Abstract
Introduction. Menopause as a potential risk factor for insulin resistance and associated metabolic and hemodynamic disorders determines the need to study the formation of the perimenopausal metabolic syndrome (MetS) phenotype with arterial hypertension (AH).
Objective: to assess correlations between MetS markers and characteristics of the menopausal transition with their role in hypertension based on the analysis of a perimenopausal normoglycemic cohort.
Patients and methods. Of the 88 women aged 35–59 years, 58 women had hypertension and 30 were normotensive. The following were determined: waist circumference (WC), blood pressure (BP), triglyceride (TG), HDL-C, insulin, follicle-stimulating hormone (FSH), estradiol and glucose levels, TyG, HOMA2-IR indices. The following were estimated (SPSS, version 17): median (25; 75%); intergroup differences according to the Mann-Whitney criterion; comparison of proportions according to Pearson's χ2; Spearman's correlation (R) and partial correlation (Rрс) analyses were performed to level out the influence of age; binary logistic regression was used to identify prognostic factors.
Results. The TyG index correlated age-dependently with FSH (R=0.211; p=0.048) and estradiol (R= -0.262; p=0.014), and age independently with BP, WC, and HDL-C. The associations of WC with BP that are relevant in partial correlation are the closest with TyG (R=0.526 and Rpc=0.424; p<0.001) and HOMA2-IR (R=0.507 and Rpc=0.370; p<0.001), age is dependent on HDL-C, duration of postmenopause and estradiol (R= -0.313; p=0.003). According to the stepwise multiple logistic regression analysis, with an increase in WC by 1 cm, the chance of having hypertension increases by 9%; with an increase in the TyG index by 1 conventional unit - by 16 times.
Conclusion. The ascending hormonal and metabolic trajectory of the components of metabolic syndrome in perimenopause with the central pathogenetic link of insulin resistance emphasizes the importance of factors specific to women and attention to arterial hypertension with its leading role in the cluster.