Lipid metabolism and hormonal interactions: impact on cardiovascular disease and healthy aging

Abstract

Populations in developed nations are aging gradually; it is predicted that by 2050 almost a quarter of the world’s population will be over 60 years old, more than twice the figure at the turn of the 20th century. Although we are living longer, this does not mean the extra years will be spent in good health. Cardiovascular diseases are the primary cause of ill health and their prevalence increases with age. Traditionally, lipid biomarkers have been utilized to stratify disease risk and predict the onset of cardiovascular events. However, recent evidence suggests that hormonal interplay with lipid metabolism could have a significant role to play in modulating cardiovascular disease risk. This review will explore recent findings which have investigated the role hormones have on the dynamics of lipid metabolism. The aim is to offer an insight into potential avenues for therapeutic intervention.

Keywords::

• aging
• cardiovascular disease
• growth hormone
• leptin
• lipid metabolism
• stress hormone

Financial & competing interests disclosure

The authors were supported by internal university funds. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Developed populations are aging gradually and this presents a number of problems.

• Cardiovascular disease (CVD) mortality rates have halved in the last two decades, but morbidity among older people persists.

• Dysregulation of lipid metabolism has historically been used as a risk for CVD.

• The mechanisms that underpin age-related dyslipidemia are incompletely understood.

• CVD is not a pathology caused by one single biological change; instead, it is more likely the result of a combination of several factors.

• Exploring hormonal interplay with lipid metabolism is one such factor that could help to further elucidate the mechanisms. This will lead to novel risk factors for CVD/cardiometabolic risk.

• For stress hormones to be used as a risk factor, an improved understanding of the effects of stress hormones on the regulation of adipose tissue metabolism is fundamental in order to establish the clinical connection between psychological stress and the dysregulation of lipid metabolism.

• Recent evidence points at several other hormonal candidates that could be used, for instance, leptin levels could be utilized due to its ability to predict insulin resistance and other cardiometabolic risk factors independent of obesity.

• Growth hormone measurement in older people could also have an important role to play in reducing CVD risk.

• Dietary intervention could help to normalize the dyslipidemia in middle age.

• Careful monitoring of estrogen or hormonal intervention might improve postmenopausal dyslipidemia in females.

Notes