Hormonal-metabolic trajectory of menopausal transition in a normoglycemic cohort of women with different blood pressure levels

Introduction. The gradual clustering of cardio-metabolic factors in women depending on age and decline of ovarian function justifies attention to the phenotype of the formation of the metabolic syndrome during the menopausal transition depending on the presence of hypertension without dysglycemia.

Aim. To evaluate the association of indicators of the functional state of the pituitary-ovarian axis with markers of metabolic syndrome (MetS) and parameters of insulin resistance (IR) in a cohort of normoglycemic women aged 35-59 years with different levels of blood pressure.

Patients and methods. In a cohort of women 35–59 years old without dysglycemia (n = 88), 58 women had hypertension, 30 were normotensive. It was determined: body mass index (BMI), waist circumference (WC), levels of blood pressure, triglycerides (TG), HDL-C, insulin, follicle-stimulating hormone (FSH) and estradiol, fasting glucose (FG); TyG and HOMA2-IR indices. Using SPSS (version 17) assessed the median (25; 75%); intergroup differences using the Mann-Whitney test; correlation analyzes: Spearman (R) and partial correlation (R_рс) to level out the influence of age.

Results. In the general cohort of women, the influence of postmenopausal duration, FSH and estradiol levels on MetS and TyG parameters depended on age, except for the correlation of postmenopausal duration with FG (R_pc = 0.313; p = 0.004). The range of associations of MetS markers with each other and TyG in the group of patients with hypertension is similar to those in the general cohort of women. In both cohorts, the interrelations between FG, WC, insulin and TyG remained relevant with partial correlation. The Index TyG, associated with HOMA2-IR (R=0.600; p<0.001; R_pc=0.426; p<0.001), had a greater range of connections with MetS components, as well as with FSH (R=0.312; p=0.017; R_pc =0.286; p=0.030) and estradiol (R= -0.393; p=0.002; R_pc = -0.376; p=0.004) in the presence of hypertension.

Conclusion. The influence of indicators of the functional state of the pituitary-ovarian axis on MetS and TyG markers was revealed, along with a spectrum of associations of parameters and factors in the formation of menopausal MetS with IR indices, especially TyG. Correlation relations between FG with postmenopausal duration and MetS components, as well as estradiol in case of hypertension, reflect a high risk of progression to dysglycemia.