Cardiometabolic Disease Patterns Related to Race, Ethnicity in Midlife Women

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Women entering menopause had patterns of cardiometabolic risk components related to race/ethnicity.

Women entering menopause had patterns of cardiometabolic risk components (constellations) related to race/ethnicity, but modifiable lifestyle factors may be targets in this population to prevent cardiometabolic disease, according to findings published in the Journal of Clinical Endocrinology & Metabolism.

At midlife, women have a high risk of developing metabolic syndrome, defined as having at least 3 of 5 cardiometabolic risk components: high fasting triglyceride, low high-density lipoprotein cholesterol, high fasting plasma glucose, large waist circumference, and hypertension. The constellations of these risk components can indicate cardiometabolic status and risk for future cardiovascular disease and type 2 diabetes. 

However, patterns of these components have not been established overall, or for different racial/ethnic groups. In the current study, data from the Study of Women’s Health Across the Nation were used to characterize and identify factors related to constellations of cardiometabolic risk components in a diverse population of women undergoing the transition to menopause. The cohort included 1412 non-Hispanic white women, 851 black women, 272 Japanese women, 237 Hispanic women, and 231 Chinese women.

Abdominal obesity was the most common component in the overall cohort. Frequently observed incident constellations were:

  •  large waist circumference/high fasting triglyceride/low high-density lipoprotein cholesterol (18% overall), most commonly observed in non-Hispanic white and Chinese women;
  • large waist circumference/hypertension/low high-density lipoprotein cholesterol (16%), most commonly observed in black and Hispanic women; and
  • large waist circumference/hypertension/high fasting plasma glucose (14%), most commonly observed in black women.

Women who were physically active had a lower risk for incident metabolic syndrome vs those who were inactive, and physical activity (hazard ratio [HR], 1.68; 95% CI, 1.06-2.68) and lower caloric intake (HR per 100 calories/day, 0.96; 95% CI, 0.93-0.99) were associated with recovery from metabolic syndrome.

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A clear association between menopause transition stage and risk for these constellations was not observed. However, distribution of race/ethnicity varied among the constellations, “reflecting the higher prevalence of [hypertension] and lower prevalence of [high fasting triglyceride] in [black women],” wrote the researchers, adding that “Black and Hispanic midlife women had an increased risk [for] incident [metabolic syndrome], after adjusting for multiple factors.”

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Ward E, Gold EB, Johnson WO, et al. Patterns of cardiometabolic health as midlife women transition to menopause: a prospective multi-ethnic study [published online October 25, 2018]. J Clin Endocrinol Metab. doi:10.1210/jc.2018-00941