TAJ Journal of Teachers Association · Mar 2026
Evaluating Non-HDL Cholesterol and Atherogenic Indices as Key Predictors of Cardiovascular Risk in Post-Menopausal Women
By Uddin MS, Sunny M, Chowdhury TH et al.
Background: Following menopause, the significant decline in circulating estrogen levels alters systemic lipid metabolism in women, accelerating atherogenesis and substantially increasing cardiovascular vulnerability. Traditional lipid parameters such as total cholesterol and LDL-C in isolation frequently fail to reflect the true extent of atherogenic burden in this demographic, necessitating evaluation of non-traditional atherogenic indices for more sensitive cardiovascular risk stratification. Objectives: To evaluate and compare fasting lipid parameters between pre-menopausal and post-menopausal women and to assess the diagnostic performance of Non-HDL cholesterol and atherogenic indices over conventional LDL-C in predicting cardiovascular risk. Methods: A cross-sectional analytical case-control study was conducted at North East Medical College Hospital, Central Medicare Services Beanibazar, and Lab Aid Diagnostic Ltd Sylhet, from July 2023 to June 2025, enrolling 210 post-menopausal women (Group A) and 190 pre-menopausal women (Group B). Fasting lipid profiles and atherogenic indices including Non-HDL cholesterol, Atherogenic Index of Plasma (AIP), Castelli Risk Index I (CRI-I), and Castelli Risk Index II (CRI-II) were computed and compared. Data were analyzed using SPSS version 25. Results: Post-menopausal women demonstrated significantly elevated total cholesterol, triglycerides, LDL-C, Non-HDL cholesterol, AIP, CRI-I, and CRI-II compared to pre-menopausal controls (p<0.001). Non-HDL cholesterol and AIP showed superior diagnostic sensitivity over isolated LDL-C for identifying elevated cardiovascular risk. ROC curve analysis confirmed AIP as the strongest individual predictor (AUC=0.84). Conclusion: Non-HDL cholesterol and atherogenic indices are superior to conventional LDL-C alone for cardiovascular risk stratification in post-menopausal women and should be incorporated into routine lipid screening protocols for this high-risk demographic.