Menopause and Heart Disease, Osteosarcopenia, and More

In endocrinology news this week, scientists in Finland directly tied hormonal changes during menopause to the decline in cardiovascular health women often experience during this time. Another new study linked slower metabolism to an increased risk of the musculoskeletal disorder osteosarcopenia in postmenopausal women. On a lighter note, a new art competition sponsored by the Endocrine Society celebrates the beauty and intricacy of the endocrine system…in extreme close-up.

Hormone changes in menopause linked to increase in bad cholesterol, decline in heart health

All women with ovaries experience menopause and the accompanying, often aggravating symptoms. In addition to sleep disruption, fatigue, and vaginal dryness, menopause is associated with a steep increase in a woman’s risk of heart disease, in part due to higher levels of LDL (“bad”) cholesterol.

Now, new research from the University of Jyväskylä, Finland, finds that 10% of the increase in bad cholesterol seen during menopause can be attributed to shifts in sex hormones—and that this increase in bad cholesterol may be mitigated with hormone replacement therapy.

The research was published in the European Journal of Preventive Cardiology.

Menopause, which generally occurs between ages 48 and 52, causes a decline in estrogen and an increase in follicle-stimulating hormone (FSH). Estrogen is seen as heart protective for a number of reasons including that it keeps blood pressure low and helps tissues and blood vessels stay supple and flexible.

While previous studies have shown that menopause is associated with metabolic changes that promote heart disease, this is the first study to link these metabolic shifts directly to changes in female sex hormones. It further found that taking hormone replacement therapy (HRT) may mitigate women’s increased vulnerability to heart disease by lowering levels of bad cholesterol.

“Menopause is unavoidable but it is possible that the negative metabolite shift can be diminished by eating healthily and being physically active,” said study author Dr. Eija K. Laakkonen of the University of Jyväskylä, Finland, in a press release. “In particular, women should pay attention to the quality of fat in their diet and get sufficient exercise to maintain cardiorespiratory fitness. HRT is an option that women should discuss with healthcare providers at this point in their lives.”

For the analysis, researchers analyzed 218 perimenopausal women not using hormone replacement therapy at baseline. Levels of 180 metabolites (lipids, lipoproteins, and amino acids) and two hormones (estrogen and FSH) were obtained from blood samples at baseline and every three to six months until early postmenopause. Additionally, scientists assessed the menopausal state using menstrual diaries and blood FSH levels. Thirty-five women (15%) started hormone replacement therapy during the study.

“Our study investigated whether the menopausal hormonal change modulates the metabolite profile measured in blood samples taken before and after menopause. Because the menopausal transition, i.e. the time with variable hormone levels and irregular menses, varies tremendously from person to person, the time points for assessment were individualised,” Laakkonen said.

Slower metabolism tied to increased risk of osteosarcopenia in postmenopausal women

In an aging population, osteoporosis and sarcopenia are major musculoskeletal disorders that are highly associated with increased illness and death. They share common risk factors and biological pathways.

Some older people are affected by both. Osteosarcopenia is a clinical condition marked by the coexistence of osteoporosis and sarcopenia. This hazardous duo is represented by low bone and muscle mass along with increased fat deposits around vital organs. Individuals with osteosarcopenia are at higher risk for falls, fractures, hospitalization, frailty, and death.

Now, a cross-sectional study investigating the relationship between osteoporosis and sarcopenia and their common risk factors finds that a lower basal metabolic rate in women after menopause is associated with increased risk of osteosarcopenia.

The goal of the study, which was published in BMC Women’s Health, was to clarify clinical, functional, and biochemical features of postmenopausal women who are at risk of developing osteosarcopenia.

Scientsists analysed 305 postmenopausal Iranian women ranging in age between 48 and 78 with an average age of 58. Among participants, 35.7% were obese; about 45% had insufficient physical activity and at least half of participants had insufficient intake of protein. The researchers controlled for confounding factors including age, menopausal age, obesity, sun exposure, physical activity, macronutrient composition, and calcium and vitamin D supplementation were considered.

Bone status measurements were taken with dual X-ray absorptiometry using spectral imaging.

Scientists found a significant correlation between bone density and muscle mass and basal metabolic rate. The study showed that a lower basal metabolic rate was independently associated with both lower muscle mass and lower bone density in lumbar and hip sites.

Where endocrinology and art collide

Science can be beautiful. Just take a look at the winning images in the Endocrine Society’s inaugural Endocrine Images Art Competition, which were recently announced. With vibrant colors, mysterious shapes, and almost otherworldly designs, these images celebrate the beauty of the endocrine system.

Gary Hammer, M.D., Ph.D., Millie Schembechler Professor of Adrenal Cancer at the University of Michigan in Ann Arbor, Mich., took first place with a trio of images of the mouse adrenal gland that bursts with color like a pointillism painting. Red marks the adrenal cortex, containing cells that produce aldosterone, cortisol, and glucocorticoids. The remaining cells of the fetal adrenal cortex glow yellow while the core—the medulla, where epinephrine (adrenaline) is produced—shines blue.

Tied for second place: a slice of an adult pituitary gland in shades of magenta, green, and white by a postdoctoral researcher at the University of Chicago, and an image of breast cancer with multiple hormone receptors stained in green, white, yellow, and pink by a team at the University of Colorado.

Seven honorable mentions were also awarded.

More than 40 entries were judged based on aesthetic value and their significance to endocrine research. Winning images will be displayed at ENDO 2022, the Endocrine Society’s annual scientific meeting, June 11-14 in Atlanta, Ga.

  • Jari E. Karppinen, Timo Törmäkangas, Urho M. Kujala, Sarianna Sipilä, Jari Laukkanen, Pauliina Aukee, Vuokko Kovanen, Eija K. Laakkonen, Menopause modulates the circulating metabolome: evidence from a prospective cohort study, European Journal of Preventive Cardiology, 2022;, zwac060,
  • Maghbooli, Z., Mozaffari, S., Dehghani, Y. et al. The lower basal metabolic rate is associated with increased risk of osteosarcopenia in postmenopausal women. BMC Women’s Health 22, 171 (2022).
  • Endocrine Society press release, May 4, 2022, “Endocrine Images Award 2022 Winners: Endocrine Images Art Competition.”
Melissa Erickson

Freelance writer

Melissa Erickson has more than 30 years of experience as a journalist, including reporting for a group of weekly newspapers in the Chicago suburbs and contributing to the news service for GateHouse Media Inc. and Gannett Co.