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Obese Women and the Relation Between Cardiovascular Risk Profile and Hormone Therapy, Glucose Tolerance, and Psychosocial Conditions

¹ Department of Clinical Sciences, Lund University, Malmö, Sweden
² Department of Clinical Sciences, Lund University, Lund, Sweden

Address correspondence and reprint requests to Jonas Lidfeldt, Department of Clinical Sciences/Primary Care/University Hospital MAS, SE-20502 Malmö, Sweden. E-mail: jonas.lidfeldt{at}med.lu.se

OBJECTIVE— To evaluate the relation between cardiovascular disease (CVD) risk factors and hormone therapy, serum hormone levels, glucose tolerance, and psychosocial and psychological conditions in subjectively healthy obese female subjects.

RESEARCH DESIGN AND METHODS— The study included 606 women, aged 50–64 years, with BMI 30–40 kg/m² and no history of cardiovascular or other severe diseases. One group with a CVD risk profile (n = 473) (i.e., cholesterol >7.0 mmol/l, HDL cholesterol <1.2 mmol/l, triglycerides >2.0 mmol/l, systolic or diastolic blood pressure >140/90 mmHg, or waist-to-hip ratio >0.85) was compared with women without such risk (n = 133). Steroid hormones, leptin, insulin, and oral glucose tolerance tests (OGTTs) were analyzed. A subgroup of women with baseline impaired glucose tolerance (IGT) completed a 2.5-year follow-up OGTT.

RESULTS— Fewer obese postmenopausal women with CVD risk had ever used hormone therapy (odds ratio 0.24 [95% CI 0.07–0.75]), after multivariate adjustments. Furthermore, women with CVD risk had a higher testosterone index (1.07 [1.01–1.13]) and more had insulin resistance (1.04 [1.00–1.08]) and IGT (2.92 [1.50–5.69]), while OGTT was similar at follow-up. No differences were observed regarding family history or lifestyle, except that fewer women with CVD risk consumed fruits, boiled vegetables, or whole-grain cereals. More women with CVD risk lived alone (3.26 [1.28–8.31]) and had more mental problems (1.16 [1.05–1.28]).

CONCLUSIONS— Previously healthy obese women with a CVD risk profile seemed to have a high risk of diabetes, as well as psychosocial or psychological problems. Hormone therapy was associated with reduced CVD risk. Obesity’s growing burden on society makes it more important to further target individuals that are at greatest risk of future health hazards.

Abbreviations: CVD, cardiovascular disease • HOMA-IR, homeostasis model assessment of insulin resistance • OGTT, oral glucose tolerance test • IGT, impaired glucose tolerance • SHBG, sex hormone–binding globulin • WHR, waist-to-hip ratio

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