Factors associated with total cholesterol levels in women around menopause attending menopause clinics in Italy

NOTA IMPORTANTE: Autore dello studio è il “Progetto Menopausa Italia Study Group”. Umberto Omodei è Coordinatore Nazionale, membro dello Steering Committee e partecipante al Progetto. La pubblicazione riporta come co-autori l’elenco dei partecipanti suddivisi per incarico specifico. La pubblicazione non viene quindi individuata automaticamente inserendo il nome dell’autore nei motori di ricerca in rete. Il Progetto Menopausa Italia, del quale Umberto Omodei è co-fondatore, è un grande studio epidemiologico che aveva come obiettivo la raccolta di informazioni sulla menopausa e le condizioni cliniche correlate, basato su un network nazionale connesso in rete di 268 Centri per la Menopausa, con circa 1.500 operatori sanitari coinvolti. Il Progetto si è svolto dal 1997 al 2004 ed ha reclutato un campione di circa 130.000 pazienti seguite per oltre 5 anni. Objective: To obtain data on correlates of total cholesterol (TC) levels in women around menopause attending menopause clinics in Italy. Methods: Since 1997, a large cross-sectional study has been conducted concerning the characteristics of women around the time of the menopause attending a network of first-level menopause out-patient clinics in Italy for general counselling about the menopause or treatment of menopausal symptoms. Women observed consecutively at the participating centers were eligible for the study. Up to March 2000, TC was measured in 23 018 cases, which are considered in this analysis. Results: The adjusted mean level of TC rose with age, from 216 mg/dl in women aged < 50 years to 234 mg/dl in those aged > 57 years. Mean TC increased with body mass index (BMI, kg/m2), being 224 mg/dl in women with BMI < 24, 227 mg/dl in those with BMI 24–26 and 228 mg/dl in those with BMI > 26. Considering menopausal status, the crude mean TC level was 216 mg/dl in premenopausal women, 227 mg/dl in women reporting a surgical menopause and 229 mg/dl in women reporting a natural meno- pause. These differences were still present when the analysis took into account the effect of age and other potential covariates, the adjusted values being 221, 225 and 227, respectively. Similar findings emerged when we considered the distribution of study sub- jects according to selected levels of TC (< 210, 210–250, 251–290, < 290). For example, the odds ratio of TC 210–250 mg/dl and > 250 mg/dl vs. < 210 mg/dl was, respectively, 1.8 and 2.8 in women aged ≥ 57 years in comparison with women aged < 50 years. The corresponding odds ratio values for women with a BMI > 26 vs. < 24, and for women in spontaneous menopause vs. premenopause, were all 1.2 (all statistically significant). Conclusions: This analysis, based on a large data set, confirms the role of overweight as a determinant of TC in postmenopausal women, and indicates the role of the menopause as a determinant of TC level in women aged 50–60 years.