Effect of menopausal status on body composition and abdominal fat distribution

OBJECTIVE: Preliminary studies suggest that the menopause transition is associated with deleterious changes in body composition and abdominal fat distribution. Limitations of the methodology used in these studies, however, render their conclusions controversial. Thus, the present study used radiologic imaging techniques to examine the effect of menopausal status on body composition and abdominal fat distribution. DESIGN: Cross-sectional. SUBJECTS: Fifty-three healthy, middle-aged, premenopausal women (mean +/- SD; 47 +/- 3 y) and 28 early-postmenopausal women (51 +/- 4 y). MEASUREMENTS: Total and regional body composition by dual energy X-ray absorptiometry and abdominal fat distribution by computed tomography. RESULTS: No differences in total body fat-free mass or appendicular skeletal muscle mass were noted between groups. In contrast, total body fat mass was 28% higher (23 +/- 7 vs 18 +/- 7 kg) and percentage fat 17% higher (35 +/- 6 vs 30 +/- 9%; both P < 0.01) in postmenopausal women compared with premenopausal women. Postmenopausal women had a 49% greater intra-abdominal (88 +/- 32 vs 59 +/- 32 cm2; P < 0.01) and a 22% greater abdominal subcutaneous fat area (277 +/- 93 vs 227 +/- 108 cm2; P < 0.05) compared to premenopausal women. The menopause-related difference in intra-abdominal fat persisted (P < 0.05) after statistical adjustment for age and total body fat mass, whereas no difference in abdominal subcutaneous fat was noted. A similar pattern of differences in total and abdominal adiposity was noted in sub-samples of pre- and postmenopausal women matched for age or fat mass. CONCLUSION: Our data suggest that early-postmenopausal status is associated with a preferential increase in intra-abdominal fat that is independent of age and total body fat mass.