Racial differences in body composition and cardiometabolic risk during the menopause transition: a prospective, observational cohort study

EMAS position statement: Thyroid disease and menopause

INTRODUCTION

Thyroid diseases are common in women in their late reproductive years; therefore, thyroid disease and menopause may co-exist. Both conditions may present with a wide range of symptoms, leading to diagnostic challenges and delayed diagnosis. Aim To construct the first European Menopause and Andropause Society (EMAS) statement on thyroid diseases and menopause.

MATERIALS AND METHODS

Literature review and consensus of expert opinion (EMAS executive board members/experts on menopause and thyroid disease).

SUMMARY RECOMMENDATIONS

This position paper highlights the diagnostic and therapeutic dilemmas in managing women with thyroid disease during the menopausal transition, aiming to increase healthcare professionals' awareness of thyroid disorders and menopause-related symptoms. Clinical decisions regarding the treatment of both conditions should be made with caution and attention to the specific characteristics of this age group while adopting a personalized patient approach. The latter must include the family history, involvement of the woman in the decision-making, and respect for her preferences, to achieve overall well-being.

Association of menopausal status with body composition and anthropometric indices in Korean women

BACKGROUND

Menopause induces various health problems and is associated with obesity, but the association between menopausal status and obesity is unclear due to several confounding factors, such as aging and reduced physical activity. The objective of this study was to examine the association of menopausal status with anthropometric indices and body composition indices in South Korean women.

METHODS

In this cross-sectional study, a total of 734 subjects (297 postmenopausal women, 437 premenopausal women) from five university hospitals in South Korea were included. A binary logistic regression analysis was performed to examine the association of menopause with anthropometric indices and body composition indices.

RESULTS

Height, body mass index, waist-to-height ratio, waist-to-hip ratio, and neck, armpit, chest, rib, waist, iliac, and hip circumferences were associated with menopausal status in the crude analysis, but these associations disappeared in the adjusted models. Among the body composition indices, menopausal status was strongly associated with total body water, skeletal muscle mass, body fat mass, and body fat percentage in the crude analysis. However, the associations with body fat mass and body fat percentage disappeared in the adjusted models. Only the associations with total body water and skeletal muscle mass remained in the adjusted models.

CONCLUSION

Most of the anthropometric indices and body composition indices were not associated with menopausal status, but total body water and skeletal muscle mass were significantly lower in postmenopausal women than in premenopausal women.

Influence of Obesity on the Relationship of Cardiometabolic Risks Factors With Cardiovascular Disease in Older African and European Americans

PURPOSE

This study evaluated the impact of obesity on cardiometabolic risk factors (CRF) interrelationships and predictive efficiency of CVD development in older African (AA) and European Americans (EA).

DESIGN

A comparative research design evaluated CRF risk profile differences between participant groups.

SETTING

Seven neighborhoods in a southern US city.

SUBJECTS

A sample of 179 older AA (n = 128) and EA (n = 51) adults.

MEASURES

Non-fasting blood samples were evaluated for lipids and lipoproteins, glycosylated hemoglobin, systolic -(SBP) and diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF%) and physical function.

ANALYSIS

Data were analysis with descriptive statistics, t-tests, and correlations.

RESULTS

AA were heavier than EA although all had above average age-appropriate fitness. Means and relationships between CRF and other variables were different (P < .05) based on race. Both AA (41.3 + 5.8) and EA (38.6 + 6.4) BF% were CRF risks. Holding BMI constant, CRF were generally not related, and the relationships were different for AA and EA. AA had a range of 13.0 to 27.2% more favorable values for cholesterol, HDL-C, and triglyceride. EA had favorable A1c (EA 5.8 vs AA 6.2%) values.

CONCLUSIONS

A limitation of this report is the small sample size. Although further research is warranted, these findings suggest population specific CRF selections would improve CVD prediction in AA.

