title: Adiposity and hot flashes in midlife women: a modifying role of age.
abstract: BACKGROUND
  The nature of the relationship between adiposity and hot flashes has been debated, but it has not been examined using physiological measures of hot flashes. We examined associations between body size/composition and physiologically assessed hot flashes among women with hot flashes.
  
  
  METHODS
  A subcohort of women in the Study of Women's Health Across the Nation (n = 52; 25 African-American and 27 non-Hispanic Caucasian; ages, 54 to 63 yr) who reported hot flashes, had their uterus and ovaries, and were not taking medications impacting hot flashes were recruited in 2008-2009. Women completed anthropometric measures [bioimpedance analysis of total percentage of body fat, body mass index (BMI), waist circumference], a blood draw (estradiol, SHBG, FSH, dehydroepiandrosterone sulfate), and 4 d of ambulatory sternal skin conductance monitoring with diary (physiological and reported hot flashes, respectively). Associations between anthropometrics and hot flashes were estimated with generalized estimating equations with covariates age, race, and anxiety.
  
  
  RESULTS
  Higher BMI (odds ratio, 0.97; 95% confidence interval, 0.94-0.99; P < 0.05) and waist circumference (odds ratio, 0.98; 95% confidence interval, 0.97-0.99; P < 0.01) were associated with fewer physiological hot flashes. Interactions by age (P < 0.05) indicated that inverse associations of body fat, BMI, and waist circumference with hot flashes were most apparent among the oldest women in the sample. Estradiol and SHBG reduced but did not eliminate age-related variations in relations between body size/composition and hot flashes.
  
  
  CONCLUSIONS
  Higher adiposity was associated with fewer physiological hot flashes among older women with hot flashes. A modifying role of age must be considered in understanding the role of adiposity in hot flashes.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA. thurstonrc@upmc.edu
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005006:Ethnicity; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D019584:Hot Flashes / Q000503:physiopathology*; D006801:Humans; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D050177:Overweight / Q000503:physiopathology; D012738:Sex Hormone-Binding Globulin / Q000032:analysis / Q000378:metabolism; D012959:Socioeconomic Factors; D055105:Waist Circumference / Q000502:physiology
chemical_list: D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D005640:Follicle Stimulating Hormone