratios of triglycerides/high density lipoprotein cholesterol, low density lipoprotein cholesterol/high density lipoprotein cholesterol, and apolipoprotein B/apolipoprotein AI as compared with premenopausal women not using oral contraceptives. The current use of oral contraceptives or of hormone replacement therapy was associated with a lower low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio. These changes were caused mainly by increased serum concentrations of triglycerides, total cholesterol, and apolipoprotein B and not by changes in high density lipoprotein concentrations. 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 saturated 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 premenopausal women, the use of oral contraceptives increased apolipoprotein Al concentrations.