One-year trajectories of nutritional status in perimenopausal women: a community-based multi-centered prospective study

BACKGROUND

Nutritional status is a modifiable factor associated with perimenopausal women's health and quality of life. Assessing body composition indicators helps to comprehensively understand nutritional status compared with using body mass index (BMI) only. However, few published studies measured the trends in body composition among perimenopausal women.

OBJECTIVES

To assess the one-year trajectory of the nutritional status of perimenopausal women and to explore its influential factors.

METHODS

A community-based observational study with 3-wave repeated measurements at 6-month intervals was carried out. The nutritional status indicators include weight, body mass index (BMI), and body composition variables. Bioelectrical impedance analysis was used to assess body composition. Repeated measures ANOVA and Chi-square test were used to calculate the changes in nutritional status and generalized estimating equations were performed to explore their influential factors.

RESULTS

2760 participants completed the study. Increasing trajectories in weight (from 56.05 ± 7.55 to 57.02 ± 7.60), fat mass (from 17.99 ± 4.80 to 20.49 ± 4.90), and waist-hip ratio (from 0.86 ± 0.04 to 0.91 ± 0.15) were found (P < 0.001). Decreasing trajectories in skeletal muscle (from 20.30 ± 2.38 to 19.19 ± 2.46), protein level (from 7.39 ± 0.79 to 7.06 ± 0.81), and total body water (from 27.87 ± 2.92 to 27.00 ± 3.01) were found (P < 0.001). Being married/unmarried with a partner and without negative life events were associated with higher total body water, skeletal muscle, and protein level, while negatively associated with fat mass and waist-hip ratio. Age was positively associated with fat mass (P < 0.001). Participants with junior high school education were prone to increased fat mass (P = 0.018) compared with those holding primary school education and below. A per capita monthly income of 1500 to 3000 Yuan was associated with higher total body water, skeletal muscle, and protein level (P < 0.001) compared with a per capita monthly income of less than 1500 Yuan.

CONCLUSION

Worsening nutritional status exists in perimenopausal women, which is characterized by increased weight, fat mass, and waist-hip ratio, and decreased skeletal muscle, total body water, and protein level. For greater efficiency, precision nutritional interventions are needed, and recipients should be classified into different risk levels based on their sociodemographic background.

New mechanistic insights of anti-obesity by sleeve gastrectomy-altered gut microbiota and lipid metabolism

Background

The obesity epidemic has been on the rise due to changes in living standards and lifestyles. To combat this issue, sleeve gastrectomy (SG) has emerged as a prominent bariatric surgery technique, offering substantial weight reduction. Nevertheless, the mechanisms that underlie SG-related bodyweight loss are not fully understood.

Methods

In this study, we conducted a collection of preoperative and 3-month postoperative serum and fecal samples from patients who underwent laparoscopic SG at the First Affiliated Hospital of Shandong First Medical University (Jinan, China). Here, we took an unbiased approach of multi-omics to investigate the role of SG-altered gut microbiota in anti-obesity of these patients. Non-target metabolome sequencing was performed using the fecal and serum samples.

Results

Our data show that SG markedly increased microbiota diversity and Rikenellaceae, Alistipes, Parabacteroides, Bactreoidales, and Enterobacteraies robustly increased. These compositional changes were positively correlated with lipid metabolites, including sphingolipids, glycerophospholipids, and unsaturated fatty acids. Increases of Rikenellaceae, Alistipes, and Parabacteroide were reversely correlated with body mass index (BMI).

Conclusion

In conclusion, our findings provide evidence that SG induces significant alterations in the abundances of Rikenellaceae, Alistipes, Parabacteroides, and Bacteroidales, as well as changes in lipid metabolism-related metabolites. Importantly, these changes were found to be closely linked to the alleviation of obesity. On the basis of these findings, we have identified a number of microbiotas that could be potential targets for treatment of obesity.

