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

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


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]).


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).


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.


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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Fig. 1
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10-item Cervantes Scale


Body mass index


Cardiovascular disease


Excessive body mass index


Fibroblast growth factor 21


Fibroblast growth factor 23


Glucagon-like peptide-1


Glucose-dependent insulinotropic peptide


High-density lipoprotein cholesterol


Homeostatic model assessment


Insulin growth factor-binding protein 1


Interleukin 6


Interleukin 8


Low-density lipoprotein cholesterol


Metabolic syndrome


Normal body mass index


Obstructive sleep apneas






Plasminogen activator inhibitor-1


Soluble Fas ligand


Soluble form of cluster of differentiation 40 ligand


Soluble leptin receptor


Stages of Reproductive Aging Workshop


Tumor necrosis factor alpha


Urokinase-type plasminogen activator


Vascular endothelial growth factor A


Waist-to-hip ratio


World Health Organization


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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”.


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.

Author information

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.

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.

Ethical approval

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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All study participants were informed about the research, its purposes and requested to provide written consent of participation.

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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 (2020).

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  • Metabolic syndrome
  • Perimenopause
  • Excessive body weight
  • Insulin
  • Adipokines
  • Adiposity
  • Digestive metabolism
  • Inflammation
  • Menopausal symptoms
  • Cervantes Scale