Reproductive hormones and obesity: 9 years of observation from the Study of Women's Health Across the Nation.
The effect of change in reproductive hormones and menopause on incident obesity (body mass index > or =30 kg/m(2)) and severe obesity (body mass index > or =35 kg/m(2)) was evaluated over 9 years in 3,260 US women recruited in the multiethnic Study of Women's Health Across the Nation in 1996-1997. After 9 years, cumulative incidences of obesity and severe obesity reached 21.8% and 12.3%, respectively. In multivariate analysis, hormone changes, chronic health conditions, lower physical activity, race/ethnicity, and age were significantly associated with incident obesity and/or severe obesity. The odds of incident severe obesity increased with surgical menopause (odds ratio (OR) = 5.07, 95% confidence interval (CI): 2.29, 11.20; P < 0.001) and initiation of hormone therapy prior to 12 months of amenorrhea (OR = 2.94, 95% CI: 1.14, 7.58; P = 0.03). Predictors of obesity included an increase in free androgen index (OR = 1.37, 95% CI: 1.12, 1.68; P = 0.002) and a decrease in sex hormone-binding globulin (OR = 0.60, 95% CI: 0.45, 0.80; P = 0.0005). Similar results were found for severe obesity. Obesity rates varied by race, but no hormone-by-race interactions were observed. These longitudinal data demonstrate that higher androgens, lower sex hormone-binding globulin, surgical menopause, and early hormone therapy use predict incident obesity and/or severe obesity in a multiracial cohort of women transitioning into menopause.
Sutton-Tyrrell
Kim
K
Department of Epidemiology, University of Pittsburgh, Pennsylvania 15261, USA. tyrrell@edc.pitt.edu
Zhao
Xinhua
X
Santoro
Nanette
N
Lasley
Bill
B
Sowers
MaryFran
M
Johnston
Janet
J
Mackey
Rachel
R
Matthews
Karen
K
D000367:Age Factors; D000568:Amenorrhea / Q000150:complications; D015992:Body Mass Index; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood* / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008593:Menopause / Q000502:physiology; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D044469:Racial Groups; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D014481:United States / Q000453:epidemiology
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D005640:Follicle Stimulating Hormone