The association between reproductive history and abdominal adipose tissue among postmenopausal women: results from the Women's Health Initiative.

Autor:	Banack HR; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Cook CE; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Grandi SM; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada., Scime NV; Department of Health & Society, University of Toronto Scarborough, Scarborough, Canada., Andary R; School of Medicine, University of California, Irvine, CA, USA., Follis S; Stanford Prevention Research Center, School of Medicine , Stanford University, Stanford, CA, USA., Allison M; Division of Preventive Medicine, Department of Family Medicine, UC San Diego, San Diego, CA, USA., Manson JE; Division of Preventive Medicine, Harvard Medical School, Boston, MA, USA.; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Jung SY; Department of Epidemiology, Fielding School of Public Health, School of Nursing, UCLA, Los Angeles, CA, USA., Wild RA; Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK, USA., Farland LV; Epidemiology and Biostatistics Department, University of Arizona, Tucson, AZ, USA., Shadyab AH; Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, Herbert Wertheim School of Public Health & Human Longevity Science, UC San Diego, San Diego, CA, USA., Bea JW; Department of Health Promotion Science, University of Arizona, Tucson, AZ, USA., Odegaard AO; Division of Preventive Medicine, Department of Family Medicine, UC San Diego, San Diego, CA, USA.
Jazyk:	angličtina
Zdroj:	Human reproduction (Oxford, England) [Hum Reprod] 2024 Aug 01; Vol. 39 (8), pp. 1804-1815.
DOI:	10.1093/humrep/deae118
Abstrakt:	Study Question: What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women? Summary Answer: Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity. What Is Known Already: Postmenopausal women are predisposed to accumulation of VAT and SAT. Reproductive health variables are known predictors of overall obesity status in women, defined by BMI. Study Design, Size, Duration: This study is a secondary analysis of data collected from the baseline visit of the Women's Health Initiative (WHI). The WHI is a large prospective study of postmenopausal women, including both a randomized trial and observational study. There were 10 184 women included in this analysis. Participants/materials, Setting, Methods: Data were collected from a reproductive health history questionnaire, dual-energy x-ray absorptiometry scans, and anthropometric measures at WHI baseline. Reproductive history was measured via self-report, and included age at menarche, variables related to pregnancy, and age at menopause. Reproductive lifespan was calculated as age at menopause minus age at menarche. Statistical analyses included descriptive analyses and multivariable linear regression models to examine the association between reproductive history with VAT, SAT, total body fat, and BMI. Main Results and the Role of Chance: Women who reported early menarche (<10 years) or early menopause (<40 years) had the highest levels of VAT. Adjusted multivariable linear regression results demonstrate women who experienced menarche >15 years had 23 cm2 less VAT (95% CI: -31.4, -14.4) and 47 cm2 less SAT (95% CI: -61.8, -33.4) than women who experienced menarche at age 10 years or earlier. A similar pattern was observed for age at menopause: compared to women who experienced menopause <40 years, menopause at 50-55 years was associated with 19.3 cm2 (95% CI: -25.4, -13.3) less VAT and 27.4 cm2 (-29.6, 10.3) less SAT. High parity (>3 pregnancies) was also associated with VAT and SAT. For example, adjusted beta coefficients for VAT were 8.36 (4.33, 12.4) and 17.9 (12.6, 23.2) comparing three to four pregnancies with the referent, one to two pregnancies. Limitations, Reasons for Caution: The WHI reproductive health history questionnaire may be subject to poor recall owing to a long look-back window. Residual confounding may be present given lack of data on early life characteristics, such as maternal and pre-menarche characteristics. Wider Implications of the Findings: This study contributes to our understanding of reproductive lifespan, including menarche and menopause, as an important predictor of late-life adiposity in women. Reproductive health has also been recognized as a sentinel marker for chronic disease in late life. Given established links between adiposity and cardiometabolic outcomes, this research has implications for future research, clinical practice, and public health policy that makes use of reproductive health history as an opportunity for chronic disease prevention. Study Funding/competing Interest(s): HRB and AOO are supported by the National Institute of Health National Institute of Aging (R01AG055018-04). JWB reports royalties from 'ACSM'S Body Composition Assessment Book' and consulting fees from the WHI. The remaining authors have no competing interests to declare. Trial Registration Number: N/A. (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)
Databáze:	MEDLINE
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