"Weight loss is my goal and being healthy is my goal… I can get over the hot flashes": a qualitative exploration of menopausal transition experiences and preferences for weight management among White women

OBJECTIVES

A qualitative research study design was used to (1) describe experiences of White women during the menopausal transition, and (2) identify barriers and facilitators for participating in a lifestyle program targeting weight management.

METHODS

Perimenopausal and postmenopausal White women who self-reported a desire to lose or maintain weight participated in focus groups. Women were queried about their past diet, exercise, and weight management practices; menopausal transition; and specific components and considerations for developing a lifestyle program for weight management. Thematic analysis was conducted on coded transcripts and four main themes emerged, each containing three to six subthemes.

RESULTS

Twenty-eight White women (age 54 ± 3 y, body mass index 31.4 ± 9.5 kg/m 2 ) were enrolled. Overall, women felt menopause was a major life event that coincided with weight gain and frustrating body changes. Women already engaged in many different types of exercises and diets to lose weight. Women also talked to healthcare professionals about menopause but were disappointed in the support they received. Women were interested in a lifestyle program that included menopause-specific education, which focused on results beyond weight, which was flexible to their busy lifestyle, and which provided opportunities to build camaraderie among other women experiencing menopause.

CONCLUSIONS

This cohort of White women were interested in receiving menopause information and improving their overall health as part of a lifestyle program targeting weight management during this transition. Building camaraderie with other women affected by menopause is important to women, as is creating a lifestyle program that is flexible with daily life.

Differential Association of Sex Hormones with Metabolic Parameters and Body Composition in Men and Women from the United States

Sex hormones impact body composition. Data on the specific impact of each hormone on different body depots in men and women are scarce. The aim of this study is to evaluate the association between testosterone, estradiol and body fat distribution in the general population. This is a population-based cross-sectional study based on data from the 2013-2016 cycles of the National Health and Nutrition Examination Survey. Dual energy X-ray absorptiometry (DXA) and liquid chromatography tandem mass spectrometry were performed on participants aged 18-59 years to evaluate body composition and sex hormone levels, respectively. Weighted multivariable linear regression analyses were performed to evaluate the association between these parameters after adjustment for potential confounders. A total of 6655 participants (3309 males and 3346 females) was included in the analysis. Men with lower testosterone levels were older, had a higher body mass index (BMI) and had a generally unfavorable metabolic profile, while no specific trends were found in women. Among men, testosterone was positively associated with lean body mass and was negatively associated with fat mass and the android/gynoid (A/G) ratio, while an opposite trend was found for estradiol. Among women, testosterone did not impact body composition, while estradiol levels were positively associated with lean mass and were negatively associated with fat mass. Our results support the notion that the impact of different sex hormones on specific fat depots varies substantially between men and women.

Detrimental Changes in Health during Menopause: The Role of Physical Activity

Midlife women experience changes in cardiometabolic, physical, and psychosocial health during menopause that negatively impacts their overall quality of life. Factors that contribute to these increases in cardiometabolic risk include weight gain as well as increases in fat mass (particularly abdominal adiposity), insulin resistance, and vascular dysfunction. Other deleterious changes in physical health (e. g. reduced sleep health, bone density, and balance) as well as changes in psychosocial health (e. g. mood, anxiety, and depression) often coincide and are linked to these increases in cardiometabolic risk. Physical activity and exercise are important lifestyle components that have been demonstrated to improve cardiometabolic, physical, and psychosocial health, yet physical activity and exercise is known to decline during perimenopause and into the postmenopausal years. In this narrative review, we summarize these changes in overall health during menopause as well as how declining physical activity contributes to these changes. Additionally, we discuss how incorporating physical activity and exercise during menopause can potentially ameliorate health declines. We conclude that there exists a significant, positive impact of physical activity on cardiometabolic, physical, and psychological health among midlife women, particularly if undertaken during the perimenopausal and postmenopausal years.

