Dr. Annie Sawyer
Visceral fat (VF), also known as an independent predictor of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD), is significantly increasing with the transition to menopause. As it is already known, visceral fat (VF), that is surrounding the internal organs around the waistline, is metabolically different type of fat from the subcutaneous one, located beneath the skin. Many researchers have shown the well known fact that visceral fat is a source of inflammation that contributes to premature atherosclerosis and risk of acute coronary syndrome.
At the same time, there is very little known on the exact mechanism of how and which exactly hormonal changes during the period of menopause are closely related to the increase in visceral fat. An amazing new discovery published in Obesity (2009) as a longitudinal, community-based study done at Rush University Medical Center (Chicago, Illinois), discovered the little known and almost unrecognized relationship between high bioavailable testosterone and visceral fat in middle aged women in various menopausal stages of transition. This study, also known as the Study of Women's Health Across the Nation (SWAN) examines the cross-sectional relationship between free (bioavailable) testosterone and computed tomography (CT) assessed visceral fat in women in different age of their menopausal transition. The researchers selected randomly 359 women (47, 2% black) aged between 42-60 years from a complete community census in which a 72% participation rate was achieved. In several multivariate models, bioavailable testosterone was associated with VF independent of age, race, percent total body fat, and other cardiovascular risk factors.
The research proved that the culprit behind the VF accumulation is likely not the advanced age (as it was commonly believed), but the change in hormone balance that occurs during the menopause transition. As a final conclusion of SWAN-the elevated free and bioavailable testosterone in women was proved as stronger predictor than estradiol decline and was interchangeable in its strength of association with sex hormone-binding globulin (SHBG). As bioavailable testosterone was associated with VF even after adjusting the available insulin resistance, this suggests that free testosterone plays an important and maybe a main role in regional fat distribution. Janssen stated: “For many years, it was thought that estrogen protected premenopausal women against cardiovascular disease and that the increased cardiovascular risk after menopause was related only to the loss of estrogen’s protective effect. But our studies suggest that in women, it is the change in the hormonal balance – specifically, the increase in active testosterone – that is predominantly responsible for visceral fat, and for the increased risk of cardiovascular disease”.
Findings from the new SWAM study may have direct implications in explaining the effect of menopause-related testosterone predominance on VF accumulation and subsequent cardiovascular risk (Janssen, I., Powell, L., Kazlauskaite, R., et al., 2009). In Janssen proper words: “Of all the factors we analyzed that could possibly account for the increase in visceral fat during this period in a woman’s lifetime, levels of active testosterone proved to be the one most closely linked with abdominal fat.” The study’s findings are extending proceeding of an earlier research conducted by the same authors on testosterone’s link with what is called the metabolic syndrome during menopause, published in the Archives of Internal Medicine in 2008. That study, examining women six years before and six years after their final menstrual period, found that the rise in metabolic syndrome – a collection of risk factors for heart disease – corresponded with the rise in testosterone activity.
Visceral fat (VF), also known as an independent predictor of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD), is significantly increasing with the transition to menopause. As it is already known, visceral fat (VF), that is surrounding the internal organs around the waistline, is metabolically different type of fat from the subcutaneous one, located beneath the skin. Many researchers have shown the well known fact that visceral fat is a source of inflammation that contributes to premature atherosclerosis and risk of acute coronary syndrome.
At the same time, there is very little known on the exact mechanism of how and which exactly hormonal changes during the period of menopause are closely related to the increase in visceral fat. An amazing new discovery published in Obesity (2009) as a longitudinal, community-based study done at Rush University Medical Center (Chicago, Illinois), discovered the little known and almost unrecognized relationship between high bioavailable testosterone and visceral fat in middle aged women in various menopausal stages of transition. This study, also known as the Study of Women's Health Across the Nation (SWAN) examines the cross-sectional relationship between free (bioavailable) testosterone and computed tomography (CT) assessed visceral fat in women in different age of their menopausal transition. The researchers selected randomly 359 women (47, 2% black) aged between 42-60 years from a complete community census in which a 72% participation rate was achieved. In several multivariate models, bioavailable testosterone was associated with VF independent of age, race, percent total body fat, and other cardiovascular risk factors.
The research proved that the culprit behind the VF accumulation is likely not the advanced age (as it was commonly believed), but the change in hormone balance that occurs during the menopause transition. As a final conclusion of SWAN-the elevated free and bioavailable testosterone in women was proved as stronger predictor than estradiol decline and was interchangeable in its strength of association with sex hormone-binding globulin (SHBG). As bioavailable testosterone was associated with VF even after adjusting the available insulin resistance, this suggests that free testosterone plays an important and maybe a main role in regional fat distribution. Janssen stated: “For many years, it was thought that estrogen protected premenopausal women against cardiovascular disease and that the increased cardiovascular risk after menopause was related only to the loss of estrogen’s protective effect. But our studies suggest that in women, it is the change in the hormonal balance – specifically, the increase in active testosterone – that is predominantly responsible for visceral fat, and for the increased risk of cardiovascular disease”.
Findings from the new SWAM study may have direct implications in explaining the effect of menopause-related testosterone predominance on VF accumulation and subsequent cardiovascular risk (Janssen, I., Powell, L., Kazlauskaite, R., et al., 2009). In Janssen proper words: “Of all the factors we analyzed that could possibly account for the increase in visceral fat during this period in a woman’s lifetime, levels of active testosterone proved to be the one most closely linked with abdominal fat.” The study’s findings are extending proceeding of an earlier research conducted by the same authors on testosterone’s link with what is called the metabolic syndrome during menopause, published in the Archives of Internal Medicine in 2008. That study, examining women six years before and six years after their final menstrual period, found that the rise in metabolic syndrome – a collection of risk factors for heart disease – corresponded with the rise in testosterone activity.
References:
1. Janssen I, Powell LH, Kazlauskaite R, et al. Testosterone and visceral fat in midlife women: The study of Women's Health Across the Nation (SWAN) Fat Patterning Study. Obesity (Silver Spring) 2009;
2. Increase in visceral fat during menopause linked with testosterone. Rush news release. August 20, 2009. Retrieved from: http://www.rush.edu/webapps/MEDREL/servlet/NewsRelease?id=1263
1. Janssen I, Powell LH, Kazlauskaite R, et al. Testosterone and visceral fat in midlife women: The study of Women's Health Across the Nation (SWAN) Fat Patterning Study. Obesity (Silver Spring) 2009;
2. Increase in visceral fat during menopause linked with testosterone. Rush news release. August 20, 2009. Retrieved from: http://www.rush.edu/webapps/MEDREL/servlet/NewsRelease?id=1263
If you would like to learn more on the above topic, please call and require a personal consultation: (715) 392-7591; (218) 213-6167; or (218) 213-7087
These statements have not been evaluated by the Food and Drug Administration. The material in this newsletter is provided for informational purposes only. Thus our intentions are not to diagnose, cure, mitigate, treat or prevent any disease. If you use the information in this newsletter without the approval of your health professional, the authors of this letter do not assume any responsibility. Copyright @ 2009, Natural Health-Wellness LLC. All rights reserved.
These statements have not been evaluated by the Food and Drug Administration. The material in this newsletter is provided for informational purposes only. Thus our intentions are not to diagnose, cure, mitigate, treat or prevent any disease. If you use the information in this newsletter without the approval of your health professional, the authors of this letter do not assume any responsibility. Copyright @ 2009, Natural Health-Wellness LLC. All rights reserved.
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