Features of the formation of menopausal metabolic syndrome in arterial hypertension

Abstract

Introduction. The concept of staging of cardiometabolic diseases (CMD) in the clustering of metabolic syndrome (MS) components is closely related to insulin resistance (IR), which depends on the status of sex hormones and age. It is assumed that the formation of menopausal MS starts in perimenopause due to changes in the functional state of the pituitary-ovarian axis. However, mechanisms explaining sex differences in IR, especially during the menopausal transition, have not been established.Aim. To evaluate the relationship of MS markers in a cohort of women aged 35–59 years without carbohydrate metabolism disorders with different functional state of the ovaries, depending on the presence of arterial hypertension (AH) and the influence of age-associated factors.Materials and methods. In 88 normoglycemic women aged 35–59 years with different functional state of the pituitary-ovarian axis and divided into 2 groups depending on the presence of hypertension, the following were determined: BMI, waist circumference (WC), levels of blood pressure (BP), triglycerides (TG), HDL cholesterol, FSH and estradiol, fasting glucose (FG), TyG index. SPSS (version 13) assessed ME (25–75%); intergroup differences according to the Mann-Whitney test; Correlation analysis according to Spearman and partial correlation were performed to level the effect of age.Results. The largest range of significant associations, independent of age and in tandem with it, was found only in the group of patients with hypertension: in OT and FG, which increase at FSH levels > 25 mU/l; lipid parameters among themselves and with FG; TyG with FSH and estradiol levels, and TyG with all parameters focusing on OT and HDL cholesterol.Conclusions. In the process of the formation of menopausal MS in AH, significant relationships of traditional CMD markers with the TyG index, which reflects the presence of IR through the relationship of carbohydrate and lipid metabolism, are partially influenced by FSH and estradiol levels in tandem with age-associated indicators: the duration of AH and postmenopause.