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Longitudinal analysis of changes in weight and waist circumference in relation to incident vasomotor symptoms: the Study of Women's Health Across the Nation (SWAN)

Gold, Ellen B. PhD; Crawford, Sybil L. PhD; Shelton, Janie F. PhD, MPH; Tepper, Ping G. PhD; Crandall, Carolyn J. MD, MS; Greendale, Gail A. MD; Matthews, Karen A. PhD; Thurston, Rebecca C. PhD; Avis, Nancy E. PhD

doi: 10.1097/GME.0000000000000723
Original Articles
Editorial

Objective: Greater body mass index (BMI) and body fat are associated with vasomotor symptoms (VMS). Thus, weight loss may prevent VMS. We analyzed whether concurrent BMI or waist circumference and/or changes in weight or waist circumference predicted incident VMS and whether these relations differed by menopause stage or race/ethnicity.

Methods: Data from 10 follow-up visits for 1,546 participants in the Study of Women's Health Across the Nation who reported no VMS at baseline were modeled for time to first symptomatic visit in relation to concurrent BMI and waist circumference and change in weight and waist circumference during early and late menopause using discrete survival analyses, adjusting for covariates.

Results: Greater concurrent BMI and waist circumference were significantly related to greater any and frequent (≥6 d in the last 2 wk) incident VMS in early menopause and lower VMS risk in late menopause. Percentage weight change since baseline and since the prior visit was unrelated to incident any VMS in either menopause stage. Percentage weight change since baseline had a significant shallow U-shaped association with incident frequent VMS in early menopause (P = 0.02), a shallow inverse U-shape in late menopause (P = 0.02), and a significant interaction with menopause stage (P = 0.004) but not with race/ethnicity. Recent weight change was unassociated with incident VMS in either menopause stage. Results were similar for waist change.

Conclusions: Concurrent BMI and waist circumference were positively related to incident VMS in early menopause and negatively related in late menopause. Maintaining healthy weight in early menopause may help prevent VMS.

1Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, CA

2Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA

3Departments of Psychiatry and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA

4Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA

5Department of Social Sciences and Health Policy, Wake Forest University, School of Medicine, Winston-Salem, NC.

Address correspondence to: Ellen B. Gold, PhD, Department of Public Health Sciences, University of California, Davis, School of Medicine, One Shields Avenue, MS 1C, Davis, CA 95616. E-mail: ebgold@ucdavis.edu

Received 16 February, 2016

Revised 8 June, 2016

Accepted 8 June, 2016

The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.

Funding/support: The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the NIH Office of Research on Women's Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495).

Financial disclosure/conflicts of interest: Dr Tepper previously received a research grant from Pfizer for a study of the use of novel anticoagulants among atrial fibrillation patients, which has ended. No other authors have any competing financial conflicts of interest.

© 2017 by The North American Menopause Society.