Correlation between some metabolic markers of vascular risk and carotid artery intima-media thickness in postmenopausal women

Abstract

Aim and setting: This study investigated correlations between insulinemia, insulin sensitivity, body mass index, lipids and lipoproteins with intima-media thickness in a group of 25 (age range 40–55 years) postmenopausal women (minimum duration of menopause 2 years) not on hormone replacement treatment. Methodology: Uni and multivariate correlations showed a direct relationship between insulin pattern, insulin sensitivity, body mass index, low density lipoproteins and increased intima-media thickness. Results: Our multivariate correlation results revealed that intima-media thickness is influenced by the associations of the different metabolic functions investigated. Therefore, carotid wall intima-media thickness represents a dependent variable in postmenopausal women for some metabolisms whose dysfunction leads to atherosclerosis. Conclusion: This multielement synergy is able to detect cardiovascular risk and may underlie cardiovascular mortality in postmenopausal women.

Introduction

Cardiovascular mortality is higher in postmenopausal than fertile women [1], [2], [3], [4], [5] and in the former reaches the incidence observed in men of the same age [2], [5]. Diverse mechanisms have been called upon to explain this phenomenon, and attention has been focused on the elevated concentrations of low density proteins that are very sensitive to oxidation [4], [6]. Moreover, reduced release of endothelial vasodilatating hormones (e.g., prostacyclin) and increased release of vasoconstrictors and proaggregants (e.g., inflammatory leucotriens and thromboxan A2) that occur when estrogen production ceases have been considered relevant [7], [8], [9], [10]. In addition, the variations in the metabolic processes of glucose and insulin metabolism between the pre and postmenopausal periods have been investigated.

A decrease of pancreatic insulin production has been reported in postmenopausal women [11], accompanied by reduced hormone elimination [12] and followed by changes in plasma insulin concentrations [11], [12], [13], [14], [15], [16], [17]. Thus, the menopause is directly associated with metabolic dysfunctions, such as elevated insulin levels and insulin resistance, both of which are considered independent variables of cardiovascular risk [18].

Several studies have underlined that increased carotid wall intima-media thickness can be considered a sensitive marker of cardiovascular risk [19]. The aim of this study was to assess insulin and insulin sensitivity in postmenopausal women and correlate them with vascular wall status and metabolic patterns.