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Perimenopause, body fat, metabolism and menopausal symptoms in relation to serum markers of adiposity, inflammation and digestive metabolism

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Abstract

Background

Perimenopausal women gain weight that may alter inflammatory status, endocrine equilibrium, and the intensity of vasomotor symptoms.

Objective

To measure serum levels of markers related to adiposity, inflammation/angiogenesis and digestive metabolism and correlate them with body mass index (BMI), waist-to-hip ratio (WHR), metabolic parameters and menopausal symptoms (assessed with the 10-item Cervantes Scale [CS-10]).

Methods

Serum of perimenopausal women (n = 24), STRAW stages-2 and -1, was analyzed using the Bio-Plex 200 System technology to assess 30 proposed analytes. The MetS was defined by the American Heart Association criteria and women were divided as: normal BMI (NBMI), excessive BMI (EBMI), and EBMI with MetS (EBMI–MetS).

Results

Weight, BMI, abdominal circumference, WHR, systolic blood pressure, glucose and triglyceride levels were significantly higher and high-density lipoprotein cholesterol (HDL-C) was lower in EBMI-MetS women compared to NBMI ones. Insulin, C-peptide, resistin, adipsin, GIP, leptin, IL-6, FGF21 and PAI-1 levels were significantly higher and ghrelin and IGFBP-1 lower in EBMI–MetS women as compared to NBMI ones. Spearman’s correlation of pooled data showed a significant positive correlation between abdominal perimeter and WHR and C-peptide, insulin, adipsin, resistin, leptin, PAI-1 and FGF21 and a negative correlation with IGFBP-1 levels. Total CS-10 scores and hot flush intensity did not differ between studied groups, yet positively correlated with anthropometric values but not with studied analytes.

Conclusion

Perimenopausal women with EBMI and the MetS showed an altered metabolic profile, but no differences in menopausal symptoms which also did not correlate with changes in studied biomarkers.

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Abbreviations

CS-10:

10-item Cervantes Scale

BMI:

Body mass index

CVD:

Cardiovascular disease

EBMI:

Excessive body mass index

FGF21:

Fibroblast growth factor 21

FGF23:

Fibroblast growth factor 23

GLP-1:

Glucagon-like peptide-1

GIP:

Glucose-dependent insulinotropic peptide

HDL-C:

High-density lipoprotein cholesterol

HOMA:

Homeostatic model assessment

IGFBP-1:

Insulin growth factor-binding protein 1

IL-6:

Interleukin 6

IL-8:

Interleukin 8

LDL-C:

Low-density lipoprotein cholesterol

MetS:

Metabolic syndrome

NBMI:

Normal body mass index

OSAS:

Obstructive sleep apneas

PGE:

Pancreato-gastro-enteric

PON1:

Paraoxonase/arylesterase

PAI-1:

Plasminogen activator inhibitor-1

sFASL:

Soluble Fas ligand

sCD40L:

Soluble form of cluster of differentiation 40 ligand

sLeptinR:

Soluble leptin receptor

STRAW:

Stages of Reproductive Aging Workshop

TNF-α:

Tumor necrosis factor alpha

uPA:

Urokinase-type plasminogen activator

VEGF-A:

Vascular endothelial growth factor A

WHR:

Waist-to-hip ratio

WHO:

World Health Organization

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Acknowledgements

We thank women who participated in the “The Omega II, Women’s Health Project: Evaluación de severidad de síntomas menopaúsicos, estado metabólico y depresión en mujeres de mediana edad”.

Funding

This research was partially supported by the Sistema de Investigación y Desarrollo and the Vice-Rectorado de Investigación & Postgrado of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, through Grant no. SIU-318-853-2014 (The Omega II, Women’s Health Project 2014) provided to Peter Chedraui and Grant no. SIU-411-11-2017 provided to Isabel Grijalva-Grijalva; and also by VitaNova project, Grant CUP D18C15000130008, University of Pisa, Pisa Italy provided to Tommaso Simoncini.

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Author notes

  1. G. Palla and C. Ramírez-Morán contributed equally to the research.

Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    G. Palla, M. M. Montt-Guevara, J. Shortrede & T. Simoncini

  2. Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador

    C. Ramírez-Morán, D. Salazar-Pousada, I. Grijalva-Grijalva & P. Chedraui

  3. Red de Investigación de Obstetricia, Ginecología y Reproducción, Instituto de Investigaciones Sanitarias de Aragón, University of Zaragoza, Faculty of Medicine, Zaragoza, Spain

    F. R. Pérez-López

  4. Facultad de Ciencias de la Salud, Universidad Católica “Nuestra Señora de la Asunción”, Asunción, Paraguay

    P. Chedraui

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Contributions

PC, TS and FRPL conceived and designed the research; CRM, IGG and DSP recruited participants; GP, CRM, MMG and JS performed biochemical assays; GP and MMG analyzed the data and wrote the original draft; PC, TS and FRPL performed data interpretation and contributed to the final editing of the manuscript. All authors reviewed and approved the final version.

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Correspondence to T. Simoncini or P. Chedraui.

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All the authors declare that there are no conflicts of interest regarding the publication of this paper.

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The research protocol was reviewed and approved by the Ethics and Bioethics Committee of the Enrique C. Sotomayor Hospital. All procedures performed in the present study involving humans were in accordance with the ethical standards of the institution or practice at which the studies were conducted. This article does not contain any studies with animals performed by any of the authors.

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Palla, G., Ramírez-Morán, C., Montt-Guevara, M.M. et al. Perimenopause, body fat, metabolism and menopausal symptoms in relation to serum markers of adiposity, inflammation and digestive metabolism. J Endocrinol Invest 43, 809–820 (2020). https://doi.org/10.1007/s40618-019-01168-6

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