Effect of sleep restriction on insulin sensitivity and energy metabolism in postmenopausal women: A randomized crossover trial

OBJECTIVE

The aim of this study was to investigate the effect of sleep restriction (SR) on insulin sensitivity and energy metabolism in postmenopausal women.

METHODS

In a randomized crossover trial, 14 women underwent four nights of habitual sleep (HS, 100% normal sleep) and SR (60% of HS) while following a eucaloric diet. Outcomes included the following: (1) insulin sensitivity by hyperinsulinemic-euglycemic clamp, defined as the glucose infusion rate (GIR); (2) resting metabolism and substrate oxidation by indirect calorimetry; and (3) glucose, insulin, and C-peptide concentrations following a standard meal test.

RESULTS

Nine postmenopausal women (mean [SD], age 59 [4] years, BMI 28.0  [2.6] kg/m2 ) were analyzed. Accelerometer-determined total time in bed was 8.4 ± 0.6 hours during HS versus 5.0 ± 0.4 hours during SR (38% reduction, p < 0.0001). SR reduced low-dose insulin GIR by 20% (HS: 2.55 ± 0.22 vs. SR: 2.03 ± 0.20 mg/kg/min; p = 0.01) and high-dose insulin GIR by 12% (HS: 10.48 ± 0.72 vs. SR: 9.19 ± 0.72 mg/kg/min; p < 0.001). SR reduced fat oxidation during high-dose insulin infusion (p < 0.01), and it did not alter resting energy metabolism.

CONCLUSIONS

Four nights of SR reduced insulin sensitivity and fat oxidation in postmenopausal women. These findings underscore the role of insufficient sleep in metabolic dysfunction following menopause. Larger trials investigating how sleep disturbances cause metabolic dysfunction during menopause are needed across all stages of menopause.

Longitudinal patterns of abdominal visceral and subcutaneous adipose tissue, total body composition, and anthropometric measures in postmenopausal women: Results from the Women's Health Initiative

BACKGROUND

Abdominal adiposity, including visceral and subcutaneous abdominal adipose tissue (VAT and SAT), is recognized as a strong risk factor for cardiometabolic disease, cancer, and mortality.

OBJECTIVE

The primary aim of this analysis is to describe longitudinal patterns of change in abdominal adipose tissue in postmenopausal women, overall and stratified by age, race/ethnicity, and years since menopause.

METHODS

The data are from six years of follow up on 10,184 postmenopausal women (7828 non-Hispanic White women, 1423 non-Hispanic Black women, and 703 Hispanic women) who participated in the Women's Health Initiative (WHI). The WHI is a large prospective cohort study of postmenopausal women across the United States. All participants in this analysis had DXA scans in the 1990s as part of the WHI protocol. Hologic APEX software was used to re-analyze archived DXA scans and obtain measures of abdominal adipose tissue. Analyses examined differences in abdominal adipose tissue, overall adiposity, and anthropometric variables.

RESULTS

There were important differences in VAT and SAT by age and race/ethnicity. In women <60 years, VAT increased over the follow-up period, while in women ≥70 years, VAT decreased. Non-Hispanic Black women had the highest levels of SAT. Hispanic women had the highest VAT levels. Women more than ten years since menopause had less SAT and more VAT than women less than ten years since menopause, resulting in a higher VAT/SAT ratio. There was a moderate to strong correlation between measures of abdominal adipose tissue and anthropometric measurements of body size. Still, there were substantial differences in the quantity of VAT and SAT within BMI and waist circumference categories.

CONCLUSIONS

These results demonstrate differences in VAT and SAT according to age, race/ethnicity, time since menopause, and compared to standard measures of body composition in a large and diverse cohort of postmenopausal women.

