The physically active lifestyle is associated with low future morbidity and mortality, but the causality between physical activity and health is not always clear. As some inherited biological ...characteristics and childhood experiences may cause selection bias in observational studies, we sought to take them into account by identifying 16 twin pairs (7 MZ, 9 DZ, mean age 60 years) discordant for leisure time physical activity habits for thirty years. We conducted detailed health-related examinations among these twin pairs. Our main aims were to study the effects of physical activity and genes on fitness and body composition, with special reference to body fat compartments, metabolic syndrome components and related diseases and risk factor levels, status of arteries, structure and function of the heart, bone properties, and muscle and fat tissue-related mechanisms linked to physical activity and chronic disease development. Our physical activity assessments showed that inactive co-twins were on average 8.8 MET hours/day less active than their active co-twins through out their midlife (2.2+/-2.3 vs. 11.0+/-4.1 MET h/day, p< .001). Follow-up fitness tests showed that physically inactive co-twins were less fit than their active co-twins (estimated VO(2peak) 26.4+/-4.9 vs. 32.5+/-5.5 ml/kg/min, p< .001). Similar differences were found in both MZ and DZ pairs. On the basis of earlier epidemiological observations on nonrelated individuals, these physical activity and fitness differences are large enough to cause differences in many mechanisms and risk factors related to the development of chronic diseases and to permit future analyses.
Abstract
Background
To examine longitudinal changes in physical performance during the menopausal transition and the role of physical activity (PA) in these changes.
Methods
Based on ...follicle-stimulating hormone levels and bleeding diaries, women (47–55 years) were classified as early (n = 89) and late perimenopausal (n = 143) and followed prospectively until postmenopausal status, with mean duration of 17.5 and 13.8 months, respectively. Physical performance was measured by handgrip force, knee extension torque, vertical jumping height, maximal walking speed, and 6-minute walking distance. Physical activity was self-reported and categorized as inactive, low, medium, and high. Longitudinal associations of menopausal status, physical performance, and related changes with PA level were analyzed using generalized estimation equations adjusted for duration of hormonal therapy.
Results
A significant decline over the menopausal transition in handgrip force (−2.1%, 95% CI −3.8 to −0.4), knee extension torque (−2.6%, 95% CI −4.5 to −0.8), and vertical jumping height (−2.6%, 95% CI −4.2 to −1.1) and a significant increase in 6-minute walking distance (2.1%, 95% CI 1.4 to 2.7) were observed in the total sample. A significant interaction of PA by time was observed in handgrip force and in vertical jumping height. High PA women had greater increase in handgrip strength but greater decline in vertical jumping height than medium, low, and inactive women (all p ≤ .001).
Conclusions
Both early and late perimenopausal women show decline in muscle strength and power during the transition to postmenopause. Physical activity seems to influence physical performance during the menopausal transition but understanding the benefits of PA requires interventional studies.
To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA).
Based on a hormonal analysis and bleeding ...diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjusted for age, marital and employment status, parity, self-reported mental disorder, use of psycholeptics and psychoanaleptics, and menopausal symptoms.
Depressive symptoms were lower amongst the pre than postmenopausal women (B = 0.07, confidence interval 0.01-0.13). Menopausal symptoms attenuated these associations. Menopausal status showed no associations with life satisfaction, or with positive or negative affectivity.Women with high PA scored higher on positive affectivity, and the pre, early peri, and postmenopausal women scored higher on life satisfaction (B = 0.79, P < 0.001; B = 0.63, P = 0.009; B = 0.42, P = 0.009, respectively) and scored lower on depressive symptoms (B = -0.13, P = 0.039; B = -0.18, P = 0.034; and B = -0.20, P < 0.001, respectively) than their low PA counterparts. The pre and postmenopausal women with medium PA scored higher on life satisfaction (B = 0.54, P = 0.001; B = 0.038, P = 0.004, respectively) than those with low PA.
Postmenopausal women reported marginally higher depressive symptoms scores compared with premenopausal women, but menopause was not associated with positive mental well-being. However, this association varies with the level of PA. : Video Summary:http://links.lww.com/MENO/A520.
Summary
Female middle age is characterized by a decline in skeletal muscle mass and performance, predisposing women to sarcopenia, functional limitations, and metabolic dysfunction as they age. ...Menopausal loss of ovarian function leading to low circulating level of 17β‐estradiol has been suggested as a contributing factor to aging‐related muscle deterioration. However, the underlying molecular mechanisms remain largely unknown and thus far androgens have been considered as a major anabolic hormone for skeletal muscle. We utilized muscle samples from 24 pre‐ and postmenopausal women to establish proteome‐wide profiles, associated with the difference in age (30–34 years old vs. 54–62 years old), menopausal status (premenopausal vs. postmenopausal), and use of hormone replacement therapy (HRT; user vs. nonuser). None of the premenopausal women used hormonal medication while the postmenopausal women were monozygotic (MZ) cotwin pairs of whom the other sister was current HRT user or the other had never used HRT. Label‐free proteomic analyses resulted in the quantification of 797 muscle proteins of which 145 proteins were for the first time associated with female aging using proteomics. Furthermore, we identified 17β‐estradiol as a potential upstream regulator of the observed differences in muscle energy pathways. These findings pinpoint the underlying molecular mechanisms of the metabolic dysfunction accruing upon menopause, thus having implications for understanding the complex functional interactions between female reproductive hormones and health.
