Changes in body composition and weight during the menopause transition
Changes in body composition and weight during the menopause transition
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DOI：
10.1172/jci.insight.124865
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发表时间：
2019-03-07
期刊：
影响因子：
8
通讯作者：
Karlamangla, Arun S.
中科院分区：
文献类型：
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作者：
Greendale, Gail A.;Sternfeld, Barbara;Karlamangla, Arun S.
背景资料。更年期转变(MT)与身体成分或体重变化之间的关系仍不确定。我们假设，与年龄增长无关，MT会对身体成分产生不利影响。方法：参与者来自全国妇女健康纵向研究(SWAN)队列。我们用双能X射线骨密度仪评估身体成分。多变量混合效应回归适合分段线性模型，以重复测量作为末次月经期(FMP)前后时间的结果。协变量为FMP年龄、种族、研究地点和激素治疗。结果：移植前脂肪和瘦体重增加。在MT开始时，脂肪增加率翻了一番，瘦肉质量下降；持续到FMP后2年。此后，脂肪和瘦肉的运动轨迹减速至零斜率。体重在绝经前呈线性上升，在MT时没有加速。其运动轨迹在运动后变得平坦。结论：脂肪质量的加速增加和瘦质量的减少是与运动相关的现象。在绝经前和MT之间，脂肪质量和瘦质量总和的增加率没有差异；因此，MT开始时体重增加的速度没有明显的变化。
BACKGROUND. The relation between the menopause transition (MT) and changes in body composition or weight remains uncertain. We hypothesized that, independent of chronological aging, the MT would have a detrimental influence on body composition.METHODS. Participants were from the longitudinal Study of Women's Health Across the Nation (SWAN) cohort. We assessed body composition by dual energy x-ray absorptiometry. Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of outcomes as a function of time before or after the final menstrual period (FMP). Covariates were age at FMP, race, study site, and hormone therapy.RESULTS. Fat and lean mass increased prior to the MT. At the start of the MT, rate of fat gain doubled, and lean mass declined; gains and losses continued until 2 years after the FMP. After that, the trajectories of fat and lean mass decelerated to zero slope. Weight climbed linearly during premenopause without acceleration at the MT. Its trajectory became flat after the MT.CONCLUSION. Accelerated gains in fat mass and losses of lean mass are MT-related phenomena. The rate of increase in the sum of fat mass and lean mass does not differ between premenopause and the MT; thus, there is no discernable change in rate of weight gain at the start of the MT.