High LDL-c ups early-onset vasomotor symptom risk in premenopausal women

A high serum concentration of low-density lipoprotein cholesterol (LDL-c) appears to be an important risk factor for early-onset vasomotor symptoms (VMS) in premenopausal women, a recent study has found.

The present cohort study included 2,540 premenopausal women, aged 42–52 years, all of whom were free of VMS at baseline. Over a median follow-up of 4.4 years, researchers monitored for VMS, including hot flushes and night sweats, using the Menopause-Specific Quality of Life questionnaire.

Over 11,196.18 person-years of follow-up, 1,243 incident cases of incident early-onset VMS arose, yielding an incidence rate of 11.1 per 100 person-years. Cox proportional hazards regression analysis found that high LDL-c levels increased the risk of early-onset VMS.

For instance, levels between 100–129 mg/dL yielded an age-adjusted hazard ratio [HR] estimate of 1.17 (95 percent confidence interval [CI], 1.02–1.35) for early VMS, while levels ≥130 mg/dL increased such risk by more than 20 percent (age-adjusted HR, 1.23, 95 percent CI, 1.06–1.42). All risk estimates were relative to women with LDL-c levels <100 mg/dL (p_trend=0.008).

Additional controls for other confounders, such as body mass index, blood pressure, comorbidities, lifestyle, and parity, did not attenuate the impact of LDL-c on early-onset VMS. Serum concentrations between 100 and <130 mg/dL (adjusted HR, 1.19, 95 percent CI, 1.03–1.37) and ≥130 mg/dL (adjusted HR, 1.20, 95 percent CI, 1.03–1.40) continued to raise VMS risk by around 20 percent.

“Further studies are required to clarify the independent association of LDL-c with early-onset VMS considering estrogen and other sex hormone effects in women before menopause,” the researchers said.