Study data were drawn from the Study of Women Across the Nation (SWAN) database to address the question of whether or not weight gain preceded or followed the hormonal changes associated with the menopause transition . The cohort consisted of 1528 women with a mean age of 46 years who had baseline measurements of waist circumference, body mass index (BMI), and serum follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), testosterone, and estradiol drawn at baseline and at 3, 6, and 9 years after entry. The outcome measure of weight gain or waist circumference versus hormone levels was assessed in the following manner. The dynamic sequential relationships between hormones and waist circumference were examined using structural equation modeling. Specifically, these equations examined the following three longitudinal relationships: (1) the association of current hormone values and waist circumference with their respective future values; (2) the associations of current waist circumference with future hormone values; and (3) the associations of current hormone values with future waist circumference. The results indicate that the changes in adiposity and waist circumference occur during and following the menopause transition. Current waist circumference predicted future decreases in FSH and SHBG and the increase in serum testosterone. Waist circumference predicted future estradiol levels, while current estradiol levels were associated with future weight gain. Both relationships were dependent upon the changing estradiol levels but the former result was greater than the latter .
David F. Archer
Professor of Obstetrics and Gynecology, Department of obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA