Department of Medicine, University of California, San Francisco, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
Clin Infect Dis. 2023 Jul 26;77(2):265-271. doi: 10.1093/cid/ciad165.
Women are at risk for weight gain during the transition to menopause, but few have examined the contribution of menopause to weight gain in women with human immunodeficiency virus (WWH).
From 2000 to 2013, participants (621 WWH; 218 without HIV [WWOH]) from the Women's Interagency HIV Study were categorized by menopausal phase using serial measures of anti-Müllerian hormone (AMH). Multivariable linear mixed models examined the association of menopausal phase with body mass index (BMI) and waist circumference (WC) trajectory, stratified by HIV status.
In models controlled for chronologic age, the estimated effects (95% confidence interval) of menopausal phase on annual rate of BMI change across early perimenopause, late perimenopause, and menopause, respectively, compared to premenopause were -0.55% (-.80 to -.30), -0.29% (-.61 to .03), and -0.67% (-1.12 to -.20) in WWH, whereas estimated effects were 0.43% (-.01 to .87) and 0.15% (-.42 to .71) across early and late perimenopause, respectively, and -0.40% (-1.24 to .45) across menopause in WWOH. The estimated effects on rate of WC change were negative across early perimenopause (-0.21% [-.44 to .03]) and menopause (-0.12% [-.5 to .26]) and positive across late perimenopause (0.18% [-.10 to .45]) in WWH, and positive across all 3 menopausal phases in WWOH, but these effects were not statistically significant.
In WWH, the menopausal transition was associated with BMI and WC trajectories that were mostly in a negative direction and opposite from WWOH after adjusting for age, suggesting that HIV blunts weight gain during the menopausal transition.
女性在绝经过渡期间有体重增加的风险,但很少有研究检查绝经对感染人类免疫缺陷病毒(HIV)的女性(WWH)体重增加的贡献。
2000 年至 2013 年,来自妇女艾滋病病毒研究机构间小组的参与者(621 名 WWH;218 名无 HIV [WWOH])根据抗苗勒氏管激素(AMH)的连续测量结果分为绝经阶段。多变量线性混合模型检查了绝经阶段与体重指数(BMI)和腰围(WC)轨迹的关联,按 HIV 状态分层。
在控制年龄的模型中,与绝经前相比,绝经过渡期、晚期绝经和绝经后分别估计的绝经阶段对 BMI 年变化率的影响(95%置信区间)在 WWH 中分别为-0.55%(-0.80 至-0.30)、-0.29%(-0.61 至 0.03)和-0.67%(-1.12 至-0.20),而在 WWOH 中,估计的影响分别为 0.43%(-0.01 至 0.87)和 0.15%(-0.42 至 0.71),在绝经期间为 0.40%(-1.24 至 0.45)。在 WWH 中,在绝经早期(-0.21%[-0.44 至 0.03])和绝经后期(-0.12%[-0.5 至 0.26])WC 变化率的估计影响为负,而在绝经后期(0.18%[-0.10 至 0.45])为正,而在 WWOH 中,所有 3 个绝经阶段均为正,但这些影响无统计学意义。
在 WWH 中,绝经过渡与 BMI 和 WC 轨迹相关,这些轨迹在调整年龄后大多为负向,与 WWOH 相反,这表明 HIV 减轻了绝经过渡期间的体重增加。