High-Risk Lipoprotein(a) Levels in Saudi Women and Its Relationship to Menopause and Adiposity

Lipoprotein(a) is an inherent CVD risk biomarker that varies by race, and the levels of Lp(a) in Saudi women are relatively unexplored. We aimed to examine the effect of age and menopause on Lp(a) and explore the correlation between adiposity and cardiometabolic risk factors with Lp(a) in Saudi women. The third aim was to determine the predictors of elevated Lp(a) in this population. In this cross-sectional study of 229 women, we compared Lp(a) serum levels, adiposity indices, and lipid and glycemic profiles between menopausal groups. We used immunoturbidimetry to measure serum Lp(a) and BIA to assess body composition. We evaluated the relationship between Lp(a) and our parameters using ANOVA and Spearman's correlations. Regression was used to determine the predictors of high-risk Lp(a) levels. The mean of Lp(a) was 28.37 mg/dL, and the concentration increased significantly in postmenopausal (premenopausal 20.98 ± 12.30; perimenopausal 29.92 ± 9.53; postmenopausal 32.49 ± 9.83 mg/dL; p < 0.001. High-risk levels were 57.1% in postmenopausal and 19.1% in premenopausal. The magnitude of Lp(a) increased significantly after age 50. Lp(a) was significantly associated with age and cholesterol and negatively associated with % FFM. Lp(a) increased by 0.41 units for every year of age, indicating the strongest correlation.

Physical activity, lifestyle, sociocultural factors and prevalence of excess weight gain among postmenopausal women: A cross-sectional study

BACKGROUND

Most women experienced postmenopausal symptoms during the menopause transition, and they are a common reason for seeking medical attention and lifestyle modification during this phase of life.

OBJECTIVE

This study assessed the physical activity, lifestyle, and sociocultural levels-associated prevalence of excess weight (overweight and obesity) among postmenopausal women (PW) in Bono-East (Techiman) region, Ghana.

DESIGN

This is cross-sectional study.

METHOD

This was a cross-sectional study conducted at Bono-East regional capital, Techiman in Ghana over 5 months. Self-administered questionnaires were used to obtain sociodemographic data, physical activity, lifestyle, and sociocultural associated prevalence of excess weight. Anthropometric indices including ((body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)) were assessed.

RESULTS

A total of 393 postmenopausal women with a mean age of 60.09 ± 6.24 years participated in the study. When reporting prevalence, obesity, and overweight were distinguished. Using the anthropometric parameters (BMI, WHtR, and WHR) as measured for being overweight, the prevalent rates were 35.7%, 21.7%, and 9.0% respectively. Also, when using obesity, the prevalent rate was 37.8%, 70.1%, and 82.0% using BMI, WHtR, and WHR, respectively. Over 55 (55.2%) of the study participants engaged in moderate physical activities, 23.1% were low and 21.7% with high physical activities. Housewives and unemployed participants are shown to have a higher risk of gaining weight (obese) especially when assessed with WHR and WHtR. Most participants responded that cultural beliefs prevent them from losing weight. Most participants had a poor attitude toward their eating habits.

CONCLUSION

According to the findings, postmenopausal Ghanaian women showed a high level of obesity and a moderate level of being overweight. The cultural perception of beauty influences Ghanaian postmenopausal women's physical activity level and dietary habits.

Cardiometabolic risk factors and cardiovascular disease predictions in older African and European Americans

