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Abstract
Gender differences in prevalence and consequences of the metabolic syndrome as a strong
predictor of cardiovascular disease (CVD), are challenging problems. Postmenopausal
status may explain in part the cause of acceleration of CVD with aging. The purpose
of this study was to investigate the relation of menopause and metabolic syndrome
independent of aging among Iranian women.
On the basis of consecutive recruitment, 940 women between 20 and 76 years old participated
in the study. Anthropometric indices, fasting blood glucose, lipid profile were measured,
Framingham risk score and homeostasis model assessment (HOMA-IR) were calculated for
all participants. The metabolic syndrome (MetS) was defined according to the National
Cholesterol Education Program Adult Treatment Panel III. We used IDF definition for
metabolic syndrome modified by our recent local data as an alternative measurements.
The overall prevalence of metabolic syndrome was 26.4%. Its prevalence was 53.5% in
postmenopausal versus 18.3% in premenopausal women. On binary logistic regression
analysis, HOMA index, body mass index, waist to hip ratio, family history of diabetes
and hypertension had an independent and significant effect on metabolic syndrome.
Age-adjusted odds ratio (OR) of postmenopausal status for metabolic syndrome was 2.85
(95%CI: 1.31-6.20) (P<0.008). Framingham risk score was 8.3+/-7.7 in MetS+ve cases
versus 1.9+/-2.1 in MetS-ve cases (P<0.001). There were significant differences between
Framingham risk score in postmenopause 9.1+/-6.4 versus premenopause 1.6+/-1.6 (P<0.001).
A significant correlation was found between Framingham risk score and body mass index,
waist to hip ratio, HOMA-IR and components of metabolic syndrome (P<0.001). Forty
percent of participants with premature menopause had metabolic syndrome versus 24%
in age-matched group and Framingham risk score was significantly higher than normal
cases 5.4+/-4.9 versus 2.0+/-2.3 (P<0.001).
Menopausal status can be a predictor of metabolic syndrome independent of age in Iranian
women. Menopause is a process closely related to insulin resistance and cardiovascular
risk factors.
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