Menopozun kardiyovasküler risk üzerindeki etkisi

Abstract

Arka Plan: Menopoz sonrası dönemde kardiyovasküler hastalık (KVH) riski, hormonal değişikliklere bağlı olarak gelişen abdominal obezite, dislipidemi ve düşük düzeyli inflamasyon nedeniyle anlamlı şekilde artmaktadır. Yüksek duyarlıklı C-reaktif protein (hsCRP), subklinik inflamasyonun iyi tanımlanmış bir biyobelirteci olmakla birlikte, menopozdaki kadınlarda antropometrik ve biyokimyasal parametrelerle ilişkisi tam olarak açıklığa kavuşmamıştır. Amaç: Menopozdaki kadınlarda hsCRP düzeylerine göre tanımlanan alt gruplar arasında kardiyovasküler riski değerlendirmek ve subklinik inflamasyonun temel antropometrik ve biyokimyasal belirleyicilerini tanımlamak. Yöntem: Bu kesitsel çalışma, bilinen KVH’si olmayan 117 kadını içermektedir. Katılımcılar hsCRP düzeylerine göre üç gruba ayrılmıştır: düşük (<1 mg/L), orta (1–3 mg/L) ve yüksek (>3 mg/L). Antropometrik ve biyokimyasal parametreler — VKİ, bel çevresi, lipid profili, karaciğer enzimleri (ALT, AST, GGT), ürik asit, glukoz ve HbA1c — alt gruplar arasında karşılaştırılmıştır. hsCRP düzeyini belirleyen değişkenleri saptamak için Spearman korelasyon ve çoklu doğrusal regresyon analizleri uygulanmıştır. Bulgular: Yüksek hsCRP düzeyine sahip kadınlar, anlamlı derecede daha yüksek bel çevresi ve VKİ değerleri göstermiştir; inflamasyonla en güçlü ilişki abdominal obeziteyle bulunmuştur. GGT aktivitesi orta ve yüksek risk gruplarında anlamlı olarak artarken, ürik asit düzeyleri hsCRP ile birlikte yükselme eğilimi göstermiş ve yüksek risk grubunda referans aralığının üst sınırına yaklaşmıştır. Lipid profili analizinde yüksek hsCRP düzeyine sahip kadınlarda daha düşük HDL, daha yüksek trigliserid, artmış TG/HDL oranı ve yükselmiş non-HDL kolesterol düzeyleri saptanmıştır. Çoklu regresyon analizinde menopoz sonrası kadınlarda bel çevresi, yaş ve LDL-kolesterol hsCRP’nin bağımsız belirleyicileri olarak tanımlanmıştır (düzeltilmiş R² = 0.252). Sonuç: Menopoz dönemindeki kadınlarda bel çevresi, subklinik inflamasyonun VKİ’den daha güçlü bir göstergesidir. Santral obezite, karaciğer enzim aktivitesi (GGT) ve lipid değişikliklerinin birleşimi, bu popülasyonda kardiyovasküler riskin çok boyutlu doğasını yansıtmaktadır. Bel çevresi ve hsCRP gibi inflamatuvar biyobelirteçlerin rutin olarak ölçülmesi, menopoz sonrası kadınlarda kardiyovasküler riskin erken tespitini kolaylaştırabilir ve hedefe yönelik koruyucu stratejilere katkı sağlayabilir.

Keywords

• Menopoz
• hsCRP
• bel çevresi
• kardiyovasküler risk
• GGT
• ürik asit
• inflamasyon.

Associations of hsCRP, anthropometric, and biochemical parameters with cardiovascular risk in menopause status: a cross-sectional study

Abstract

Aims: Cardiovascular disease (CVD) risk increases significantly after menopause, partly due to hormonal changes leading to abdominal obesity, dyslipidemia, and low-grade inflammation. High-sensitivity C-reactive protein (hsCRP) is a well-established biomarker of subclinical inflammation, yet its associations with anthropometric and biochemical parameters in menopausal women remain incompletely defined. To evaluate cardiovascular risk across hsCRP-based subgroups in menopausal women and identify the key anthropometric and biochemical predictors of subclinical inflammation. Methods: This cross-sectional study included 117 women without established CVD. Participants were classified into three groups according to hsCRP levels: low (<1 mg/L), moderate (1–3 mg/L), and high (>3 mg/L). Clinical and biochemical parameters, including BMI, waist circumference, lipid profile, liver enzymes (ALT, AST, GGT), uric acid, glucose, and HbA1c, were compared across subgroups. Spearman correlation and multiple linear regression analyses were used to identify determinants of hsCRP concentration. Results: Women with higher hsCRP levels exhibited significantly greater waist circumference and BMI, with abdominal obesity showing the strongest association with inflammation. GGT activity was significantly higher in moderate and high-risk groups, while uric acid concentrations tended to increase with hsCRP, approaching the upper reference limit in the high-risk group. Lipid profile analysis revealed lower HDL, higher triglycerides, elevated TG/HDL ratios, and increased non-HDL cholesterol in women with high hsCRP levels. Multiple regression analysis identified waist circumference, age, and LDL-cholesterol as independent predictors of hsCRP in postmenopausal women (adjusted R²=0.252). Conclusion: Waist circumference showed the strongest association with hsCRP among postmenopausal women. The combination of central obesity, hepatic enzyme activity, and lipid alterations reflects the multidimensional nature of cardiovascular risk in this population. Routine measurement of waist circumference and inflammatory biomarkers such as hsCRP could enhance early detection of cardiovascular risk, supporting targeted prevention strategies in postmenopausal women.

Keywords

• Menopause
• hsCRP
• waist circumference
• cardiovascular risk
• GGT
• uric acid
• inflammation

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