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

Abstract

OBJECTIVE The age‐related decline in skeletal muscle mass (i.e. sarcopenia) and bone mineral density (BMD; i.e. low bone mass, osteoporosis) contribute to physical disability in older women. Although menopause‐related loss of BMD is well documented, whether menopause influences muscle mass and sarcopenia is unclear. We determined the extent to which appendicular lean mass (ALM) and BMD differ across the stages of menopause in healthy women. METHODS 145 women (aged 30–70 years) classified as premenopausal (Pre; regular menstrual cycles; n=30, 38±6yrs; mean ± SD), early perimenopausal (Eperi; > 2 cycles with cycle length changes of ≥7 days; n=31, 50±3yrs), late perimenopausal (Lperi; ≥2 but <12 months of amenorrhea; n=30, 50±4yrs), early postmenopausal (Epost; ≤5 yrs since menopause; n=26, 55±3yrs), or late postmenopausal (Lpost; >5 yrs since menopause; n=28, 62±4yrs) were enrolled. Dual‐energy x‐ray absorptiometry (DEXA) was used to assess ALM (kg/m2), BMD, total body lean mass, and fat mass. RESULTS ALM was lower (p<0.05) in Lperi and Lpost compared to Eperi with no significant differences between other groups (Pre, 6.6±0.6; Eperi, 6.8±0.8; Lperi, 6.1±0.8; Epost, 6.5±1.1; and Lpost, 6.2±0.9 kg/m2). The prevalence of sarcopenia (ALM ≤5.67 kg/m2) was 7, 3, 30, 27, and 32% in Pre, Eperi, Lperi, Epost, and Lpost, respectively. BMD tends to be lower (p=0.05, both) in Lperi and Epost compared to Eperi, and was lower (p<0.05) in Lpost compared to Eperi (Pre, 1.108±0.100; Eperi, 1.164±0.104; Lperi, 1.092±0.100; Epost, 1.088±0.107; and Lpost, 1.045±0.113 gm/cm2). There was a consistent increase in total fat mass and decrease in total lean mass from Pre to each subsequent stage (both, p<0.05 for Pre vs. Lpost). CONCLUSION In addition to the menopause‐related decline in bone mass, the menopause transition appears to be a vulnerable period for the loss of skeletal muscle mass that may begin during the late perimenopausal transition. Potential mechanisms underlying menopause‐related loss of muscle mass such as estrogen receptor signaling and protein metabolism should be explored in future studies. Support or Funding Information NIH R01AG049762, R01AG027678, R56HL114073, P30DK048520, P50HD073063, NCATS Colorado CTSA UL1TR001082, and Eastern Colorado VA GRECC This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Changes in body composition and lipid profile in prostate cancer patients without bone metastases given Degarelix treatment: the BLADE prospective cohort study

“…Our results indeed showed a steep decline in FSH levels at 6-month after Degarelix administration, confirming published data [ 29 ]. A recent Korean study has shown that ALMI measured across menopause stages in a series of women was inversely correlated to FSH but not to estradiol [ 30 ]. These data suggest that FSH may negatively influence muscle mass and favor sarcopenia.…”

“…This suggests a pathogenic role of FSH with regard to this unwanted physical and metabolic condition. So the greater reduction in serum FSH after LHRH antagonists compared to agonists [ 29 , 30 ] provides a possible mechanism of reduction in the risk of sarcopenic obesity associated with the administration of the former drugs as compared to the latter. These data, if confirmed, are relevant in view of the increasing impact of obesity and sarcopenia on the CVD risk in long surviving patients with PCa.…”

Bone Mineral Density in Different Menopause Stages is Associated with Follicle Stimulating Hormone Levels in Healthy Women

“…All assays were performed by the Colorado Clinical and Translational Sciences Institute (CCTSI) Clinical and Translational Research Center (CTRC) Core laboratory, which is CAP-and CLIA-accredited. The intra-and inter-assay coefficients of variation have been described previously [24]. The coefficient of variation (CV, 95% CI) for each hormone are as follows: intra-assay CV: estradiol, 4.3%; estrone, 11.5%; FSH, 1.8%; progesterone, 4.4%; testosterone, 2.1%; IL6, 7.8%; and inter-assay CV: estradiol, 8.2%; estrone, 19.8%; FSH, 3.8%; progesterone, 7.9%; testosterone, 5.1%; IL6, 11%.…”

Menopause and the Loss of Skeletal Muscle Mass in Women

“…However, less is known about whether skeletal muscle mass and the prevalence of sarcopenia differ between the menopausal stages. Using a cross-sectional study ( 5 ), we recently determined that perimenopausal transition is a vulnerable period for the loss of muscle mass. One hundred forty four healthy women (aged 30–70 yr) were classified as premenopausal (n=30), early (n=31) and late perimenopausal (n=30), and early (n=26) and late postmenopausal (n=27).…”

“…Appendicular lean mass (ALM) index, calculated by ALM adjusted by the square of height, was assessed using dual-energy x-ray absorptiometry ( 5 ).…”