SAN FRANCISCO – Postmenopausal status is independently associated with a twofold increased risk of hepatic steatosis, the Dallas Heart Study has shown.
Among 1,018 women aged 30-65 years enrolled in the population-based study, 48% were postmenopausal. Their prevalence of hepatic steatosis as defined by greater than 5.5% hepatic fat content measured by magnetic resonance spectroscopy was 34%. In contrast, the prevalence was significantly less at 24% in the premenopausal women, Dr. Monika Sanghavi reported at the annual meeting of the American College of Cardiology.
The absolute hepatic triglyceride content in the postmenopausal cohort was 4.0%, significantly more than the 2.9% value in premenopausal women.
Of note, the prevalence of hepatic steatosis rose with greater time since the last menstrual period (LMP). The prevalence was 22% among women whose LMP was less than 2 months earlier, 31% in those whose LMP was 2-12 months earlier, and 35% in women whose LMP was more than 12 months prior, according to Dr. Sanghavi of the University of Texas Southwestern Medical Center, Dallas.
Women who were postmenopausal were, of course, substantially older on average than premenopausal women. However, they also had significantly higher average systolic blood pressure, 129 compared with 117 mm Hg; a greater prevalence of diabetes, 16% vs. 7%; a mean LDL cholesterol of 113 compared with 98 mg/dL, and an average serum triglyceride level of 107 mg/dL compared with 81 mg/dL in premenopausal women. In a multivariate analysis adjusted for these variables as well as smoking status, body mass index, and C-reactive protein level, being postmenopausal remained independently associated with a twofold increased likelihood of hepatic steatosis (odds ratio, 2.0).
Hepatic steatosis has come under increasing research scrutiny of late because it appears to be a marker of increased atherosclerotic risk. The liver abnormality is associated with the metabolic syndrome, but as the Dallas Heart Study data show, postmenopausal status confers an increased risk of hepatic steatosis through a mechanism independent of obesity, hyperlipidemia, and other conventional cardiovascular risk factors.
Dr. Sanghavi reported having no relevant financial conflicts.