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Impact of menopause and diabetes on atherogenic lipid profile: is it worth to analyse lipoprotein subfractions to assess cardiovascular risk in women?

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ABSTRACT

Cardiovascular disease is the leading cause of death in women at advanced age, who are affected a decade later compared to men. Cardiovascular risk factors in women are not properly investigated nor treated and events are frequently lethal. Both menopause and type 2 diabetes substantially increase cardiovascular risk in the female sex, promoting modifications on lipid metabolism and circulating lipoproteins. Lipoprotein subfractions suffer a shift after menopause towards a more atherogenic lipid profile, consisted of hypertriglyceridemia, lower levels of both total high density lipoprotein (HDL) and its subfraction HDL2, but also higher levels of HDL3 and small low-density lipoprotein particles. This review discusses the impact of diabetes and menopause to the lipid profile, challenges in lipoprotein subfractions determination and their potential contribution to the cardiovascular risk assessment in women. It is still unclear whether lipoprotein subfraction changes are a major driver of cardiometabolic risk and which modifications are predominant. Prospective trials with larger samples, methodological standardizations and pharmacological approaches are needed to clarify the role of lipoprotein subfractions determination on cardiovascular risk prediction and intervention planning in postmenopausal women, with or without DM.

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Main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus
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Fig1: Main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus

Mentions: The increased risk for atherosclerosis in postmenopausal diabetic women depends on low HDL-c levels, hypertriglyceridemia and predominance of small dense LDL particles [151]. Additionally, type 2 DM clusters with other disturbances from the spectrum of the metabolic syndrome, contributing to an elevated cardiovascular mortality [152]. Interestingly, the deleterious impact of DM in the LDL particle size seems to be greater in the diabetic women than in men [153, 154] and postmenopausal diabetic women exhibited decreased large HDL particles (HDL2) levels together with increased small HDL particles compared to normoglycemic women after menopause [31]. Figure 1 summarizes the main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus.Fig. 1


Impact of menopause and diabetes on atherogenic lipid profile: is it worth to analyse lipoprotein subfractions to assess cardiovascular risk in women?
Main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5384156&req=5

Fig1: Main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus
Mentions: The increased risk for atherosclerosis in postmenopausal diabetic women depends on low HDL-c levels, hypertriglyceridemia and predominance of small dense LDL particles [151]. Additionally, type 2 DM clusters with other disturbances from the spectrum of the metabolic syndrome, contributing to an elevated cardiovascular mortality [152]. Interestingly, the deleterious impact of DM in the LDL particle size seems to be greater in the diabetic women than in men [153, 154] and postmenopausal diabetic women exhibited decreased large HDL particles (HDL2) levels together with increased small HDL particles compared to normoglycemic women after menopause [31]. Figure 1 summarizes the main characteristics of structural and functional abnormalities of lipid metabolism during atherogenic process and aging and the impact of diabetes mellitus.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Cardiovascular disease is the leading cause of death in women at advanced age, who are affected a decade later compared to men. Cardiovascular risk factors in women are not properly investigated nor treated and events are frequently lethal. Both menopause and type 2 diabetes substantially increase cardiovascular risk in the female sex, promoting modifications on lipid metabolism and circulating lipoproteins. Lipoprotein subfractions suffer a shift after menopause towards a more atherogenic lipid profile, consisted of hypertriglyceridemia, lower levels of both total high density lipoprotein (HDL) and its subfraction HDL2, but also higher levels of HDL3 and small low-density lipoprotein particles. This review discusses the impact of diabetes and menopause to the lipid profile, challenges in lipoprotein subfractions determination and their potential contribution to the cardiovascular risk assessment in women. It is still unclear whether lipoprotein subfraction changes are a major driver of cardiometabolic risk and which modifications are predominant. Prospective trials with larger samples, methodological standardizations and pharmacological approaches are needed to clarify the role of lipoprotein subfractions determination on cardiovascular risk prediction and intervention planning in postmenopausal women, with or without DM.

No MeSH data available.


Related in: MedlinePlus