Cardiometabolic (CMO) risks factors do not provide similar cardiovascular disease (CVD) predictions in young African (AA) and European Americans (EA) adults. Whether CMO risk predictions contribute to this disparity in older adults is unclear. We hypothesize that older AA CMO clustering pattern will be different from EA clustering patterns when determine with non-fasting lipid and lipoproteins. The participants were 106 older adults (66 AA and 40 EA) from a working/middle class neighborhood (income $46,364 – $80,904) in an urban North Carolina community. The participants were evaluated for CMO risk factors (total cholesterol, high- (HDL) and low-density lipoproteins (LDL), triglyceride (TG), glycosylated hemoglobin (HbA1c), systolic –SBP- and diastolic blood pressures -DBP), body mass index (BMI), body fat % (BF%) and timed up and go test (assessed falls risk and physical function). The AA participants were heavier, had higher BMI, BF%, and timed up and go values (p < 0.01). The data were evaluated for differences (t-test) and Pearson correlations for relationships. If data differ by p < 0.05 the data were significantly different. The AA had a 17.6 % higher HDL (64.7 vs 55.1 mg/dL – p < 0.05) and 7.6 % higher HbA1c (5.8 vs 5.4 % – p < 0.01) than EA. Higher HDL values in EA indicate lower CVD risks. The HDL paradox for AA (AA had higher HDL values, but greater CVD risks) was observed and the HbA1c difference may be misleading, as similar glucose values in AA tend to have higher HbA1c values. Lipid, lipoprotein, and blood pressure was not different between the races. AA had higher body composition and HDL values. Although future research on this topic with larger samples, dietary data and detailed descriptions of participations medications is warranted to validate findings from this study. These data suggest older AA and EA adults with similar environmental conditions have similar CMO risks when measures with none fasting blood samples. Since AA have a greater prevalence of CVD, these finding suggests that population specific CMO risk factor clustering may be more effective predictors of CVD for AA.

Total and regional body adiposity increases during menopause-evidence from a follow-up study

For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual-energy X-ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47-55 (n = 230 and 148, mean follow-up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m² ). We also examined associations between menopausal progression and skeletal muscle fiber characteristics, as well as adipose tissue-derived adipokines. Relative increases of 2%-14% were observed in regional and total body adiposity measures, with a pronounced fat mass increase in the android area (4% and 14% during short- and long-term follow-ups). Muscle fiber oxidative and glycolytic capacities and intracellular adiposity were not affected by menopause, but were differentially correlated with total and regional body adiposity at different menopausal stages. Menopausal progression and regional adipose tissue masses were positively associated with serum adiponectin and leptin, and negatively associated with resistin levels. Higher diet quality and physical activity level were also inversely associated with several body adiposity measures. Therefore, healthy lifestyle habits before and during menopause might delay the onset of severe metabolic conditions in women.

Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women

BACKGROUND

Menopause characteristics have been implicated in future health consequences, yet little is known about its relevance to diabetes. We examined the associations of menopausal status and age at natural menopause with diabetes risk in Chinese women.

METHODS

We used prospective data of the China Kadoorie Biobank study that recruited 302,522 women aged 30-79 years in 2004-2008 from 10 areas across China. During average 10.8 years of follow-up, 11,459 incident diabetes cases were recorded among 281,319 women without prior diabetes diagnosis at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for incident diabetes associated with menopausal status and age at natural menopause.

RESULTS

Overall, the mean (SD) age at natural menopause was 48.2 (4.4) years among 141,789 post-menopausal women. Naturally peri-, or post-menopausal women were at higher risk of diabetes, with HRs of 1.17 (95% CI 1.06-1.29) and 1.15 (1.06-1.25) compared with pre-menopausal women, adjusting for several potential confounders. Among women who had natural menopause, the HR of diabetes was 1.14 (1.01-1.30), 1.01 (0.93-1.09), 1.10 (1.04-1.16), and 1.10 (1.01-1.20) for menopause at ages less than 40, 40-44, 50-53, and 54 years or older, respectively, relative to 45-49 years.

CONCLUSIONS

In this study, we found that women with naturally peri-, or post-menopausal status had higher risk of developing diabetes. Besides, among the post-menopausal women, both earlier and later age at natural menopause were associated with increased risk of diabetes.