We studied the changes in the circulating metabolome and their relation to the menopausal hormonal shift in 17β-oestradiol and follicle-stimulating hormone levels among women transitioning from ...perimenopause to early postmenopause.
We analysed longitudinal data from 218 Finnish women, 35 of whom started menopausal hormone therapy during the study. The menopausal transition was monitored with menstrual diaries and serum hormone measurements. The median follow-up was 14 months (interquartile range: 8-20). Serum metabolites were quantified with targeted nuclear magnetic resonance metabolomics. The model results were adjusted for age, follow-up duration, education, lifestyle, and multiple comparisons. Menopause was associated with 85 metabolite measures. The concentration of apoB (0.17 standard deviation SD, 99.5% confidence interval CI 0.03-0.31), very-low-density lipoprotein triglycerides (0.25 SD, CI 0.05-0.45) and particles (0.21 SD, CI 0.05-0.36), low-density lipoprotein (LDL) cholesterol (0.17 SD, CI 0.01-0.34) and particles (0.17 SD, CI 0.03-0.31), high-density lipoprotein (HDL) triglycerides (0.24 SD, CI 0.02-0.46), glycerol (0.32 SD, CI 0.07-0.58) and leucine increased (0.25 SD, CI 0.02-0.49). Citrate (-0.36 SD, CI -0.57 to -0.14) and 3-hydroxybutyrate concentrations decreased (-0.46 SD, CI -0.75 to -0.17). Most metabolite changes were associated with the menopausal hormonal shift. This explained 11% and 9% of the LDL cholesterol and particle concentration increase, respectively. Menopausal hormone therapy was associated with increased medium-to-large HDL particle count and decreased small-to-medium LDL particle and glycine concentration.
Menopause is associated with proatherogenic circulating metabolome alterations. Female sex hormones levels are connected to the alterations, highlighting their impact on women's cardiovascular health.
For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially ...adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual‐energy X‐ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47–55 (n = 230 and 148, mean follow‐up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m2). We also examined associations between menopausal progression and skeletal muscle fiber characteristics, as well as adipose tissue‐derived adipokines. Relative increases of 2%–14% were observed in regional and total body adiposity measures, with a pronounced fat mass increase in the android area (4% and 14% during short‐ and long‐term follow‐ups). Muscle fiber oxidative and glycolytic capacities and intracellular adiposity were not affected by menopause, but were differentially correlated with total and regional body adiposity at different menopausal stages. Menopausal progression and regional adipose tissue masses were positively associated with serum adiponectin and leptin, and negatively associated with resistin levels. Higher diet quality and physical activity level were also inversely associated with several body adiposity measures. Therefore, healthy lifestyle habits before and during menopause might delay the onset of severe metabolic conditions in women.
Menopause is associated with increases in total and regional body adiposity, with a pronounced increase in the android area. Adipose tissue‐derived adipokines, adiponectin, leptin and resistin, were uniquely associated with menopausal transition. Lifestyle habits, such as higher diet quality and physical activity level, but not external hormone use, were associated with lower adiposity in several body regions.
•Menopausal symptoms were associated with higher cholesterol levels and body adiposity.•Associations with cholesterol levels diminished after controlling for confounders.•Menopausal symptoms were not ...associated with blood pressure and physical activity.•Symptoms did not predict the changes in cardiometabolic risk during the follow-up.
To study associations of menopausal symptoms with cardiometabolic risk factors.
A cross-sectional and longitudinal study of a representative population sample of 1393 women aged 47–55 years with a sub-sample of 298 followed for four years. The numbers of vasomotor, psychological, somatic or pain, and urogenital menopausal symptoms were ascertained at baseline through self-report. Their associations with cardiometabolic risk factors were studied using linear regression and linear mixed-effect models. Models were adjusted for age, menopausal status, body mass index, the use of hormonal preparations, education, smoking, and alcohol consumption.
Cardiometabolic risk factors included total cholesterol, low-density and high-density lipoprotein cholesterol, blood pressure, glucose, triglycerides, total and android fat mass, and physical activity.
All cholesterol and fat mass measures had modest positive associations with menopausal symptoms. The number of vasomotor symptoms, in particular, was associated with total cholesterol (B = 0.13 mmol/l, 95 % CI 0.07, 0.20; 0.15 mmol/l 0.02, 0.28) and low-density lipoprotein cholesterol (0.08 mmol/l 0.03, 0.14; 0.12 mmol/l 0.01, 0.09) in cross-sectional and longitudinal analyses, respectively. However, these associations disappeared after adjusting for confounders. The number of symptoms was not associated with blood pressure, glucose, triglycerides, and physical activity. Menopausal symptoms at baseline did not predict the changes in the risk factors during the follow-up.
Menopausal symptoms may not be independently associated with cardiometabolic risk, and they do not seem to predict the changes in risk factors during the menopausal transition.
The older Finnish Twin Cohort (FTC) was established in 1974. The baseline survey was in 1975, with two follow-up health surveys in 1981 and 1990. The fourth wave of assessments was done in three ...parts, with a questionnaire study of twins born during 1945–1957 in 2011–2012, while older twins were interviewed and screened for dementia in two time periods, between 1999 and 2007 for twins born before 1938 and between 2013 and 2017 for twins born in 1938–1944. The content of these wave 4 assessments is described and some initial results are described. In addition, we have invited twin-pairs, based on response to the cohortwide surveys, to participate in detailed in-person studies; these are described briefly together with key results. We also review other projects based on the older FTC and provide information on the biobanking of biosamples and related phenotypes.
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