EARLY menopause significantly increases the risk of heart failure (HF) in postmenopausal women, independent of adipokine levels, while adiponectin is the only adipokine independently associated with HF incidence.
Heart failure is a leading cause of morbidity and mortality, with hormonal and metabolic changes during menopause potentially playing a role in its development. Early menopause, defined as menopause occurring before the age of 45, may increase HF risk through mechanisms involving adiposity and adipokine dysregulation. This study aimed to assess the relationship between early menopause, serum adipokines (adiponectin, leptin, and resistin), and HF incidence in postmenopausal women.
This analysis included 746 postmenopausal women from the Multi-Ethnic Study of Atherosclerosis. Participants, with a mean age of 65.1 years, reported their menopausal age and underwent serum adipokine measurements. Incident HF events were recorded over a median follow-up period of 17.8 years, during which 45 HF events occurred. Cox proportional hazards models adjusted for waist circumference, cardiovascular risk factors, and prior myocardial infarction showed that early menopause was strongly associated with HF. The hazard ratios for HF were 4.50 (95% CI: 1.41–14.3), 4.64 (1.46–14.7), and 5.16 (1.59–16.7) in models incorporating adiponectin, leptin, and resistin, respectively. Among the adipokines, only adiponectin demonstrated an independent association with HF (HR: 2.20, 95% CI: 1.35–3.57). Interaction terms between early menopause and adipokines were not statistically significant (Pint = 0.08–0.82).
These findings emphasise the significant role of early menopause as a risk factor for HF in postmenopausal women, regardless of serum adipokine levels. Adiponectin, as the sole adipokine associated with HF, highlights the complex interplay between metabolic regulation and cardiovascular health. Clinically, these results emphasise the need for early cardiovascular risk assessment and tailored interventions for women experiencing early menopause. Future research should explore additional mechanisms linking early menopause and HF, including inflammatory and metabolic pathways, to better inform prevention strategies and clinical management.
Abigail Craig, EMJ
Reference
Ebong IA et al. Menopausal age, adipokines, and heart failure incidence in postmenopausal women of Multi-Ethnic Study of Atherosclerosis. Menopause. 2024; DOI: 10.1097/GME.0000000000002456.
