Post-Menopause Fat Deposition Accelerates Atherosclerosis

Increased visceral adipose tissue (VAT) accumulation during menopause is associated with a greater risk for subclinical internal carotid atherosclerosis, according to a new study.

Researchers at the University of Pittsburgh (Pitt; PA, USA) and Rush University Medical Center (Rush; Chicago, IL, USA) conducted a study involving 362 women (mean age 51 years, 61% White) in order to characterize abdominal VAT volume trajectory relative to final menstrual period (FMP), and it’s association with common carotid artery intima-media thickness (CCA-IMT) and/or internal carotid artery intima-media thickness (ICA-IMT). Estimates were adjusted for age at FMP, body mass index (BMI), and sociodemographic, lifestyle, and cardiovascular disease (CVD) risk factors.

The results showed that VAT increased significantly (8.2%) per year from two years before FM, and 5.8% per year after FMP. There were no significant changes seen in VAT more than two years before FMP, but from two years before to FMP, VAT predicted greater ICA-IMT, with a 20% greater VAT associated with a 2% greater ICA-IMT. On adjusted analysis, however, VAT was not an independent predictor of ICA-IMT in other time periods, or of CCA-IMT measures. The study was published on March 1, 2021, in Menopause.

“Almost 70% of post-menopausal women have central obesity, or excessive weight in their mid-section. That fat, that hugs the abdominal organs, is related to greater secretion of toxic molecules that can be harmful to cardiovascular health,” said lead author Saad Samargandy, PhD, MPH, MBBS, of Pitt. “Our analysis showed an accelerated increase of visceral abdominal fat during the menopausal transition of eight percent per year, independent of chronological aging.”

“We need to shift gears on how we think about heart disease risk in women, particularly as they approach and go through menopause," said senior author epidemiologist Samar El Khoudary, PhD, MPH, of Pitt Public Health. “Our research is increasingly showing that it isn't so important how much fat a woman is carrying, which doctors typically measure using weight and BMI, as it is where she is carrying that fat.”

Visceral fat, often referred to as the “middle-age spread”, lies out of reach, deep within the abdominal cavity, where it fills the spaces between the organs. It has been linked to metabolic disturbances and increased risk for CVD and type 2 diabetes (T2D). In women, it is also associated with breast cancer and the need for gallbladder surgery. Visceral fat can also be considered an extra organ, as it pumps out hormones and cytokines (such as tumor necrosis factor and interleukin-6), that have deleterious effects on sensitivity to insulin, blood pressure, and blood clotting.

Related Links:
University of Pittsburgh
Rush University Medical Center