American Journal of Epidemiology Advance Access originally published online on August 12, 2009
American Journal of Epidemiology 2009 170(6):766-774; doi:10.1093/aje/kwp203
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ORIGINAL CONTRIBUTIONS |
Gains in Body Fat and Vasomotor Symptom Reporting Over the Menopausal Transition
The Study of Women's Health Across the Nation
Correspondence to Dr. Rebecca C. Thurston, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213 (e-mail: thurstonrc{at}upmc.edu).
Received for publication March 27, 2009. Accepted for publication June 11, 2009.
Although most women report vasomotor symptoms (hot flashes, night sweats) during midlife, their etiology and risk factors are incompletely understood. Body fat is positively associated with vasomotor symptoms cross-sectionally, but the longitudinal relation between changes in body fat and vasomotor symptoms is uncharacterized. The study aim was to examine whether gains in body fat were related to vasomotor symptom reporting over time. Measures of bioelectrical impedance for body fat, reproductive hormones, and reported vasomotor symptoms were assessed annually over 4 years from 2002 to 2006 among 1,659 women aged 47–59 years participating in the Study of Women's Health Across the Nation. Body fat change was examined in relation to vasomotor symptoms by using generalized estimating equations. Body fat gains were associated with greater odds of reporting hot flashes in models adjusted for age, site, race/ethnicity, education, smoking, parity, anxiety, and menopausal status (relative to stable body fat, gain: odds ratio = 1.23, 95% confidence interval: 1.02, 1.48; P = 0.03; loss: odds ratio = 1.07, 95% confidence interval: 0.89, 1.29; P = 0.45). Findings persisted controlling for estradiol, the free estradiol index, or follicle-stimulating hormone concentrations. The relations between body fat changes and night sweats were not statistically significant. Body fat gains are associated with greater hot flash reporting during the menopausal transition.
adipose tissue; adiposity; body composition; body fat distribution; climacteric; hot flashes; menopause
Abbreviations: CI, confidence interval; NIA, National Institute on Aging; NIH, National Institutes of Health; OR, odds ratio; SHBG, sex hormone-binding globulin; SWAN, Study of Women's Health Across the Nation