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Review
. 2017 Apr 7:9:22.
doi: 10.1186/s13098-017-0221-5. eCollection 2017.

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

Marília Izar Helfenstein Fonseca  1 , Isis Tande da Silva  2 , Sandra Roberta G Ferreira  1   2
Affiliations
Review

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

Marília Izar Helfenstein Fonseca et al. Diabetol Metab Syndr. .

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.

Keywords: Cardiovascular risk; Diabetes mellitus; Lipoprotein subfractions; Menopause; Women.

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Figures

Fig. 1
Fig. 1
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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