Metabolic syndrome in perimenopausal and postmenopausal women attending gynaecology outpatient department at a tertiary institution in South Africa

Abstract

Background

The prevalence of metabolic syndrome in menopause varies globally. There is a paucity of data regarding knowledge of metabolic syndrome in menopause in South Africa.

Objective(s)

The study was designed to describe the prevalence of metabolic syndrome in perimenopausal and postmenopausal and the lipid changes that occur during the menopause transition.

Study Design

A prospective cross-sectional study was conducted at Dr George Mukhari Academic Hospital, the gynaecological outpatient department, Pretoria, South Africa. Perimenopausal and postmenopausal women were included. Six hundred ninety menopausal women were enrolled in this study. The participants were evaluated by physical examination. Blood samples were also taken for biochemical assay. The researcher also took their blood pressure. Data compiled from the study were analyzed using the Statistical Package for Social Sciences version 21. Descriptive statistical analysis established the range, mean (including 95% confidence interval), and standard deviation for quantitative variables. Categorical variables were analysed using Fisher's exact test, and risk analysis of factors associated with Metabolic syndrome was performed by calculating the odds ratio (OR) and its 95% confidence interval for both perimenopausal and postmenopausal women. A 2-tailed statistical analysis yielding a p-value <.05 was taken as statistically significant.

Results

The study consisted of 690 women (n=690), including 338 perimenopausal women (n=338; 49.0%) and 352 postmenopausal women (n=352; 51.0%). The prevalence of metabolic syndrome was noted to be 47% and 61.4% in the perimenopausal and postmenopausal groups, respectively. The mean waist circumference was higher than the cut-off value of 88cm for perimenopausal and postmenopausal women. There were no statistically significant differences in lipid profiles between perimenopausal and postmenopausal women. The odds ratio for elevated triglycerides was 0.65 (95% CI: 0.32–1.01) and for low HDL levels was 0.83 (95% CI: 0.41–0.98). Perimenopausal women had significantly higher odds (OR 2.19, P<.0001) of experiencing hot flushes compared to postmenopausal women. Multivariate logistic regression analysis demonstrated that age (P=.3789) was not significantly associated with metabolic syndrome. However, the prevalence of metabolic syndrome was higher in postmenopausal women compared to perimenopausal women. Sleep disorders (P<.0001) and vasomotor symptoms (P=.0198) showed significant correlations with the presence of metabolic syndrome. When comparing women with and without metabolic syndrome, both perimenopausal (HDL; P<.0001, triglycerides; P<.0001) and postmenopausal groups (HDL; P<.0001, triglycerides; P<.0001) demonstrated significant associations between dyslipidaemia and metabolic syndrome.

Conclusion

This study reflects the current high burden of metabolic syndrome amongst perimenopausal and postmenopausal women in South Africa. The prevalence of metabolic syndrome was noted to be higher in postmenopausal women as compared to perimenopausal women. There was a correlation between metabolic syndrome and age, sleep disorders, vasomotor symptoms, and dyslipidaemias.