Vaihdevuosien aikaisen hormonihoidon yhteys metaboliseen terveyteen

Cardiovascular diseases and type 2 diabetes are major contributors to the decline in health and functional capacity of older people. They are also a major public health cost. Metabolic syndrome is a risk factor for these diseases. Both lifestyle and aging affect metabolic health. During menopause, estrogen production from the ovaries ceases, and the risk of metabolic syndrome increases. Menopausal symptoms are treated with hormone therapy (HT), which can also affect metabolic health. The aim of this study was to determine whether the changes in metabolic syndrome components that occur during natural menopause (NM) differ from the changes occurring during HT-treated menopause. The variables included in the study were total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, glucose, waist circumference, systolic blood pressure and diastolic blood pressure. The University of Jyväskylä's ERMA and EsmiRs data were used as material. The subjects were women aged 47–55 years from Jyväskylä, who had not reached menopause at baseline and who transitioned from one menopausal phase to another during follow-up. The subjects were divided into a HT group (n = 33) and NM group (n = 115). Repeated measures analysis of variance was used as the main method of analysis. The model was controlled for baseline visceral fat and menopausal stage. Whitin the groups changes promoting metabolic health were an increase in HDL cholesterol and a decrease in diastolic blood pressure in both groups, as well as a decrease in glucose and systolic blood pressure in the HT group. Systolic blood pressure and glucose increased in the NM group. Between the groups in uncontrolled main analyses the main effect of time on the variables was statistically significant (p < 0.001) except for systolic blood pressure (p = 0.486) and glucose (p = 0.578). A statistically significant (p = 0.012) group and time interaction explained 8.9% of the variation in diastolic blood pressure. In controlled analyses, time was associated with HDL-cholesterol variation (p = 0.007). In both groups the change was similar and minor. Except for diastolic blood pressure (p = 0.006) group-level changes did not differ from each other. The group and time interaction explained 5.1% of the variation in diastolic blood pressure. In the HT group diastolic blood pressure decreased by 5.5% and in the NM group by 0.9%. The results support the previous understanding of the deterioration of metabolic health during menopause. Diastolic blood pressure decreased more in the HT group, which may indicate better heart health. The study strengthened the understanding of the complexity of the effects of HT, the diversity of the challenges related to its research, and underlined the necessity of further research. It is important to study the subject further because HT is common, and its connections with the components of the metabolic syndrome are still contradictory.