Metabolic syndrome, adipokines and sex hormone concentrations in middle-aged women

Abstract

The incidence of metabolic syndrome (MetS) increases with age, something which is more noticeable in women, particularly perimenopausal women. Weight gain and the development of abdominal obesity are considered to be the main cause of increased risk of MetS and cardiometabolic factors in perimenopausal women. Increased visceral adipose tissue correlates with elevated insulin resistance, inflammation, hypertension and hyperlipidaemia in middle-aged women. In recent years, particular attention has been drawn to the endocrine role of adipose tissue, mainly visceral adipose tissue, and the concentrations of adipokines and inflammation markers such as: leptin, adiponectin, free fatty acids, adipocyte fatty acid binding protein, C-reactive protein (CRP), and inflammatory cytokines. The development of abdominal obesity is mostly associated with a loss of the protective role of oestrogens and a relative increase of circulating androgens. After menopause, the adipose tissue serves as the primary source of oestrogen production via aromatisation that converts androstenedione and testosterone to oestrone and 17b-oestradiol (E2), respectively. Studies looking at the relation between menopause and MetS conducted over the past years have mostly focused on the analysis of such hormone balance parameters as: E2, free oestradiol, oestrone and androgenic indicators: total testosterone, free testosterone, sex hormone binding globulin or dehydroepiandrosterone sulfate. In most cases, the results of the research indicate a greater importance of androgenic markers in the assessment of MetS and cardiometabolic risk factors occurrence in perimenopausal and postmenopausal women.