The Concept of CMR

The influence of menopause on adipose tissue distribution

Page: 2 of 7

The physiological changes associated with menopause have a significant impact on total body fat and adipose tissue distribution. Because intra-abdominal adipose tissue deposition in women is also influenced by age, it is important to consider this variable when discussing the influence of menopause on adipose tissue distribution.  

Several cross-sectional studies have reported a significant difference in body mass index (BMI)—a crude marker of obesity—between pre-menopausal and post-menopausal women that was no longer significant after adjusting for age (1, 2). However, other studies have found that menopause has a significant effect on BMI independent of age (3-5). Some studies that have used dual energy X-ray absorptiometry (DEXA) to measure total body fat more precisely have found that menopause has no significant effect on total body fat (4, 6), whereas other groups have reported that post-menopausal women were heavier than pre-menopausal women after adjusting for age (7, 8).

The central accumulation of body fat with menopause, as assessed by anthropometric measurements or imaging techniques, is a well described phenomenon. Several cross-sectional studies that have used waist-to-hip ratio or waist circumference as estimates of relative or absolute accumulation of abdominal fat respectively have failed to link abdominal adipose tissue accumulation and menopause (2-4, 9-11). Even after controlling for age or BMI, no association between menopause and abdominal obesity has been found (3, 11, 12). However, by using DEXA to measure abdominal adipose tissue (trunkal fat), several investigators have noted that menopause has an independent effect on adipose tissue distribution even after controlling for age (8, 13) and BMI (1, 6) .

Reference

close

1. Ley CJ, Lees B and Stevenson JC. Sex- and menopause-associated changes in body-fat distribution. American Journal of Clinical Nutrition 1992; 55: 950-4.

2. Razay G, Heaton KW and Bolton CH. Coronary heart disease risk factors in relation to the menopause. Q J Med 1992; 85: 889-96.

3. Pasquali R, Casimirri F, Labate AMM, et al. Body weight, fat distribution and the menopausal status in women. Int J Obes 1994; 18: 614-21.

4. Pasquali R, Vicennati V, Bertazzo D, et al. Determinants of sex hormone-binding globulin blood concentrations in premenopausal and postmenopausal women with different estrogen status. Virgilio-Menopause-Health Group. Metabolism 1997; 46: 5-9.

5. den Tonkelaar I, Seidell JC, van Noord PAH, et al. Fat distribution in relation to age, degree of obesity, smoking habits, parity and estrogen use: a cross-sectional study in 11825 Dutch women participating in the DOM-project. Int J Obes 1990; 14: 753-61.

6. Panotopoulos G, Ruiz JC, Raison J, et al. Menopause, fat and lean distribution in obese women. Maturitas 1996; 25: 11-9.

7. Rico H, Revilla M, Villa LF, et al. The four-compartment models in body composition: data from a study with dual-energy X-ray absorptiometry and near-infrared interactance on 815 normal subjects. Metabolism 1994; 43: 417-22.

8. Svendsen OL, Hassager C and Christiansen C. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metabolism 1995; 44: 369-73.

9. Lanska DJ, Lanska MJ, Hartz AJ, et al. Factors influencing anatomic location of fat tissue in 52,953 women. Int J Obes 1985; 9: 29-38.

10. Tonkelaar ID, Seidell JC, van Noord PA, et al. Factors influencing waist/hip ratio in randomly selected pre- and post-menopausal women in the dom-project (preliminary results). Int J Obes 1989; 13: 817-24.

11. Troisi RJ, Wolf AM, Manson JE, et al. Relation of body fat distribution to reproductive factors in pre- and postmenopausal women. Obes Res 1995; 3: 143-51.

12. Zamboni M, Armellini F, Milani MP, et al. Body fat distribution in pre- and post-menopausal women: metabolic and anthropometric variables and their inter-relationships. Int J Obes Relat Metab Disord 1992; 16: 495-504.

13. Tremollieres FA, Pouilles JM and Ribot CA. Relative influence of age and menopause on total and regional body composition changes in postmenopausal women. Am J Obstet Gynecol 1996; 175: 1594-600.

Page: 2 of 7