1Chita State Medical Academy - Chita - Russian Federation
Objective: To estimate the ischemic heart disease risk factors in women with surgical menopause.
Methods: 141 women with surgical menopause were included in the investigation. All of them underwent general clinical examination, body mass index (BMI) calculation, measurement of waist circumference, menopausal index evaluation, ambulatory blood pressure and electrocardiogram monitoring (Cardiotens-01, Meditech), determination of general cholesterol, lipid fractions and glucose tolerance. We also measured the level of non-etherized fatty acids and glycerol in blood serum and calculated its` proportion. Postmenopausal women were 45,3±2,8 years old; the duration of menopause was from 6 months to 7 years. The expression of menopausal syndrome was assessed according to the menopausal index dimension, which was 41,3±11,06 score. Control group consisted of 17 healthy women (mean age 37,2±4,2). Patients with coronary heart disease, essential hypertension, endocrine and grievous somatic diseases were excluded. Statistical method such as Mann-Whitney test was used
Results: Almost all postmenopausal women had 2 or more attributes of menopausal metabolic syndrome: obesity (BMI 32,6±1,4 kg\m2) with the prevalence of visceral adipose tissue (waist circumference = 80 cm) – 78%, hypercholesterolemia – 62%, hypertriglyceridemia – 75%, pathological glucose tolerance – 45%, arterial hypertension, stages 1-2 – 68%. Moreover, it was found, that the level of non-etherized fatty acids in patients with surgical menopause consisted 134% from the level of this index in healthy women (p<0,05); and the level of glycerol was decreased in 29% (p<0,05). The ratio of non-etherized fatty acids to glycerol permits to estimate the velocity of substrate utilization by peripheral tissues and myocardium as well. This index in postmenopausal women was 42% more than in control group (p<0,01). We can conclude that the level of non-etherized fatty acids increases not only owing to lipolytic process activation, but results from the disturbances of this substrate utilization. The increase of non-etherized fatty acids level contributes to the development of insulin resistance, which is the key link of menopausal metabolic syndrome. Conclusions. Thus, postmenopausal women have expressive disorders in lipid and glucose metabolism, which cause rapid atherosclerosis development in these patients.