Wang Xiaoyi, Yang Dongjian, Li Jiahui, Jin Lei, Xia Shuhua, Jin Furui
International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
Front Endocrinol (Lausanne). 2025 Jul 23;16:1628612. doi: 10.3389/fendo.2025.1628612. eCollection 2025.
The decline in muscle mass is a common concern among perimenopausal women. However, the association between menopause-related symptoms and muscle mass remains inconclusive, and the mechanistic role of estrogen is still unclear.
The study included 407 peri- and postmenopausal women aged 40-60 years who visited the International Peace Maternity and Child Health Hospital. Menopausal symptoms were assessed using the modified Kupperman Index (KMI). Muscle mass was evaluated using the InBody 270 analyzer, and sex hormone levels were determined by chemiluminescent immunoassay. Multiple linear regression and Mediation analysis were conducted to examine the association of KMI with MMI and the mediation of estrogen.
A total of 407 valid cases were collected. The mean age of the patients was 49.96 ± 3.25 years, with an average body weight of 58.02 ± 7.36 kg and an average BMI of 22.50 ± 2.61 kg/m². The findings showed that advanced age, lower education level, and reduced muscle mass index (MMI) were linked to elevated KMI scores (p<0.05). Patients with hypertension had higher KMI scores (p<0.05). Additionally, decreased estradiol (E) levels correlated with heightened menopausal symptoms (p<0.05). After controlling for confounding factors such as age, educational level, menopausal stage, history of hypertension, follicle-stimulating hormone (FSH), and E, KMI was negatively correlated with MMI (β=-1.612, 95% CI: -2.677 to -0.546, p=0.003). Specifically, for each unit increase in MMI, KMI decreased by 1.612 points (R²=0.186, p=0.003). Stratified analysis showed that the negative correlation between KMI and MMI was significant only in premenopausal women. Both the direct and indirect effects of MMI and E on KMI were statistically significant (p<0.01). The mediating effect of MMI on KMI through E accounted for 26.9% (p=0.001).
Lower muscle mass is associated with severe menopausal symptoms, partially mediated by estrogen. Maintaining muscle mass may alleviate symptoms, highlighting the importance of resistance training and hormone regulation in perimenopausal women. However, due to the cross-sectional nature of the study, causality cannot be inferred. Longitudinal or interventional studies are warranted to further validate these associations and explore underlying mechanisms.
肌肉量下降是围绝经期女性普遍关注的问题。然而，绝经相关症状与肌肉量之间的关联尚无定论，雌激素的作用机制仍不明确。
本研究纳入了407名年龄在40 - 60岁之间、前往国际和平妇幼保健院就诊的围绝经期及绝经后女性。使用改良的库珀曼指数（KMI）评估绝经症状。使用InBody 270分析仪评估肌肉量，并通过化学发光免疫分析法测定性激素水平。进行多元线性回归和中介分析，以检验KMI与肌肉量指数（MMI）的关联以及雌激素的中介作用。
共收集到407例有效病例。患者的平均年龄为49.96 ± 3.25岁，平均体重为58.02 ± 7.36 kg，平均BMI为22.50 ± 2.61 kg/m²。结果显示，年龄较大、教育水平较低以及肌肉量指数（MMI）降低与KMI评分升高相关（p<0.05）。患有高血压的患者KMI评分更高（p<0.05）。此外，雌二醇（E）水平降低与绝经症状加重相关（p<0.05）。在控制年龄、教育水平、绝经阶段、高血压病史、促卵泡生成素（FSH）和E等混杂因素后，KMI与MMI呈负相关（β=-1.612，95%CI：-2.677至-0.546，p=0.003）。具体而言，MMI每增加一个单位，KMI下降1.612分（R²=0.186，p=0.003）。分层分析显示，KMI与MMI之间的负相关仅在绝经前女性中显著。MMI和E对KMI的直接和间接效应均具有统计学意义（p<0.01）。MMI通过E对KMI的中介效应占26.9%（p=0.001）。
较低的肌肉量与严重的绝经症状相关，部分由雌激素介导。维持肌肉量可能减轻症状，凸显了围绝经期女性进行抗阻训练和激素调节的重要性。然而，由于本研究的横断面性质，无法推断因果关系。有必要进行纵向或干预性研究以进一步验证这些关联并探索潜在机制。
