Factors associated with total cholesterol levels in women around menopause attending menopause clinics in Italy

Objective To obtain data on correlates of total cholesterol (TC) levels in women around menopause attending menopause clinics in Italy. Methods Since 1997, a large cross-sectional study has been conducted concerning the characteristics of women around the time of the menopause attending a network of first-level menopause out-patient clinics in Italy for general counselling about the menopause or treatment of menopausal symptoms. Women observed consecutively at the participating centers were eligible for the study. Up to March 2000, TC was measured in 23 018 cases, which are considered in this analysis. Results The adjusted mean level of TC rose with age, from 216 mg/dl in women aged < 50 years to 234 mg/dl in those aged > 57 years. Mean TC increased with body mass index (BMI, kg/m(2)), being 224 mg/dl in women with BMI < 24, 227 mg/dl in those with BMI 24-26 and 228 mg/dl in those with BMI > 26. Considering menopausal status, the crude mean TC level was 216 mg/dl in premenopausal women, 227 mg/dl in women reporting a surgical menopause and 229 mg/dl in women reporting a natural menopause. These differences were still present when the analysis took into account the effect of age and other potential covariates, the adjusted values being 221, 225 and 227, respectively. Similar findings emerged when we considered the distribution of study subjects according-to selected levels of TC (< 210, 210-250, 251-290, < 290). For example, the odds ratio of TC 210-250 mg/dl and > 250 mg/dl vs. < 210 mg/dl was, respectively, 1.8 and 2.8 in women aged greater than or equal to 57 years in comparison with women aged < 50 years. The corresponding odds ratio values for women with a BMI > 26 vs. < 24, and for women in spontaneous menopause vs. premenopause, were all 1.2 (all statistically significant). Conclusions This analysis, based on a large data set, confirms the role of overweight as a determinant of TC in postmenopausal women, and indicates the role of the menopause as a determinant of TC level in women aged 50-60 years.