Body weight and fat mass across the menopausal transition: hormonal modulators.

Autor: Moccia P; Department of Obstetrics and Gynecology, Research Unit on Women's Health - Institute of Health Research INCLIVA, Valencia, Spain., Belda-Montesinos R; Service of Obstetrics and Gynecology, Hospital de Sagunto, Valencia, Spain., Monllor-Tormos A; Department of Obstetrics and Gynecology, Research Unit on Women's Health - Institute of Health Research INCLIVA, Valencia, Spain., Chedraui P; Instituto de Investigación e Innovación en Salud Integral and Laboratorio de Biomedicina, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.; Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción, Asunción, Paraguay., Cano A; Department of Obstetrics and Gynecology, Research Unit on Women's Health - Institute of Health Research INCLIVA, Valencia, Spain.; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain.
Jazyk: angličtina
Zdroj: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology [Gynecol Endocrinol] 2022 Feb; Vol. 38 (2), pp. 99-104. Date of Electronic Publication: 2021 Dec 13.
DOI: 10.1080/09513590.2021.2004395
Abstrakt: Background: The role of the menopause in weight gain is an understudied yet important field, given the rising prevalence of obesity and its associated risk of disease.
Objective: To review the current evidence regarding the impact of the menopausal transition on changes in body composition and fat accrual in women and the hormonal mechanisms underlying the process.
Methods: A critical appraisal of the current literature by experts in the field.
Results: Menopause is associated with an overall increase in fat mass, which tends to accumulate around the waist. There is also a decrease in lean mass, particularly evident in the lower limbs. Reduced energy expenditure (EE) has been confirmed in parallel with increased food intake, the latter being more evident in experimental models. A prominent role has been found for the estrogen receptor (ER) alpha isoform in fat accrual. Human studies suggest a role for androgens in central fat accumulation and type 2 diabetes. FSH is a key factor in the process of fat accumulation, but only in rodents. Clinical studies suggest that these endocrine alterations are insufficient to explain the observed changes.
Conclusions: The menopausal transition is associated with an increase in adiposity, which accumulates preferentially in the abdominal area. Hypoestrogenism and the imbalance of the androgen/estrogen ratio are strong candidates to explain the phenomenon, although other hormonal factors probably also play a role. The impact on risk of disease is still insufficiently known, although an association with risk factors, such as an unfavorable lipid profile or insulin resistance seems likely.
Databáze: MEDLINE
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