Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Mar;20(1):49-59.
doi: 10.1007/s42000-020-00216-8. Epub 2020 Jun 18.

Association between HDL-C levels and menopause: a meta-analysis

Hongwei Li  1   2 , Runlu Sun  1   2 , Qian Chen  1   2 , Qi Guo  1   2 , Junjie Wang  1   2 , Liming Lu  3 , Yuling Zhang  4   5
Affiliations
Meta-Analysis

Association between HDL-C levels and menopause: a meta-analysis

Hongwei Li et al. Hormones (Athens). 2021 Mar.

Abstract

Purpose: Menopause modifies women's lipid profiles. However, the fact that it is still unclear whether high-density lipoprotein-cholesterol (HDL-C) levels decrease in postmenopausal women necessitated a systematic review and meta-analysis.

Methods: The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched and 498 articles published between 1987 and 2020 were retrieved. Studies reporting HDL-C, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) levels in both postmenopausal and premenopausal populations were included. The quality of the included studies was assessed using the Cross-Sectional/Prevalence Study Quality tool. The standard mean difference (SMD) and 95% confidence interval (CI) were estimated using random effects models. A meta-regression analysis and subgroup analysis were performed to identify potential modifiers. Egger's test and funnel plots were constructed to evaluate publication biases.

Results: Lipid profiles from 18 cross-sectional studies and two cohort studies including 5652 postmenopausal women and 7825 premenopausal women were meta-analyzed. HDL-C levels were not significantly different between the postmenopausal and premenopausal women (SMD = - 0.053, 95% CI - 0.171 to 0.066, p = 0.383) and were not affected by country, publication year, study quality in the meta-regression analysis, or significant publication bias. Higher LDL-C, TC, and TG levels were detected in postmenopausal women than in premenopausal controls.

Conclusion: Unlike increased LDL-C, TC, and TG levels, HDL-C levels in pre- and postmenopausal women were not different in this first meta-analysis of lipid profiles in premenopausal and postmenopausal women. Prospective studies with large populations examining HDL-C levels and functions in women with different menopausal statuses are essential in the future.

Trial registration number: None.

Keywords: Cross-sectional; High-density lipoprotein-cholesterol; Low-density lipoprotein-cholesterol; Postmenopausal; Premenopausal; Total cholesterol; Triglycerides.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of the literature search and study selection process
Fig. 2
Fig. 2
Forest plots of the meta-analysis of HDL-C (a), LDL-C (b), TG (c), and TC (d) levels using random effects models. SMD standardized mean difference, CI confidence interval
Fig. 3
Fig. 3
Sensitivity analysis and funnel plot of the meta-analysis of HDL-C, LDL-C, TG, and TC levels. Sensitivity analysis (a, b, c, d) and funnel plots (e, f, g, h) were performed to examine the heterogeneity of this meta-analysis. SMD standardized mean difference, CI confidence interval
See this image and copyright information in PMC

References

    1. El Khoudary SR. Gaps, limitations and new insights on endogenous estrogen and follicle stimulating hormone as related to risk of cardiovascular disease in women traversing the menopause: a narrative review. Maturitas. 2017;104:44–53. doi: 10.1016/j.maturitas.2017.08.003. - DOI - PubMed
    1. Gordon T, Kannel WB, Hjortland MC, McNamara PM. Menopause and coronary heart disease. The Framingham Study. Ann Intern Med. 1978;89(2):157–161. doi: 10.7326/0003-4819-89-2-157. - DOI - PubMed
    1. Matthan NR, Jalbert SM, Lamon-Fava S, Dolnikowski GG, Welty FK, Barrett HR, Schaefer EJ, Lichtenstein AH. TRL, IDL, and LDL apolipoprotein B-100 and HDL apolipoprotein A-I kinetics as a function of age and menopausal status. Arterioscler Thromb Vasc Biol. 2005;25(8):1691–1696. doi: 10.1161/01.ATV.0000172629.12846.b8. - DOI - PubMed
    1. Li Z, McNamara JR, Fruchart JC, Luc G, Bard JM, Ordovas JM, Wilson PW, Schaefer EJ. Effects of gender and menopausal status on plasma lipoprotein subspecies and particle sizes. J Lipid Res. 1996;37(9):1886–1896. doi: 10.1016/S0022-2275(20)37553-2. - DOI - PubMed
    1. Zhou JL, Lin SQ, Shen Y, Chen Y, Zhang Y, Chen FL. Serum lipid profile changes during the menopausal transition in Chinese women: a community-based cohort study. Menopause. 2010;17(5):997–1003. doi: 10.1097/gme.0b013e3181dbdc30. - DOI - PubMed

Substances