A systematic review and meta-analysis investigating differences in chronic inflammation and adiposity before and after menopause

IF 3.9 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2024-09-26 DOI:10.1016/j.maturitas.2024.108119

Laura E. Pernoud , Paul A. Gardiner , Sean D. Fraser , Kirsten Dillon-Rossiter , Melinda M. Dean , Mia A. Schaumberg

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Abstract

Background

Menopause represents a pivotal physiological transition characterized by hormonal fluctuations and an augmented susceptibility to chronic diseases. The relationship between menopause and heightened disease risk may be attributed in part to alterations in low-grade chronic inflammation and adiposity.

Methods

Three databases were searched for studies assessing differences in inflammation and body adiposity between pre- and postmenopausal women. Meta-analysis examined the association between menopausal status and key inflammatory biomarkers, including leptin, adiponectin, interleukin-6, tumour necrosis factor-α and c-reactive protein, and indices of body adiposity (fat mass, waist circumference, waist-to-hip-ratio and body mass index). The National Institute of Health Quality Assessment Tool for Observational and Cross-sectional studies was used to evaluate quality of studies, and GRADE-assessed evidence certainty.

Results

Levels of adiponectin and leptin were higher in postmenopausal women than in premenopausal women [(1.30 μg/ml, 95 % CI; 0.56 to 2.03 μg/ml, p = 0.001), (0.88 ng/ml; 95 % CI: 0.22 to 1.52; p = 0.008)]. A trend towards significance was observed for tumour necrosis factor-α (0.59 pg/ml, 95 % CI; −0.07 to 1.26 pg/ml, p = 0.080), with no significant differences in interleukin-6 and c-reactive protein [(0.83 pg/ml, 95 % CI; −0.24 to 1.91 pg/ml, p = 0.128), (0.06 mg/ml, 95 % CI; −0.17 to 0.29, p = 0.606)]. Postmenopausal women had greater waist circumference, waist-to-hip-ratio and body mass index than premenopausal women [(0.74 cm; 95 % CI: 1.02 to 0.47; p ≤0.001), (0.78; 95 % CI: 1.47 to −0.09; p = 0.027), (0.31 kg/m²; 95 % CI: 0.50 to 0.12; p = 0.001)].

Conclusions

Postmenopausal women had higher adipokine levels and greater adiposity. However, given the low certainty of the available evidence, future prospective cohort studies assessing inflammatory changes over the menopausal transition are warranted to inform future clinical decisions. Protocol registered on the Open Science Framework (OSF-ID: 10.17605/OSF.IO/DY8T6).

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对绝经前后慢性炎症和肥胖差异的系统回顾和荟萃分析研究

背景更年期是一个关键的生理过渡时期，其特点是激素波动和慢性疾病易感性增加。方法在三个数据库中搜索了评估绝经前和绝经后女性炎症和身体脂肪含量差异的研究。Meta 分析研究了绝经状态与主要炎症生物标志物（包括瘦素、脂肪连通素、白细胞介素-6、肿瘤坏死因子-α 和 c 反应蛋白）以及身体肥胖指数（脂肪量、腰围、腰臀比和体重指数）之间的关系。采用美国国立卫生研究院观察性和横断面研究质量评估工具评估研究质量，并采用 GRADE 评估证据的确定性。结果绝经后妇女的脂肪连素和瘦素水平高于绝经前妇女[（1.30 μg/ml，95 % CI；0.56 至 2.03 μg/ml，p = 0.001），（0.88 ng/ml；95 % CI：0.22 至 1.52；p = 0.008）]。肿瘤坏死因子-α呈显著性趋势（0.59 pg/ml，95 % CI；-0.07 至 1.26 pg/ml，p = 0.080），白细胞介素-6 和 c 反应蛋白[（0.83 pg/ml，95 % CI；-0.24 至 1.91 pg/ml，p = 0.128），（0.06 mg/ml，95 % CI；-0.17 至 0.29，p = 0.606）]无显著差异。绝经后妇女的腰围、腰臀比和体重指数高于绝经前妇女[（0.74 厘米；95 % CI：1.02 至 0.47；p ≤0.001），（0.78; 95 % CI: 1.47 to -0.09; p = 0.027)，(0.31 kg/m2; 95 % CI: 0.50 to 0.12; p = 0.001)].结论绝经前妇女的脂肪因子水平更高，脂肪含量更大。然而，鉴于现有证据的确定性较低，未来有必要开展前瞻性队列研究，评估绝经过渡期的炎症变化，为未来的临床决策提供依据。协议已在开放科学框架（OSF-ID：10.17605/OSF.IO/DY8T6）上注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life