Body Fat Distribution and Insulin Resistance Among Korean Middle-aged Women: a Korean National Health and Nutrition Examination Survey

Overview

Journal Obstet Gynecol Sci

Specialty Gynecology & Obstetrics

Date 2022 Jul 31

PMID 35908650

Authors

Sae Mi Lee

Ki-Jin Ryu

Serhim Son

Yeon Ju Lee

Hyuntae Park

Tak Kim

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate menopause-related changes in body fat distribution and their relationship with insulin resistance in middleaged Korean women.

Methods: We analyzed women aged 40-60 years using data from the National Health and Nutrition Examination Survey conducted from 2008 to 2011. Body fat was measured using dual-energy X-ray absorptiometry. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR).

Results: Among 3,468 participants, menopausal women (n=1,489) had a higher body mass index (BMI) and higher trunk, arm, and head fat percentages than premenopausal women (n=1,979). However, no significant difference was found in the leg fat percentage according to menopausal status. Multivariable regression analysis for HOMA-IR showed that trunk fat percentage, BMI, and waist circumference positively correlated with insulin resistance and leg fat percentage negatively correlated after adjusting for several confounding factors, whereas menopausal status was not associated with HOMAIR.

Conclusion: Middle-aged women not only have different body weights and BMI but also have different body fat distributions according to menopausal status. Each fat percentage change in the trunk and leg is differently associated with metabolic health, particularly insulin resistance. To evaluate the metabolic health of middle-aged women, BMI is generally noted; however, body fat distribution, which can be easily assessed using dual-energy X-ray absorptiometry, should also be considered.

Citing Articles

Phytonanotherapy for the Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease.

Nendouvhada L, Sibuyi N, Fadaka A, Meyer S, Madiehe A, Meyer M Int J Mol Sci. 2024; 25(11).

PMID: 38891759 PMC: 11171778. DOI: 10.3390/ijms25115571.

One-year trajectories of nutritional status in perimenopausal women: a community-based multi-centered prospective study.

Liao S, Zhao L, Huang C, Xiong A, Xiong W, He Y BMC Public Health. 2024; 24(1):914.

PMID: 38549103 PMC: 10976711. DOI: 10.1186/s12889-024-18405-0.

Prediction of resting energy expenditure in Italian older adults with severe obesity.

Danielewicz A, Lazzer S, Marra A, Abbruzzese L, DAlleva M, De Martino M Front Endocrinol (Lausanne). 2023; 14:1283155.

PMID: 38027183 PMC: 10663312. DOI: 10.3389/fendo.2023.1283155.

Body fat distribution: a crucial target for intervention in nonalcoholic fatty liver disease and fibrosis.

Wijarnpreecha K, Ahmed A, Kim D Hepatobiliary Surg Nutr. 2022; 11(5):738-742.

PMID: 36268244 PMC: 9577990. DOI: 10.21037/hbsn-22-366.

References

Dowling H, Fried S, Pi-Sunyer F . Insulin resistance in adipocytes of obese women: effects of body fat distribution and race. Metabolism. 1995; 44(8):987-95. DOI: 10.1016/0026-0495(95)90094-2. View

Hunter G, Kekes-Szabo T, Treuth M, WILLIAMS M, Goran M, Pichon C . Intra-abdominal adipose tissue, physical activity and cardiovascular risk in pre- and post-menopausal women. Int J Obes Relat Metab Disord. 1996; 20(9):860-5. View

Ku S, Kang J, Kim H, Ku P, Lee S, Suh C . Regional differences in age at menopause between Korean-Korean and Korean-Chinese. Menopause. 2004; 11(5):569-74. DOI: 10.1097/01.gme.0000142913.70089.a1. View

Lovejoy J, Champagne C, de Jonge L, Xie H, Smith S . Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008; 32(6):949-58. PMC: 2748330. DOI: 10.1038/ijo.2008.25. View

Tremollieres F, Pouilles J, Ribot C . Relative influence of age and menopause on total and regional body composition changes in postmenopausal women. Am J Obstet Gynecol. 1996; 175(6):1594-600. DOI: 10.1016/s0002-9378(96)70111-4. View

McFarlane S, Banerji M, Sowers J . Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab. 2001; 86(2):713-8. DOI: 10.1210/jcem.86.2.7202. View

Schoenaker D, Jackson C, Rowlands J, Mishra G . Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. Int J Epidemiol. 2014; 43(5):1542-62. PMC: 4190515. DOI: 10.1093/ije/dyu094. View

Hong J, Yi S, Kang H, Jee S, Kang H, Bayasgalan G . Age at menopause and cause-specific mortality in South Korean women: Kangwha Cohort Study. Maturitas. 2006; 56(4):411-9. DOI: 10.1016/j.maturitas.2006.11.004. View

Matthews K, Crawford S, Chae C, Everson-Rose S, Sowers M, Sternfeld B . Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition?. J Am Coll Cardiol. 2010; 54(25):2366-73. PMC: 2856606. DOI: 10.1016/j.jacc.2009.10.009. View

10.

Kapoor E, Collazo-Clavell M, Faubion S . Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management. Mayo Clin Proc. 2017; 92(10):1552-1558. DOI: 10.1016/j.mayocp.2017.08.004. View

11.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

12.

Manolopoulos K, Karpe F, Frayn K . Gluteofemoral body fat as a determinant of metabolic health. Int J Obes (Lond). 2010; 34(6):949-59. DOI: 10.1038/ijo.2009.286. View

13.

Snijder M, Zimmet P, Visser M, Dekker J, Seidell J, Shaw J . Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study. Int J Obes Relat Metab Disord. 2004; 28(3):402-9. DOI: 10.1038/sj.ijo.0802567. View

14.

Ambikairajah A, Walsh E, Tabatabaei-Jafari H, Cherbuin N . Fat mass changes during menopause: a metaanalysis. Am J Obstet Gynecol. 2019; 221(5):393-409.e50. DOI: 10.1016/j.ajog.2019.04.023. View

15.

Al-Safi Z, Polotsky A . Obesity and menopause. Best Pract Res Clin Obstet Gynaecol. 2015; 29(4):548-53. DOI: 10.1016/j.bpobgyn.2014.12.002. View

16.

Razmjou S, Abdulnour J, Bastard J, Fellahi S, Doucet E, Brochu M . Body composition, cardiometabolic risk factors, physical activity, and inflammatory markers in premenopausal women after a 10-year follow-up: a MONET study. Menopause. 2017; 25(1):89-97. DOI: 10.1097/GME.0000000000000951. View

17.

Ley C, Lees B, Stevenson J . Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr. 1992; 55(5):950-4. DOI: 10.1093/ajcn/55.5.950. View

18.

Sowers M, Zheng H, Tomey K, Karvonen-Gutierrez C, Jannausch M, Li X . Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab. 2006; 92(3):895-901. PMC: 2714766. DOI: 10.1210/jc.2006-1393. View

19.

Kannel W, Cupples L, Ramaswami R, Stokes 3rd J, Kreger B, Higgins M . Regional obesity and risk of cardiovascular disease; the Framingham Study. J Clin Epidemiol. 1991; 44(2):183-90. DOI: 10.1016/0895-4356(91)90265-b. View

20.

Park J, Lim Y, Kim K, Kim S, Kim J, Lim H . Body fat distribution after menopause and cardiovascular disease risk factors: Korean National Health and Nutrition Examination Survey 2010. J Womens Health (Larchmt). 2013; 22(7):587-94. DOI: 10.1089/jwh.2012.4035. View