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Changes in Regional Fat Distribution and Anthropometric Measures Across the Menopause Transition

Gail A Greendale  1 , Weijuan Han  1 , Joel S Finkelstein  2 , Sherri-Ann M Burnett-Bowie  2 , Mei Hua Huang  1 , Deborah Martin  3 , Arun S Karlamangla  1

J Clin Endocrinol Metab. 2021 Jun 1;dgab389.doi: 10.1210/clinem/dgab389. Online ahead of print.

Context: The relation between the menopause transition (MT) and changes in regional fat distribution is uncertain.

Objective: To determine whether the MT is associated with the development of central adiposity. Design: Longitudinal analysis from the Study of Women’s Health Across the Nation, spanning 1996-2013 (median follow-up 11.8 years). Setting: Community-based. Participants: 380 women with regional body composition measures by dual energy X-ray absorptiometry. Mean baseline age was 45.7 years; racial/ethnic composition was 16% Black, 41% Japanese and 43% White.

 Outcomes: Changes in android, gynoid and visceral fat and waist and hip circumferences.

Results: Android fat increased by 1.21% per year (py) and 5.54% py during premenopause and the MT, respectively (each p<0.05). Visceral and gynoid fat began increasing at the MT, annualized changes were 6.24% and 2.03%, respectively (each p <0.05). Postmenopausal annual trajectories decelerated to 1.47% (visceral), 0.90% (android), and -0.87% (gynoid), (all non-zero, p <0.05). Waist girth grew during premenopause (0.55% py), the MT (0.96% py), and postmenopause (0.55% py) (all non-zero, p<0.05; not statistically different from each other). Hip girth grew during premenopause (0.20% py) and the MT (0.35% py) (each non-zero, p<0.05; not statistically different from each other) and decelerated to zero slope in postmenopause. Results are for the White referent; there were statistically significant differences in some trajectories in Black and Japanese women.

Conclusions: The MT is associated with the development of central adiposity. Waist or hip circumferences are less sensitive to changes in fat distribution.