SOURCE:

Faculty: Health Sciences And Technology
Department: Medical Laboratory Science

CONTRIBUTORS:

Ikegwuonu, I. C.
Onyenekwe, C. C.

ABSTRACT:

Perimenopause is associated with a lot of hormonal changes. These hormonal changes also influence metabolic processes accounting for some biochemical changes which possibly give rise to metabolic syndrome (MetS) in perimenopausal women. There is insufficient information on the association between hormonal changes, MetS and perimenopause hence this study investigated some biochemical changes and possible metabolic syndrome in perimenopausal women. Two hundred subjects (one hundred and twenty perimenopausal women mean age 50 years and eighty premenopausal women mean age 35 years) who were living in Enugu were recruited for this study. Anthropometric indices (blood pressure, waist circumference, weight and height) of these women were measured. Ten milliliters of fasting blood samples collected from the participants were used for measurement of hormonal and biochemical parameters. Hormone profile (luteinizing hormone(LH), estradiol(E₂) and follicle stimulating hormone(FSH) were determined using Enzyme immunoassay (ELISA), fasting plasma glucose (FPG), lipid profile, uric acid, and alkaline phosphatase levels were assayed using enzymatic colorimetric methods while levels of inorganic phosphate and calcium were determined using phenolphthalein monophosphate substrate and o-cresolphthalein methods respectively. All data were analysed using the Statistical Package for the Social Sciences (SPSS) version 20 computer software at 95% confidence level, and results were expressed as mean ± standard deviation (SD). A comparison of the mean ± SD of the perimenopausal and the premenopausal women showed significantly (p< 0.05) higher values of blood pressure (systolic and diastolic), fasting plasma glucose, waist circumference, luteinizing hormone, follicle stimulating hormone, total cholesterol, low density lipoprotein cholesterol, uric-acid and calcium; while there was a significantly (p<0.05) lower value of estradiol in perimenopausal women compared to the premenopausal women. There were no significant difference (p>0.05) in the mean values of other parameters between perimenopausal and premenopausal women. The metabolic syndrome (MetS) of the perimenopausal and premenopausal women were observed using three different criteria the National Cholesterol Education Program- Adult Treatment Panel 111(NCEP-ATP 111), the World Health Organization (WHO) and International Diabetes Federation (IDF). The incidence of MetS was higher in the perimenopausal women compared to the premenopausal women in all the three criteria studied. The prevalence of metabolic syndrome was different in all the three criteria studied. The levels of calcium, uric-acid, inorganic phosphate and alkaline phosphatase were determined in the perimenopausal and premenopausal women with MetS in the three groups using the different cut-off points of the four parameters. Calcium was predominantly higher in the three criteria. The relationships between the parameters were observed, LH and FSH levels showed positive correlation with FPG while levels of E₂ was negatively associated with FPG. Similarly levels of LH showed positive association with inorganic phosphate while E₂ levels were negatively associated with alkaline phosphatase. The significantly higher biochemical changes in the perimenopausal women in comparison with their premenopausal counterparts which gave rise to higher metabolic syndrome in all the three different criteria assessed in this study showed that perimenopausal women in this study had higher risk of metabolic syndrome than the premenopausal women. The study demonstrated that central obesity and hypertension were the predominant components and also risk factors for the development of metabolic syndrome associated diseases among the Igbo women with metabolic syndrome in Enugu Metropolis. This study also suggests that calcium may be included in the panel of components of metabolic syndrome in Igbo women in Enugu metropolis.