Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study : Menopause

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Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study

Samargandy, Saad PhD, MPH, MBBS; Matthews, Karen A. PhD; Brooks, Maria M. PhD; Barinas-Mitchell, Emma PhD; Magnani, Jared W. MD, MSc; Janssen, Imke PhD; Kazlauskaite, Rasa MD, MSc; El Khoudary, Samar R. PhD, MPH, FAHA

Author Information

1Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA

2Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA

3Department of Medicine, University of Pittsburgh, Pittsburgh, PA

4Department of Preventive Medicine, Rush University, Chicago, IL

5Department of Medicine, Rush University, Chicago, IL.

Address correspondence to: Samar R. El Khoudary, PhD, MPH, FAHA, Associate Professor of Epidemiology, Clinical and Translational Science Institute, Epidemiology Data Center, 4420 Bayard Street, Suite 600, Pittsburgh, PA 15260. E-mail: [email protected]

Received 26 October, 2020

Revised 23 December, 2020

Accepted 23 December, 2020

Funding/support: The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), Department of Health and Human Services, through the National Institute on Aging, the National Institute of Nursing Research, and the NIH Office of Research on Women's Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, National Institute of Nursing Research, NIH Office of Research on Women's Health, or the NIH.

SWAN Heart was supported by grants from the NHLBI (HL065581, HL065591).

Financial disclosure/conflicts of interest: None reported.

An abstract related to this study was presented in the American Heart Association EPI|Lifestyle Scientific Sessions, 2019. The related abstract was published in Circulation: Samargandy S, Matthews Karen A, Brooks Maria M, et al. Abstract 028: Increase in Abdominal Visceral Adipose Tissue Accelerates Two Years Prior to Menopause: The Study of Women's Health Across the Nation (SWAN) Heart. Circulation. 2019;139(Suppl_1):A028-A028.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's Website (www.menopause.org).

Menopause 28(6):p 626-633, June 2021. | DOI: 10.1097/GME.0000000000001755

Abstract

Objectives: 

To characterize abdominal visceral adipose tissue (VAT) trajectory relative to the final menstrual period (FMP), and to test whether menopause-related VAT accumulation is associated with greater average, common carotid artery intima-media thickness (cIMT) and/or internal carotid artery intima-media thickness (ICA-IMT).

Methods: 

Participants were 362 women (at baseline: age was (mean ± SD) 51.1 ± 2.8 y; 61% White, 39% Black) with no cardiovascular disease from the Study of Women's Health Across the Nation Heart study. Women had up to two measurements of VAT and cIMT over time. Splines revealed a nonlinear trajectory of VAT with two inflection points demarcating three time segments: segment 1: >2 years before FMP; segment 2: 2 years before FMP to FMP; and segment 3: after FMP. Piecewise-linear random-effects models estimated changes in VAT. Random-effects models tested associations of menopause-related VAT with each cIMT measure separately. Estimates were adjusted for age at FMP, body mass index, and sociodemographic, lifestyle, and cardiovascular disease risk factors.

Results: 

VAT increased significantly by 8.2% (95% CI: 4.1%-12.5%) and 5.8% (3.7%-7.9%) per year in segments 2 and 3, respectively, with no significant change in VAT within segment 1. VAT predicted greater ICA-IMT in segment 2, such that a 20% greater VAT was associated with a 2.0% (0.8%-3.1%) greater ICA-IMT. VAT was not an independent predictor of ICA-IMT in the other segments or of the other cIMT measures after adjusting for covariates.

Conclusions: 

Women experience an accelerated increase in VAT starting 2 years before menopause. This menopause-related increase in VAT is associated with greater risk of subclinical atherosclerosis in the internal carotid artery.

 

Video Summary:https://links.lww.com/MENO/A722.

© 2021 by The North American Menopause Society

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