Patterns of Cardiometabolic Health as Midlife Women Transition to Menopause: A Prospective Multiethnic Study

Elizabeth Ward, Ellen B Gold, Wesley O. Johnson, Feihong Ding, Po Yin Chang, Paula Song, Samar R. El Khoudary, Carrie Karvonen-Gutierrez, Kelly R. Ylitalo, Jennifer S. Lee

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

CONTEXT: Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women. OBJECTIVE: To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components in multiracial/ethnic women in midlife. DESIGN: We conducted a prospective, longitudinal, multiethnic cohort study of 3003 midlife women undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three of five components: high fasting triglyceride (hTG) level, low high-density lipoprotein cholesterol (lHDL-C) level, high fasting plasma glucose (hGluc) level, large waist circumference (abdominal obesity; Ob), and hypertension (HTN). We described the patterns of constellations and estimated hazard ratios (HRs) for constellations at (i) incident MetS and (ii) recovery from MetS, using multivariable-adjusted Cox regression. SETTING: Seven US sites. PARTICIPANTS: In all, 1412 non-Hispanic white, 851 black, 272 Japanese, 237 Hispanic, and 231 Chinese women. EXPOSURES: Race/ethnicity, lifestyle factors, and MT stage. MAIN OUTCOMES MEASURES: Cardiometabolic constellations, incident MetS, and MetS recovery. RESULTS: Central obesity was the most frequent component. Having no components was the most frequent (31%) baseline constellation. Physical activity (HR = 1.68; 95% CI: 1.06, 2.68) and lower caloric intake (HR = 0.96; 95% CI: 0.93, 0.99 per 100 cal/d) were associated with recovery from MetS. Ob/hTG/lHDL-C (18%), Ob/HTN/lHDL-C (16%), and Ob/HTN/hGluc (14%) were frequent incident constellations. Physically active women had 26% to 62% lower hazards of incident MetS than inactive women. CONCLUSIONS: Modifiable lifestyle behaviors were related to recovery from MetS and decreased risk of the most frequent MetS constellations in midlife women.

Original languageEnglish (US)
Pages (from-to)1404-1412
Number of pages9
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number5
DOIs
StatePublished - May 1 2019

    Fingerprint

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Ward, E., Gold, E. B., Johnson, W. O., Ding, F., Chang, P. Y., Song, P., El Khoudary, S. R., Karvonen-Gutierrez, C., Ylitalo, K. R., & Lee, J. S. (2019). Patterns of Cardiometabolic Health as Midlife Women Transition to Menopause: A Prospective Multiethnic Study. The Journal of clinical endocrinology and metabolism, 104(5), 1404-1412. https://doi.org/10.1210/jc.2018-00941