The effect of menopause on metabolic syndrome: Results from the Canadian Longitudinal Study on Aging

Metabolic syndrome is a combination of health conditions including abdominal obesity, high cholesterol, high blood pressure and pre-diabetes. One in five Canadian women meet the criteria for metabolic syndrome. It is an increasing cause of heart disease and stroke, particularly among women. Metabolic syndrome has also been associated with an increased risk of breast cancer. Changes in biology during menopause are thought to increase the risk of developing metabolic syndrome. This study will analyze the largest cohort of mature Canadian women to investigate this association. If menopause is found to be a risk factor for the development metabolic syndrome, this would provide an opportunity to focus medical care and public health programming to optimize women’s health. By identifying high risk women, targeted preventative care may be provided in an effort to reduce disease and disability.

Data were examined from women surveyed in the Canadian Longitudinal Study on Aging to evaluate whether menopause is an independent risk factor for the development of metabolic syndrome or its components, including hypertension, central obesity, dyslipidemia, or elevated glycated hemoglobin. We conducted a cross-sectional analysis of women aged 45-85 years old that participated in the Baseline data of the Canadian Longitudinal Study on Aging Comprehensive cohort collected from 2012 to 2015.

Among 12,611 women analyzed, 10,035 (79.6%) had undergone menopause and 2,576 (20.4%) were premenopausal. Postmenopausal women were more likely to meet criteria for metabolic syndrome compared to premenopausal women (32.6% vs 20.5%. Using the metabolic syndrome criteria with a lower waist circumference threshold, the prevalence of metabolic syndrome was higher at 38.2% among postmenopausal women and 23.2% among premenopausal women. After adjusting for age, body mass index, and other covariates, the occurrence of menopause was not associated with a significantly higher relative risk of metabolic syndrome, using the unified criteria for metabolic syndrome. Women with menopause had a significantly higher relative risk of metabolic syndrome when using criteria with a lower waist circumference. Menopause was also associated with a higher risk of impaired glucose tolerance, elevated blood pressure, and elevated triglycerides.

As such, menopause is associated with an increased risk of metabolic syndrome, independent of age. Lifestyle interventions targeted at women with metabolic syndrome are known to prevent Type 2 diabetes mellitus and cardiovascular risk. Perimenopause may be an important preventative care opportunity to assess metabolic risk factors and improve the health and longevity of Canadian women.