title: Body composition in the Study of Women Entering and in Endocrine Transition (SWEET): A perspective of African women who have a high prevalence of obesity and HIV infection.
abstract: OBJECTIVE
  Little data are available for sub-Saharan African women on changes in body composition in menopause transition (MT). The study aimed to determine whether there are differences in body adiposity, lean muscle mass, and bone mineral density (BMD) across MT groups in urban African women, who have a high prevalence of obesity and HIV infection, and if this is related to an altered hormonal milieu.
  
  
  METHODS
  Participants were 702 black urban women. Menopause stage was defined using STRAW+10 criteria. Levels of follicle stimulating hormone (FSH), estradiol (E2), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone (T) and sex hormone blinding globulin (SHBG) were measured. Body composition was measured with dual-energy X-ray absorptiometry (DXA) and ultrasound scans.
  
  
  RESULTS
  Whole body lean mass (p=0.002) and BMD (p<0.0005) were significantly lower in postmenopausal compared to premenopausal groups. Estradiol (p<0.0005), SHBG (p<0.0005) and DHEAS (p=0007) were significantly lower in post- than premenopausal groups, while FSH was higher (p<0.0005). FSH correlated negatively (β=-2.06, p<0.0005) with total lean mass while E2 correlated positively (β=20.0, p=0.002) with BMD. Use of antiretroviral therapy (ART) correlated negatively with total fat mass (β=-2.92, p=0.008) and total bone mineral content (BMC; β=-78.8, p=0.003).
  
  
  CONCLUSIONS
  The MT in this population is characterized by lower whole body lean mass and BMD in post- compared to premenopausal subjects but there are minimal differences in fat mass. Lower lean mass and BMD were associated with higher FSH and lower E2 serum levels, respectively. Use of ART was associated with lower fat mass and BMC.
authors.affiliation: MRC/Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg; Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg. Electronic address: nrj1@mweb.co.za.
authors.forename: Nicole G
authors.initials: NG
authors.lastname: Jaff
authors.affiliation: MRC/Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
authors.affiliation: Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg.
authors.forename: Tracy
authors.initials: T
authors.lastname: Snyman
authors.affiliation: Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg.
authors.forename: Marketa
authors.initials: M
authors.lastname: Toman
authors.affiliation: Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg.
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Crowther
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D044383:Black People; D001823:Body Composition; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D006801:Humans; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D015995:Prevalence
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Body composition; HIV-infection; Lean muscle mass; Menopause; Obesity