Department of Medicine
Amino Acids, Peptides, and Proteins | Biological Factors | Cardiovascular Diseases | Hormones, Hormone Substitutes, and Hormone Antagonists | Lipids | Reproductive and Urinary Physiology | Women's Health
The cardioprotective association of high-density lipoprotein cholesterol (HDL-C) may vary by menopause stage or estradiol level. We tested whether associations of comprehensive HDL metrics (HDL subclasses, phospholipid and triglyceride content, and HDL cholesterol efflux capacity [HDL-CEC]) with coronary artery calcium (CAC) score and density vary by menopause stage or estradiol level in women transitioning through menopause. Participants (N = 294; mean age [SD]: 51.3 [2.9]) had data on HDL metrics and CAC measures at one or two time points during the menopause transition. Generalized estimating equations were used for analyses. Effect modifications by menopause stage or estradiol level were tested in multivariable models. In adjusted models, menopause stage modified the associations of specific HDL metrics with CAC measures. Higher small HDL particles (HDL-P) concentrations (p-interaction = 0.008) and smaller HDL size (p-interaction = 0.02) were associated with greater odds of CAC presence in late perimenopause than in pre/early perimenopause stage. Women in the highest estradiol tertile, but not the lower tertiles, showed a protective association of small HDL-P with CAC presence (p-interaction = 0.007). Lower large HDL-P concentrations (p-interaction = 0.03) and smaller HDL size (p-interaction = 0.03) were associated with lower CAC density in late perimenopause than in postmenopause stage. Associations of HDL phospholipid and triglyceride content and HDL-CEC with CAC measures did not vary by menopause stage or estradiol level. We concluded that HDL subclasses may impact the likelihood of CAC presence and the stability of coronary plaque differently over the menopause transition. Endogenous estradiol levels may contribute to this observation.
HDL/structure, calcium density, calcium score, cardiovascular disease, cholesterol/Efflux, climacteric, hormones, lipoproteins, menopause, women
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Copyright © 2021 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
DOI of Published Version
El Khoudary SR, Nasr A, Matthews KA, Orchard TJ, Brooks MM, Billheimer J, McConnell D, Janssen I, Everson-Rose SA, Crawford S, Rader DJ. Associations of HDL metrics with coronary artery calcium score and density among women traversing menopause. J Lipid Res. 2021;62:100098. doi: 10.1016/j.jlr.2021.100098. Epub 2021 Jul 22. PMID: 34303684; PMCID: PMC8385165. Link to article on publisher's site
Journal of lipid research
El Khoudary SR, Nasr A, Matthews KA, Orchard TJ, Brooks MM, Billheimer J, McConnell D, Janssen I, Everson-Rose SA, Crawford SL, Rader DJ. (2021). Associations of HDL metrics with coronary artery calcium score and density among women traversing menopause. Open Access Publications by UMass Chan Authors. https://doi.org/10.1016/j.jlr.2021.100098. Retrieved from https://escholarship.umassmed.edu/oapubs/4846
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Amino Acids, Peptides, and Proteins Commons, Biological Factors Commons, Cardiovascular Diseases Commons, Hormones, Hormone Substitutes, and Hormone Antagonists Commons, Lipids Commons, Reproductive and Urinary Physiology Commons, Women's Health Commons