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American Journal of Epidemiology Advance Access published online on April 8, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp043
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Lipid Changes During the Menopause Transition in Relation to Age and Weight

The Study of Women's Health Across the Nation

Carol A. Derby, Sybil L. Crawford, Richard C. Pasternak, MaryFran Sowers, Barbara Sternfeld and Karen A. Matthews

Correspondence to Dr. Carol A. Derby, Albert Einstein College of Medicine, Louis and Dora Rousso Building, Room 336, 1165 Morris Park Avenue, Bronx, NY 10461 (e-mail: cderby{at}aecom.yu.edu).

Received for publication January 27, 2008. Accepted for publication February 5, 2009.

Few studies have prospectively examined lipid changes across the menopause transition or in relation to menopausal changes in endogenous hormones. The relative independent contributions of menopause and age to lipid changes are unclear. Lipid changes were examined in relation to changes in menopausal status and in levels of estradiol and follicle-stimulating hormone in 2,659 women followed in the Study of Women's Health Across the Nation (1995–2004). Baseline age was 42–52 years, and all were initially pre- or perimenopausal. Women were followed annually for up to 7 years (average, 3.9 years). Lipid changes occurred primarily during the later phases of menopause, with menopause-related changes similar in magnitude to changes attributable to aging. Total cholesterol, low density lipoprotein cholesterol, triglycerides, and lipoprotein(a) peaked during late peri- and early postmenopause, while changes in the early stages of menopause were minimal. The relative odds of low density lipoprotein cholesterol (≥130 mg/dL) for early postmenopausal, compared with premenopausal, women were 2.1 (95% confidence interval: 1.5, 2.9). High density lipoprotein cholesterol also peaked in late peri- and early postmenopause. Results for estradiol and follicle-stimulating hormone confirmed the results based on status defined by bleeding patterns. Increases in lipids were smallest in women who were heaviest at baseline.

body weight; lipids; menopause

Abbreviations: CI, confidence interval; SWAN, Study of Women's Health Across the Nation


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