Effects of gender, age and menopausal status on serum apolipoprotein concentrations

Clin Endocrinol (Oxf). 2016 Nov;85(5):733-740. doi: 10.1111/cen.13085. Epub 2016 Apr 29.


Objective: To undertake a comprehensive evaluation of apolipoprotein risk markers for cardiovascular disease (CVD) according to gender, age and menopausal status.

Design: Cross-sectional analysis of independent associations of gender, age and menopause with serum apolipoproteins.

Participants: Apparently healthy Caucasian premenopausal (n = 109) and postmenopausal (n = 252) women not taking oral contraceptives or hormone replacement, and Caucasian men (n = 307).

Measurements: Serum apolipoprotein (apo) B, A-I and A-II concentrations were measured, plus serum total cholesterol, low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), triglycerides, cholesterol in HDL subfractions and the apoB/apoA-I, LDL-C/apoB, HDL-C/apoA-I and HDL-C/apoA-II ratios. Analyses were undertaken with and without standardization for confounding characteristics and in 5-year age ranges.

Results: Overall, apoB concentrations were highest in men but in women rose with age and menopause to converge, in the age range of 50-55 years, with concentrations in men. The LDL-C/apoB ratio was generally higher in women than in men. ApoA-I concentrations were highest in postmenopausal women and lowest in men (standardized median (IQR) 144 (130, 158) vs 119 (108, 132) g/l, respectively, P < 0·001). ApoA-II concentrations were also highest in postmenopausal women but were lowest in premenopausal women (40·3 (37·5, 44·5) vs 32·9 (30·5, 35·7) g/l, respectively, P < 0·001). Nevertheless, postmenopausal women had HDL-C/apoA-I and HDL-C/apoA-II ratios approaching the lowest ratios, which were seen in men.

Conclusions: Consistent with adverse effects on CVD risk, male gender, ageing in women and menopause were associated with increased apoB concentrations, and menopause and male gender were associated with a decreased cholesterol content of HDL particles.

MeSH terms

  • Age Factors
  • Aging / blood*
  • Apolipoprotein A-I / blood
  • Apolipoprotein A-II / blood
  • Apolipoprotein B-100 / blood*
  • Apolipoproteins / blood*
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Menopause / blood*
  • Middle Aged
  • Postmenopause / blood
  • Premenopause / blood
  • Sex Factors
  • White People


  • APOB protein, human
  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Apolipoprotein B-100
  • Apolipoproteins
  • Cholesterol, HDL
  • Cholesterol