Increased visceral fat and decreased energy expenditure during the menopausal transition
Increased visceral fat and decreased energy expenditure during the menopausal transition
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DOI：
10.1038/ijo.2008.25
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发表时间：
2008-06-01
影响因子：
4.9
通讯作者：
Smith, S. R.
中科院分区：
文献类型：
--
作者：
Lovejoy, J. C.;Champagne, C. M.;Smith, S. R.
目的：本研究评估围绝经期妇女身体成分、脂肪分布和能量平衡的纵向变化。我们假设，总脂肪和腹部脂肪将增加在绝经期由于减少能量消耗（EE）和下降的雌激素，designations.Design：观察，纵向研究，每年测量4 years.Subjects：健康女性（103白种人，53非洲裔美国人），最初绝经前。在随访期间，月经不足1年和卵泡刺激素430 mIU ml（-1）定义为绝经后的受试者。测量：脂肪和瘦体重（双能X线吸收法），内脏（VAT）和皮下腹部脂肪（SAT）（计算机断层扫描），饮食摄入量（4天的食物记录），血清性激素和体力活动（三轴加速度计）。采用全室热量计测量34例绝经后妇女的24小时EE。结果：仅绝经4年的妇女（n = 51）体脂和体重随时间显著增加。随着时间的推移，所有女性的SAT都增加了;然而，只有那些绝经后的女性的VAT显著增加。绝经后组也表现出血清雌二醇的显着下降。体力活动在绝经前2年显著减少，并保持在低水平。绝经前3-4年的膳食能量、蛋白质、碳水化合物和纤维摄入量明显高于绝经前。24小时EE和睡眠EE随着年龄的增长而显著降低;然而，绝经后女性的睡眠EE下降幅度是绝经前对照组的1.5倍（-7.9 vs -5.3%）。绝经后妇女的脂肪氧化减少了32%（P < 0.05），但在绝经前的妇女中没有变化。结论：中年妇女随着年龄的增长而增加SAT，而绝经本身与总体脂和VAT的增加有关。绝经期开始与EE减少和脂肪氧化有关，如果不改变生活方式，可能易患肥胖症。
Objective: This study assessed longitudinal changes in body composition, fat distribution and energy balance in perimenopausal women. We hypothesized that total fat and abdominal body fat would increase at menopause due to decreased energy expenditure (EE) and declining estrogen, respectively.Design: Observational, longitudinal study with annual measurements for 4 years.Subjects: Healthy women ( 103 Caucasian; 53 African-American), initially premenopausal. During follow-up, lack of menstruation for 1 year and follicle-stimulating hormone 430 mIU ml(-1) defined a subject as postmenopausal.Measurements: Fat and lean mass (dual-energy X-ray absorptiometry), visceral ( VAT) and subcutaneous abdominal fat (SAT) ( computed tomography), dietary intake (4-day food record), serum sex hormones and physical activity (tri-axial accelerometry). Twenty-four hour EE was measured by whole-room calorimeter in a subset of 34 women at baseline and at year 4.Results: Body fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n = 51). All women gained SAT over time; however, only those who became postmenopausal had a significant increase in VAT. The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P < 0.05), but did not change in those who remained premenopausal.Conclusion: Middle-aged women gained SAT with age, whereas menopause per se was associated with an increase in total body fat and VAT. Menopause onset is associated with decreased EE and fat oxidation that can predispose to obesity if lifestyle changes are not made.