Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.
Department of Nutritional Sciences, University of Surrey, Guildford, UK.
Menopause. 2021 Feb 1;28(4):400-406. doi: 10.1097/GME.0000000000001721.
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.
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.
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.
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.
绝经会增加心血管疾病（CVD）的风险，部分原因是胆固醇和血压（BP）的升高。本研究检验了这样一个假设，即身体成分和局部脂肪沉积的绝经变化与 CVD 危险因素的变化有关。
设计了一项前瞻性回顾性研究，以捕获绝经前女性，并在绝经后不久再次检查。来自牛津生物库的 97 名女性接受了双能 X 线吸收法、血液生化和 BP 读数的检测，分别在绝经前和绝经后进行。
尽管在 5.1±0.9 年的随访期间体重几乎没有变化，但总脂肪量增加，瘦体重减少，其中内脏脂肪沉积的局部脂肪量变化最大（增加 22%，P<0.01）。血浆载脂蛋白 B（ApoB）增加（12%，P<0.01），C 反应蛋白增加（45%，P<0.01），收缩压（SBP）增加（7%，P<0.001），舒张压（DBP）增加（5%，P<0.001）。非酯化脂肪酸血浆水平下降（-20%，P<0.05），这可能反映了绝经期间脂肪组织功能的变化。前蛋白转化酶枯草溶菌素 9（PCSK-9）下降（-26%，P<0.01），这表明 LDL 受体活性下降后可能有代偿机制。使用多元线性回归分析，ApoB 和舒张压的变化与内脏脂肪量的变化有关，但当调整总脂肪量的变化时，这种相关性就消失了。
绝经后 CVD 危险因素负担的增加可能不是由身体成分的变化引起的，而是由脂肪组织和肝脏等终末器官的功能变化引起的。
