Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry

Body composition and fat distribution measured by dual-energy x-ray absorptiometry in premenopausal and postmenopausal insulin-dependent and non-insulin-dependent diabetes mellitus patients

The study aim was to measure body composition and fat distribution in premenopausal and postmenopausal women with insulin-dependent ([IDDM] n = 53) and non-insulin-dependent ([NIDDM] n = 32) diabetes mellitus by dual-energy x-ray absorptiometry. IDDM and NIDDM patients had similar, normal lean tissue mass (LTM) and 24-hour urinary excretion of creatinine. Total body and abdominal fat percentages were higher in the NIDDM group (approximately 40%) than in the IDDM group (-27%, P < .001) and were constant with age and menopausal status in both groups. In postmenopausal patients with IDDM, total body and abdominal fat values were less than in postmenopausal healthy women (approximately 27% v approximately 37%, P < .001). In premenopausal patients with NIDDM, total body and abdominal fat were higher than in premenopausal healthy women (approximately 42% v approximately 25%, P < .001). In conclusion, women with IDDM or NIDDM have a normal LTM and probably a normal muscle mass. Total body and abdominal fat were higher for women with NIDDM than for those with IDDM.

Impact of the age at menarche on adult body composition in healthy pre- and postmenopausal women

The present study focuses on the impact of age at menarche on body composition development during adulthood. With 459 healthy middle-class women between 18 and 67 years (x = 41.5) the association between age at menarche and body composition was tested. Body composition, described by absolute and relative amount of fat mass, lean body mass, and bone mass, was estimated by means of dual energy x-ray absorptiometry. In order to exclude the influence of the menopausal transition on body composition, pre- and postmenopausal females were examined separately. The absolute amount of body fat was significantly lower within the group of women whose menarche occurred later. However, postmenopausal females exhibit less significant relations between the two trait systems than premenopausal women. This may be due to the impact of menopausal transition which affected the hormone levels and body composition development independently from the adolescent hormonal transition. While in both proband groups the quantitative amount of body fat was significantly related to menarcheal age, a significant relation between menarcheal age and adult body fat distribution could not be verified.

Is there a menopausal metabolic syndrome?

Estradiol-17 beta has beneficial effects on a range of metabolic risk factors for coronary heart disease and the decline in estrogen concentrations at the menopause would be expected to have adverse effects. Review of the literature on effects of the menopause and of estradiol-17 beta provides evidence for the following changes occurring at or after the menopause: increased total cholesterol and triglycerides; decreased high density lipoprotein (HDL) and HDL subfraction 2; increased low density lipoprotein, particularly in the small, dense subfraction; increased lipoprotein (a); increased insulin resistance; decreased insulin secretion; decreased insulin elimination; increased android fat distribution; impaired vascular function; increased factor VII and fibrinogen, and reduced sex-hormone binding globulin. Many of these changes will themselves have adverse effects on other metabolic risk factors. This complex of inter-correlated adverse changes in metabolic risk factors justifies identification of a distinct menopausal metabolic syndrome which originates in estrogen deficiency and which could contribute to the increased risk of coronary heart disease seen in postmenopausal women. Estrogen replacement can diminish the expression of this syndrome.

Weight gain associated with adjuvant tamoxifen therapy in stage I and II breast cancer: fact or artifact?

There is a perception that tamoxifen causes weight gain in breast cancer patients. The purpose of this research study was to determine if weight gain is associated with tamoxifen therapy and to observe the impact of weight gain on recurrence and survival. Prognostic indicators, changes in weight, and disease status from diagnosis to the end of treatment were studied in 200 consecutive Stage I and II breast cancer patients, not receiving systemic chemotherapy, admitted from 1986 to the present, with observation periods ranging from 3-5 years. A mean weight gain of 1.2 Kgs was seen in all patients; however, weight gain was not significantly different for those receiving tamoxifen vs. those not receiving tamoxifen, (P = 0.66, CI 95% for the difference -1.8 Kgs to +1.2 Kgs). Weight gain during treatment with tamoxifen was not correlated with treatment duration or with recurrence or survival. Age at diagnosis was positively correlated to weight gain in all groups. Our data failed to show that tamoxifen is associated with weight gain. The moderate weight gain observed in this patient population is comparable to the general aging disease-free population and may no be treatment-related. These findings may help to alleviate some concerns of both physicians and patients when tamoxifen is the drug of choice for adjuvant therapy.

Menopause-associated differences in female fat patterning estimated by dual-energy X-ray absorptiometry

The aim of the present study was to describe and quantify the typical changes in fat patterning from premenopause to postmenopause. The absolute and relative fat and lean body mass were estimated using dual-energy X-ray absorptiometry in 461 healthy non-obese females between the ages of 18 and 64 years (x = 43.2). Significant differences (p < 0.001) in absolute and relative fat mass, body weight and body mass index between pre-, peri- and postmenopausal females were observed. Postmenopausal women were significantly heavier (BMI, x = 26.8) than perimenopausal (BMI, x = 24.4) and younger and older premenopausal women (BMI, x = 22.8) and showed significantly higher fat percentages (fat% x = 38.1) in comparison to perimenopausal (x = 36.8) and premenopausal females (x = 31.4). Three indices, upper body composition index, lower body composition index and fat distribution index were calculated. Typical differences in fat distribution patterns between females of differential menopausal status were found. During the premenopausal phase a more gynoid type of fat distribution prevailed, during the postmenopausal phase a more android kind of fat distribution occurred predominantly. The fat distribution during the perimenopause can be interpreted as less gynoid than during the premenopause.

Menopause, fat and lean distribution in obese women

OBJECTIVES

Whether menopause per se influences fat distribution independently of the effect of aging remains controversial. The lack of consistency in the menopause related changes in body fat distribution may be the result of differences in the methods for measuring fat distribution or in the characteristics of the women studied. The aim of this cross sectional study in obese women was to compare total body composition and regional fat and lean distribution, in premenopausal, perimenopausal and postmenopausal women.

METHODS

Body composition was assessed by dual energy X-ray absorptiometry (DEXA) in premenopausal (n = 26), perimenopausal (n = 24) and postmenopausal (n = 73) obese women with no intercurrent diseases.

RESULTS

It was shown that postmenopausal obese (n = 73) women had a higher proportion of total fat mass in the trunk and a lower proportion of total fat and lean mass in the femoral and leg regions than premenopausal women after adjustment for age and total fat mass. In the same analysis, perimenopausal women had a lower proportion of total fat in the leg and femoral regions and of total lean in the femoral region than premenopausal women; they had a regional body composition similar to that of postmenopausal women.

CONCLUSION

The present data indicate that in obese women, post menopause and perimenopause are associated with differences in fat and lean distribution, independently of age and total fat.