9/28/2018 Background CHANGES IN: Reproductive hormones MENOPAUSE - - PDF document

▶
9 28 2018
SMART_READER_LITE
LIVE PREVIEW

9/28/2018 Background CHANGES IN: Reproductive hormones MENOPAUSE - - PDF document

Dec 15, 2022 422 likes •484 views

9/28/2018 Background CHANGES IN: Reproductive hormones MENOPAUSE Energy expenditure TRANSITION Abdominal adiposity Physical activity Caucasian women have greater gains in subcutaneous RACE abdominal adiposity in the years

slide-1
SLIDE 1

9/28/2018 1

“Caucasian women have greater gains in subcutaneous abdominal adiposity in the years leading up to menopause compared to African-American women” Kara L. Marlatt, PhD, MPH

On behalf of Robbie Beyl, Jennifer Lovejoy, Steve Smith, and Leanne Redman NAMS Presentation – October 4, 2018

Background

  • Health statistics for AA are worse compared to Caucasians
  • Understanding the deleterious impact of menopause on

metabolic health among women of different races is of great public health significance.

MENOPAUSE TRANSITION

CHANGES IN:

  • Reproductive hormones
  • Energy expenditure
  • Abdominal adiposity
  • Physical activity

RACE

Question

Racial differences in the changes in:

  • Abdominal adiposity (SAT, dSAT, sSAT, VAT, TAT)
  • Reproductive hormones (estradiol, FSH, SHBG)
  • Physical activity (TriTrac accelerometer)

Are there race-specific differences in abdominal adiposity, reproductive hormones, and physical activity during the menopause transition?

‘Healthy Transitions’ Study

Menopause Effect on Obesity, Energy Balance, and Insulin

[R01: Jennifer Lovejoy, PhD (1997-2006) at Pennington] Objective: To examine the impact of menopause on changes in body composition, fat distribution, and cardiometabolic risk factors in AA and Caucasian women. MAIN STUDY

(4 YEARS)

EXTENSION STUDY

(+ 3 YEARS) Inclusion Criteria:

  • 43 years or older
  • Premenopausal (≥5 cycles in last

6 months plus FSH<30 mIU/mL)

  • Not taking HRT

Enrolled: 156 women (103 C, 53 AA) Transitioned: 51 women

  • No race differences in changes in

body composition or hormone levels.

slide-2
SLIDE 2

9/28/2018 2

Complete Longitudinal Analysis through 7 years

  • N=94 health women (25 AA, 69 Caucasian)

transitioned through menopause (indicated as Year 0)

  • Menopause defined as absence of menstruation for 1-

y and FSH>30 mIU/mL

  • Annual assessments:

1. Body composition (percent fat, fat mass) by DXA 2. Abdominal fat distribution by CT

  • Abdominal subcutaneous adipose tissue (SAT)
  • Deep SAT (dSAT), superficial SAT (sSAT)
  • Visceral adipose tissue (VAT)

3. Fasting blood collection

  • Reproductive hormone levels

4. Physical Activity (by accelerometry; TriTrac-R3D)

Characteristics of Women at Menopause Onset (Year 0)

Caucasians, but not AAs, had increased body fat leading up to menopause WEIGHT % BODY FAT Caucasians, but not AAs, had increased SAT leading up to menopause

Outlier?

ABDOMINAL SUBCUTANEOUS ADIPOSE TISSUE (SAT) VISCERAL ADIPOSE TISSUE (VAT)

slide-3
SLIDE 3

9/28/2018 3

Same for Deep SAT Are these changes mediated by hormones or physical activity?

Estradiol FSH

  • Key hormones were not associated with the observed race differences

in abdominal adiposity.

  • Physical activity difficult to interpret, but activity levels were negatively

associated with abdominal adiposity overall (but not between races).

  • Menopause symptoms were positively associated with abdominal

adiposity overall (but not between races).

MENOPAUSE TRANSITION

%fat SAT (dSAT, sSAT) VAT TAT

? Physical Activity ?

X ?

Changes in FSH and E2 did not explain race differences in adiposity

FOLLICLE-STIMULATING HORMONE (FSH) ESTRADIOL However, these changes in hormones were not associated with the observed racial differences in abdominal adiposity.

Conclusions

  • Caucasian women had significant increases

in abdominal adiposity compared to AA in the 2-6 years before menopause.

  • Reproductive hormones were not associated

with these race differences.

  • Greater physical activity was associated with

less abdominal adiposity gains.

  • Greater abdominal adiposity was associated

with more menopause symptoms.

slide-4
SLIDE 4

9/28/2018 4

Conclusions

  • No race differences in body composition were
  • bserved at menopause onset which suggests that

AA women had a worse premenopause body adiposity profile yet maintained adiposity levels throughout the menopause transition while Caucasian women caught up in body adiposity.

  • The menopause transition may impact Caucasian

women more than AA women in terms of adipose tissue deposition.

Limitations

  • Sample size was not equal between race
  • Longitudinal studies  missing data
  • Physical activity levels only gathered during

Main Study (first 4 years)

Thank you!

Mentors Other Important People Eric Ravussin / Leanne Redman Jackie Stephens Carrie Elks Ursula White Healthy Transitions Team Jennifer Lovejoy (Arivale, Inc.) Collaborators Steve Smith (TRI) Wendy Kohrt (UC-Denver) Nanette Santoro (UC-Denver) REWH Lab (Redman) Katherine Guthrie (Fred Hutch) Anne Gilmore Nick Broskey Grant Funding Jasper Most

T32-DK064584 [Obesity: From Genes to Man]

Dorien Reijnders-Most

U54-GM104940 [LA CaTS Pilot Grant (Round 7)]

Abby Altazan

P30-DK056336 [Trans-NORC Complementary Pilot]

Caitlin Hebert

QUESTIONS?