© 1999 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Menopause Is Associated With Reduced Protection From Postprandial Lipemia
Presented in part at the Scientific Conference on Hormonal, Metabolic, and Cellular Influences on Cardiovascular Disease in Women of the American Heart Association, San Diego, Calif, October 19–21, 1995, and the 66th Congress of the European Atherosclerosis Society, Florence, Italy, July 13–17, 1996.
From the Departments of Internal Medicine and Endocrinology, Laboratory of Lipid Metabolism, University Medical Center Utrecht, the Netherlands. Dr de Bruin is now at the Department of Medicine and Endocrinology, Maastricht University Medical School, Maastricht, Netherlands.
Correspondence to André P. van Beek, MD, PhD, Departments of Internal Medicine and Endocrinology, F02.124, PO Box 85.500, 3508 GA Utrecht, Netherlands. E-mail vanbeek.hopian{at}gironet.nl
Abstract—Deficiency of endogenous estrogens has been associated with a higher incidence of coronary heart disease (CHD) in women. We investigated whether natural menopause is associated with reduced protection from postprandial lipemia, which represents a risk indicator of CHD. Twenty-three postmenopausal women (mean age, 50±1 [SD] years; body mass index, 24.6±2.8 kg/m2) and 21 premenopausal women matched for age and body mass index (age, 49±1 years; body mass index, 24.1±2.6 kg/m2) underwent an oral vitamin A fat-loading test. Vitamin A is a marker of the metabolism of chylomicrons and chylomicron remnants. All women were normolipidemic, were in good health, were nonsmokers, and used no medication. Postprandial lipids and vitamin A were measured at hourly intervals up to 12 hours. In postmenopausal women, plasma total cholesterol and LDL cholesterol concentrations were significantly higher. Fasting plasma triglyceride (TG) concentrations were 1.14±0.57 mmol/L in postmenopausal women and 0.88±0.33 mmol/L in premenopausal women (P=NS). In the postprandial phase, postmenopausal women had higher plasma TG (13.0±6.1 versus 9.5±3.3 mmol · L-1 · h-1; P=0.024) and vitamin A (54.1±22.9 versus 35.9±9.6 mg · L-1 · h-1; P=0.001) responses. To correct for the possible confounding effect of fasting TG, 13 postmenopausal women were carefully matched with 19 premenopausal women. Although fasting TG levels were identical (0.72±0.20 versus 0.73±0.21 mmol/L), differences in postprandial vitamin A (45.3±14.5 versus 33.0±7.7 mg · L-1 · h-1; P=0.006) and incremental TG (ie, after subtraction of baseline TG) (3.2±1.8 versus 2.3±1.0 mmol · L-1 · h-1; P=0.023) persisted between postmenopausal and premenopausal women. Natural menopause is associated with aggravated postprandial lipemia in women matched for age and body mass index. Higher postprandial lipemia potentially explains the relation of TGs and CHD mortality risk in postmenopausal women.
Key Words: chylomicrons • estrogens • coronary heart disease • risk factors • lipids
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