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Appendicular lean mass is lower in late- compared to early- perimenopausal women: potential role of FSH

Park YM1Jankowski CM2Ozemek C3Hildreth KL1Kohrt WM4Moreau KL4.

J Appl Physiol (1985). 2020 Apr 16. doi: 10.1152/japplphysiol.00315.2019. [Epub ahead of print]



Age-related declines in skeletal muscle mass (i.e. sarcopenia) contribute to physical disability in older women. Although a menopause-related increase in fat mass is well documented, whether menopause influences muscle mass and sarcopenia is unclear. We determined the extent to which skeletal muscle mass differs across the stages of the menopause transition in women, and whether these differences are associated with estradiol or other sex hormones. This was a cross-sectional study of 144 healthy women (aged 30-70 years), classified as premenopausal (n=30, 38±6yrs; mean ± SD), early (n=31, 50±3yrs) and late perimenopausal (n=30, 50±4yrs), and early (n=26, 55±3yrs) and late postmenopausal (n=27, 62±4yrs). Appendicular lean mass (ALM) adjusted by the square of height in meters (ALM index; ALMi) was assessed using dual-energy x-ray absorptiometry. ALMi was lower (p<0.05) in late perimenopausal and postmenopausal compared to early perimenopausal with no significant differences between other groups (premenopausal, 6.6±0.6; early perimenopausal, 6.8±0.8; late perimenopausal, 6.1±0.8; early postmenopausal, 6.5±1.1; and late postmenopausal, 6.2±0.9 kg/m2). The prevalence of sarcopenia (ALMi ≤5.67 kg/m2) was 7, 3, 30, 27, and 32% in premenopausal, early and late perimenopausal, and early and late postmenopausal group, respectively. ALMi measured across menopause stages was inversely correlated to follicle stimulating hormone (FSH; r=-0.28, p=0.003) but not to estradiol (r=0.088, p=0.34). The menopause transition appears to be a vulnerable period for the loss of skeletal muscle mass that may begin during the late perimenopausal transition. Future studies are necessary to investigate the potential effect of FSH on skeletal muscle.