Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, California, USA.
Division of Research, Kaiser Permanente, Oakland, California, USA.
JCI Insight. 2019 Mar 7;4(5). doi: 10.1172/jci.insight.124865.
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.
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.
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.
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.
NIH, Department of Health and Human Services (DHHS), through the National Institute on Aging, National Institute of Nursing Research, and NIH Office of Research on Women's Health (U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, and U01AG012495).
绝经过渡期（MT）与身体成分或体重变化之间的关系仍不确定。我们假设，除了年龄的自然增长外，MT 还会对身体成分产生不利影响。
参与者来自妇女健康纵向研究（SWAN）队列。我们通过双能 X 射线吸收法评估身体成分。多变量混合效应回归分析采用分段线性模型，根据末次月经（FMP）前后的时间重复测量结果。协变量为 FMP 时的年龄、种族、研究地点和激素治疗。
在 MT 之前，脂肪和瘦体重增加。在 MT 开始时，脂肪增加速度增加了一倍，瘦体重下降；这些增加和减少一直持续到 FMP 后 2 年。之后，脂肪和瘦体重的轨迹减速至零斜率。在绝经前期，体重呈线性增长，在 MT 时没有加速。在 MT 之后，其轨迹变得平坦。
脂肪质量的加速增加和瘦体重的减少是与 MT 相关的现象。脂肪质量和瘦体重总和的增加率在绝经前期和 MT 之间没有差异；因此，在 MT 开始时，体重增加率没有明显变化。
美国国立卫生研究院（NIH），美国卫生与公众服务部（DHHS）通过国家老龄问题研究所、国家护理研究所和 NIH 妇女健康研究办公室（U01NR004061、U01AG012505、U01AG012535、U01AG012531、U01AG012539、U01AG012546、U01AG012553、U01AG012554 和 U01AG012495）提供。