Body composition and cardiometabolic health across the menopause transition

Every year, 2 million women reach menopause in the United States, and they may spend 40% or more of their life in a postmenopausal state. In the years immediately preceding menopause-known as the menopause transition (or perimenopause)-changes in hormones and body composition increase a woman's overall cardiometabolic risk. In this narrative review, we summarize the changes in weight, body composition, and body fat distribution, as well as the changes in energy intake, energy expenditure, and other cardiometabolic risk factors (lipid profile, glucose metabolism, sleep health, and vascular function), that occur during the menopause transition. We also discuss the benefits of lifestyle interventions in women in the earlier stages of menopause before these detrimental changes occur. Finally, we discuss how to include perimenopausal women in research studies so that women across the life-span are adequately represented.

Obesity, Body Composition, and Sex Hormones: Implications for Cardiovascular Risk

Cardiovascular disease (CVD) continues to be the leading cause of death in adults, highlighting the need to develop novel strategies to mitigate cardiovascular risk. The advancing obesity epidemic is now threatening the gains in CVD risk reduction brought about by contemporary pharmaceutical and surgical interventions. There are sex differences in the development and outcomes of CVD; premenopausal women have significantly lower CVD risk than men of the same age, but women lose this advantage as they transition to menopause, an observation suggesting potential role of sex hormones in determining CVD risk. Clear differences in obesity and regional fat distribution among men and women also exist. While men have relatively high fat in the abdominal area, women tend to distribute a larger proportion of their fat in the lower body. Considering that regional body fat distribution is an important CVD risk factor, differences in how men and women store their body fat may partly contribute to sex-based alterations in CVD risk as well. This article presents findings related to the role of obesity and sex hormones in determining CVD risk. Evidence for the role of sex hormones in determining body composition in men and women is also presented. Lastly, the clinical potential for using sex hormones to alter body composition and reduce CVD risk is outlined. © 2022 American Physiological Society. Compr Physiol 12:1-45, 2022.

Go for it! Exercising makes you happy and strong

Despite it is generally recognized the beneficial role of physical activity, large portion of the population is physically inactive. Very alarmingly, the well-known gender gap in physical activity is constantly increasing. Several barriers obstacle women to perform physical activity although exercising would be of paramount importance for their health in particular during pregnancy and menopause. In addition to physical health benefits, physical activity may influence well-being and resilience, greatly impacting on quality of life.

Here we explore the relationship between physical activity resilience and well-being in a group of 1107 female residents in the Metropolitan area of Naples.

A decision tree analysis on multiple factors related to menopausal symptoms

OBJECTIVES

The purpose of this study was to examine the specific characteristics that were directly linked to menopausal symptoms of midlife women from four major racial/ethnic groups in the United States using a decision tree analysis.

METHODS

This was a secondary analysis of the data from 1,027 midlife women from 2 larger Internet-based studies. The parent studies used the Midlife Women's Symptom Index with multiple questions on background characteristics and health and menopausal status. The data were analyzed using ANOVA and decision tree analyses.

RESULTS

Across all the racial/ethnic groups, menopausal stage and country of birth were significantly related to the total number and total severity scores of menopausal symptoms (P < 0.001). In each racial/ethnic group, different combined characteristics of the participants were closely linked to the total number and total severity scores of menopausal symptoms (P < 0.05). For instance, in African Americans, the total severity scores of menopausal symptoms increased among those who were postmenopausal (P < 0.001), US born (P < 0.001), and with low family income (P = 0.030).

CONCLUSIONS

Specific risk groups by the combined characteristics need to be considered in future practice with midlife women.

Diet to Reduce the Metabolic Syndrome Associated with Menopause. The Logic for Olive Oil

The rates of metabolic syndrome are increasing in parallel with the increasing prevalence of obesity, primarily due to its concomitant insulin resistance. This is particularly concerning for women, as the years around menopause are accompanied by an increase in visceral obesity, a strong determinant of insulin resistance. A fall in estrogens and increase in the androgen/estrogen ratio is attributed a determining role in this process, which has been confirmed in other physiological models, such as polycystic ovary syndrome. A healthy lifestyle, with special emphasis on nutrition, has been recommended as a first-line strategy in consensuses and guidelines. A consistent body of evidence has accumulated suggesting that the Mediterranean diet, with olive oil as a vital component, has both health benefits and acceptable adherence. Herein, we provide an updated overview of current knowledge on the benefits of olive oil most relevant to menopause-associated metabolic syndrome, including an analysis of the components with the greatest health impact, their effect on basic mechanisms of disease, and the state of the art regarding their action on the main features of metabolic syndrome.

