A prospective study of the relationships between change in body composition and cardiovascular risk factors across the menopause

Abstract

Objective: Menopause increases the risk of cardiovascular disease (CVD) which in part has been attributed to the rise in cholesterol and blood pressure (BP). This study examined the hypothesis that menopausal changes in body composition and regional fat depots relate to the change in CVD risk factors. Methods: A prospective recall study was designed to capture premenopausal women to be re-examined soon after menopause. A total of 97 women from the Oxford Biobank underwent dual x-ray absorptiometry, blood biochemistry, and BP readings pre- and postmenopause. Results: Despite minimal changes in body weight over the 5.1 ± 0.9 year follow-up period, there was an increase in total fat mass and a decline in lean mass, where the proportional change of regional fat mass was the greatest for the visceral fat depot (+22%, P < 0.01). Plasma ApoB (+12%, P < 0.01) and C-reactive protein (+45%, P < 0.01) increased as did systolic (+7%, P < 0.001) and diastolic BP (+5%, P < 0.001). Plasma nonesterified fatty acids decreased (−20%, P < 0.05) which may reflect on a change in adipose tissue function across the menopause. PCSK-9 decreased (−26%, P < 0.01) which suggests a compensation for the postmenopausal reduction in low-density lipoprotein receptor activity. Using multilinear regression analyses the changes in ApoB and diastolic BP were associated with visceral fat mass change, but this association was lost when adjusted for total fat mass change. Conclusion: The increase in CVD risk factor burden across menopause may not be driven by changes in body composition, rather by functional changes in end organs such as adipose tissue and liver.

HOTAIR interacts with PRC2 complex regulating the regional preadipocyte transcriptome and human fat distribution

“…In gluteal cells, where histone marks indicate open chromatin (H3K4me3, H3K27ac), HOTAIR expression is also subject to fine-tuning by hormones with known AT redistribution effects (estrogen and glucocorticoids). The positive association observed between HOTAIR expression and visceral fat mass in females 49 years and older may reflect the de-repression of HOTAIR expression due to declining estrogen levels and an independent (menopause-associated) increase in visceral fat mass in these individuals ( Dehghan et al., 2021 ). Thus, factors influencing estrogen levels may be confounding when examining HOTAIR expression in females, and this could explain some of the heterogeneity in GSAT HOTAIR expression.…”

Association of adiposity evaluated by anthropometric, BIA, and DXA measures with cardiometabolic risk factors in nonobese postmenopausal women: the CoLaus/OsteoLaus cohort

“…28 Another recent study including 97 women with a follow-up of 5.1 years at the menopausal transition showed a positive association between total and regional fat mass and blood pressure and robust negative association with HDL-C in both pre-and post-menopausal states. 2 They found that the absolute change in systolic blood pressure did not correlate significantly with change in total fat mass, regional fat mass, and lean mass but the rise in diastolic blood pressure was significantly associated with the absolute increments in android fat and VAT. In a community-based Korean cohort of 565 people ages >65 years (including 278 women, 76.0 W 8.8 y), VAT and android fat amount were strongly correlated with most cardiometabolic risk factors compared to SAT or gynoid fat.…”

“…1 Cardiovascular disease, diabetes, and obesity are major public health conditions affecting this population, and the risk of cardiovascular events is at least double in postmenopausal women compared with premenopausal women. 2 The cardiometabolic risk factors associated with these conditions are easy to identify under certain conditions. However, it is difficult to identify them without a broad assessment in healthy, nonobese postmenopausal women.…”

Adipocyte Metabolism and Health after the Menopause: The Role of Exercise

“…The powerful influence of exercise on whole body insulin sensitivity in an intensity-dependent fashion is demonstrated as glucose uptake by working muscles rises 7 to 20 times over its basal level during physical activity [ 120 ]. Since metabolic health, and adipose tissue metabolic health in particular, deteriorates after the menopause [ 121 , 122 , 123 ], postmenopausal women benefit tremendously from regular exercise. Furthermore, the benefits of exercise extend beyond metabolic improvements.…”