Postmenopausal Sex Hormones in Relation to Body Fat Distribution

Milan

Int J Diabetes Dev Ctries

et al. 2013

The aim of this study was to investigate the anthropometric, metabolic, cardiovascular and symptomatic profile in gynoid and android postmenopausal women. Forty five postmenopausal women aged 50 to 60 years were divided into two groups according to fat distribution [waist-to-hip ratio (WHR)]: gynoid group (WHR between 0.68 and 0.8; N=13) and android group (WHR>0.8; N= 32). Body composition, skinfold thickness, serum/plasma estradiol, creatinine, urea, lipid profile, glucose and insulin, maximal exercise testing and menopause rating scale (MRS) were evaluated. The android group when compared to the gynoid group showed (P<0.05): (i) higher values of body mass, BMI, waist circumference, body fat, lean mass and skinfold thickness; (ii) higher values of estradiol, triglycerides, very low-density lipoprotein (VLDL) and insulin levels with lower insulin sensitivity (%S) and greater insulin resistance (%IR) index; (iii) higher blood pressure (BP) during rest and lower maximal heart rate (HRmax) during maximal exercise testing and; (iv) higher scores of the somatic and urogenital-sexual symptoms. This study suggests that android postmenopausal women develop features that can lead to metabolic syndrome (MetS) and future cardiovascular disease (CVD), and these women may present higher scores of somatic and urogenital-sexual symptoms.

“…This fat distribution is similar to that reported previously [28][29][30][31], reflecting the contribution of sex hormone profiles to the accumulation of abdominal fat.…”

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 92%

Impact of fat distribution on metabolic, cardiovascular and symptomatic aspects in postmenopausal women

Milan

Int J Diabetes Dev Ctries

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

“…In postmenopausal women, the primary production of estrogen occurs in the adipose tissue via aromatization of androstenedione to estrone, such that levels of bioavailable estrogen are greater in obese than lean women (41). The ratio of estradiol to testosterone may also be relevant (42).…”

Section: Biologic Mechanismsmentioning

confidence: 99%

Comparison of Associations of Body Mass Index, Abdominal Adiposity, and Risk of Colorectal Cancer in a Large Prospective Cohort Study

Keimling

Renehan

Behrens

et al. 2013

Background: Increased body mass index (BMI) is an established colorectal cancer risk factor. High waist circumference or waist-hip-ratio (WHR) may better reflect an abnormal metabolic state and be more predictive of colorectal cancer risk than BMI.Methods: We examined BMI, waist circumference, WHR, and hip circumference in relation to colorectal cancer risk among 203,177 participants followed for 10 years. We derived standardized colorectal cancer risk estimates for each anthropometric parameter and compared predictive characteristics (Harrell's C-index). In women, we examined whether hormone replacement therapy (HRT) use modified the associations between anthropometric measures and colorectal cancer.Results: We ascertained 2,869 colorectal cancers. In men, increased colon cancer risks were associated with BMI [HR per SD, 1.14; 95% confidence interval (CI), 1.08-1.20], waist circumference (HR per SD, 1.17; 95% CI, 1.08-1.27), and WHR (HR per SD, 1.09; 95% CI, 1.04-1.14). In women, anthropometric variables were unrelated to colon cancer. For men and women, anthropometric variables were unrelated to rectal cancer. Compared with BMI, waist circumference and WHR did not materially influence colon cancer prediction models [C-index changes: À0.0041 and 0.0046 (men); 0.0004 and 0.0005 (women)]. In current HRT users, colon cancer was inversely or suggestively inversely associated with waist circumference (HR per SD, 0.78; 95% CI, 0.63-0.97) and WHR (HR per SD, 0.88; 95% CI, 0.76-1.01), but positively related to hip circumference (HR per SD, 1.39; 95% CI, 1.13-1.71).Conclusion: BMI, waist circumference, and WHR show comparable positive associations with colon cancer in men. Associations between anthropometric measures and colon cancer are weak or null in women, but there is some evidence for effect modification by HRT.Impact: These findings may improve our understanding of the relation of adiposity to colorectal cancer. Cancer Epidemiol Biomarkers Prev; 22(8); 1383-94. Ó2013 AACR.

“…The question is to what extent do the sex hormone levels contribute independently? It has been reported that sex hormone levels are positively related to the total amount of fat tissue, with an inverse relation to sex hormone binding globulin [4]. So it is not unlikely that in the current study the observed higher oestrogen levels are an association with known risk factors that lead to MI rather than being causative.…”

mentioning

confidence: 37%

Postmenopausal sex hormones: comparing apples and pears

Appelman

Lambalk

2013

Neth Heart J

The sex hormone story in relation to cardiovascular disease is always good for a surprise. Where we assumed that increased levels of female sex hormones were protective against the development of cardiovascular disease, our colleagues Mei Dong et al. from Yantai, China suggest quite the opposite. In their paper published in this edition of the Netherlands Heart Journal the authors describe a relation between the occurrence of a myocardial infarction (MI) in post-menopausal women and levels of sex hormones [1]. They report that high levels of oestradiol and increased waist-to-hip ratio (WHR) are related to the occurrence of acute MI.This story is confusing. From an epidemiological perspective it was shown that in women there is a relation between the onset of the menopause and the risk of MI. Based on these observations studies were initiated to supply sex hormones in order to postpone the onset of atherosclerosis. Yet the beneficial effects of hormone replacement therapy were off set by the induction of thrombosis, likely in subjects who already had coronary artery disease [2]. However, recent publications might change this view, as a recent paper by Schierbeck from Denmark demonstrated that an early start of hormone replacement therapy seems to benefit and decreases future atherosclerotic events [3]. Moreover, it is well known that women with premature menopause have an earlier onset of atherosclerosis.An important restriction of the paper by Dong et al. is the patient selection and moreover the control population. It is obvious they selected pears and apples. The control group had lower WHR and lower levels of sex hormones. They also had a lower body mass index (BMI). These are clearly the pears with a preserved waist size, and they were recruited at random with two controls matched for age only. The infarct patients had higher BMI and higher WHR describing the apple shape. The value of the waist-to-hip ratio with increase in BMI is relative and some studies suggest that with a BMI above 30 the relevance of the WHR is lost. In addition the cases more often had hypertension and diabetes. These are all changes related to the postmenopausal status and it is well known that all these factors contribute to an increased risk for MI. So clearly the groups are very different. The question is to what extent do the sex hormone levels contribute independently? It has been reported that sex hormone levels are positively related to the total amount of fat tissue, with an inverse relation to sex hormone binding globulin [4]. So it is not unlikely that in the current study the observed higher oestrogen levels are an association with known risk factors that lead to MI rather than being causative. In fact, in postmenopausal women androgen secretion originates from the ovarian hilus driven by high gonadotropins and the adrenal gland driven by adrenocorticotrophic hormone and the oestrogens come from peripheral conversion of these androgens. Their fat tissue is the predominant source of oestrogens via its high aromatase potentia...