Perimenopause, body fat, metabolism and menopausal symptoms in relation to serum markers of adiposity, inflammation and digestive metabolism

BACKGROUND

Perimenopausal women gain weight that may alter inflammatory status, endocrine equilibrium, and the intensity of vasomotor symptoms.

OBJECTIVE

To measure serum levels of markers related to adiposity, inflammation/angiogenesis and digestive metabolism and correlate them with body mass index (BMI), waist-to-hip ratio (WHR), metabolic parameters and menopausal symptoms (assessed with the 10-item Cervantes Scale [CS-10]).

METHODS

Serum of perimenopausal women (n = 24), STRAW stages-2 and -1, was analyzed using the Bio-Plex 200 System technology to assess 30 proposed analytes. The MetS was defined by the American Heart Association criteria and women were divided as: normal BMI (NBMI), excessive BMI (EBMI), and EBMI with MetS (EBMI-MetS).

RESULTS

Weight, BMI, abdominal circumference, WHR, systolic blood pressure, glucose and triglyceride levels were significantly higher and high-density lipoprotein cholesterol (HDL-C) was lower in EBMI-MetS women compared to NBMI ones. Insulin, C-peptide, resistin, adipsin, GIP, leptin, IL-6, FGF21 and PAI-1 levels were significantly higher and ghrelin and IGFBP-1 lower in EBMI-MetS women as compared to NBMI ones. Spearman's correlation of pooled data showed a significant positive correlation between abdominal perimeter and WHR and C-peptide, insulin, adipsin, resistin, leptin, PAI-1 and FGF21 and a negative correlation with IGFBP-1 levels. Total CS-10 scores and hot flush intensity did not differ between studied groups, yet positively correlated with anthropometric values but not with studied analytes.

CONCLUSION

Perimenopausal women with EBMI and the MetS showed an altered metabolic profile, but no differences in menopausal symptoms which also did not correlate with changes in studied biomarkers.

Follicle-Stimulating Hormone Positively Associates with Metabolic Factors in Perimenopausal Women

OBJECTIVE

Menopause is associated with the increased risk of metabolic syndrome (MetS) and cardiovascular (CV) disease. Most studies have focused the postmenopausal women and the relationships among estrogen, androgen, and Mets risk. The main aim of the study was to investigate the Mets risk in perimenopausal women and whether the variation of FSH is associated with metabolic factors.

METHODS

A single-center cross-sectional retrospective analysis including 154 premenopausal women and 124 perimenopausal women was performed.

RESULTS

The prevalence of Mets in the perimenopausal group was much higher than the premenopausal group (49.19% vs. 35.71%, p = 0.023). The prevalence of central obesity and NAFLD also increased in the perimenopausal group than in the premenopausal group. We grouped the population by FSH tertiles; compared with women in the lowest tertile, women in the highest tertile had higher age, WC, serum TC, LDL-C, AST, ALT, and creatine levels. The prevalence of hypertriglyceridemia, raised BP and Mets also increased in the highest tertile group. Further, we subdivided the perimenopausal women according to FSH tertiles. Compared with perimenopausal women in the lowest tertile, the prevalence of raised BP significantly increased in the highest tertile.

CONCLUSIONS

The risk of Mets increased in perimenopausal females than in premenopausal women. And a higher FSH level was associated with higher WC, TG, BPs, and the risk of Mets in perimenopausal women. Elevated FSH level appears to be a risk factor of MetS biomarkers in perimenopausal women.