ANDROGENS IN RELATIONSHIP TO ABDOMINAL OBESITY AND LIPOPROTEIN ALTERATIONS IN THE MENOPAUSAL TRANSITION.

BOERO, LAURA; MESCH, VIVIANA; BERG, GABRIELA; ROYER, MONIQUE; PRADA, MARIELA; SAYEGH, FABIANA; BENENCIA, HAYDEE; SISELES, NESTOR

BUENOS AIRES, ARGENTINA

Congreso; 11th WORLD CONGRESS ON THE MENOPAUSE; 2005

MENOPAUSE INTERNATIONAL SOCIETY

Background: The postmenopause is associated with a decrease in the ratio estrogens/androgens and this different androgenic status should contribute to an increase in the abdominal adiposity and to an altered lipoprotein profile. However, little is known about the relationship between androgens, abdominal obesity and lipoproteins in the menopausal transition (MT). Objective: To study the androgenic status, through the evaluation of SHBG levels, the free androgen index (FAI) and the ratio E2/To, in relation to abdominal adiposity and the ratio triglycerides (TG)/HDL as a marker of lipoprotein alterations in women in MT. Methods: We studied 82 healthy women divided into the following group:  1) 13 women older than 40 with regular menstrual cycle (age 44±4 years), 2) 22MT women, oligomenorrheic with cycle between 35 and 80 days length (age 48± 3 years ),  3) 30 MT women with 3 to 6 month of amenorrhea (age 49±3 years), 4) 17 postmenopausal women (age 57± 5 years). None of the women was under hormone replacement therapy in the previous three month. SHBG, Total To (Tot), E2, HDL and TG were determined. FAI was calculated as: Tot (nM)/SHBG (nM) x 100 and waist circumference (WC) was measured. Results: see Table. SHBG,  TG/HDL and WC are expressed as mean± SD; FAI and E2/To as median (percentiles 25th – 75th). FAI: Group 2 vs Group 3 p<0,05 and group 2 vs group 4 p<0,05. E2/To: Group 2 vs Group 4 p<0,01. SHBG presented a negative correlation with WC and TG/HDL (r=-0.33, p=0.007; r=-0.31, p=0.008 respectively). The FAI showed a positive correlation with WC and TG/HDL (r=  0.32, p=0.010; r =0.37, p=0.001 respectively). The E2/To ratio didn’t show any significant correlation neither with WC nor with TG/HDL. Conclusions: Although the SHBG levels did not differ between groups, the FAI did it, showing that  alongside we advance in the transition to menopause, the androgenic milieu increases leading to an augment of abdominal fat. The SHBG levels as well as FAI  correlated with the WC. Our results also showed a negative correlation between the TG/HDL index  vs the SHBG levels and a positive correlation between TG/HDL index vs the FAI. All this facts show that the major androgenic milieu, expressed through the decreasing levels of SHDG and the increasing FAI, traduces itself into a less favorable lipoprotein profile. We didn’t  find significant correlation between the E2/To ratio and WC and TG/ HDL. This could be due to the E2 levels variability that is often found during MT. Our results should support the importance of considering the FAI as an indicator of androgenicity , which is associated  with abdominal obesity and an adverse lipoprotein profile.