Body Fat Distribution After Menopause and Cardiovascular Disease Risk Factors: Korean National Health and Nutrition Examination Survey 2010

Background: The prevalence of cardiovascular disease in women increases sharply after menopause. The purpose of this study was to clarify the relationship between menopause and body fat distribution and to investigate their association with cardiovascular disease risk factors. Methods: We analyzed 2035 women 20-79 years of age using the National Health and Nutrition Examination Survey (KNHANES) 2010 database. Body fat was measured using dual-energy X-ray absorptiometry. Results: The percentage of total body fat and the body fat distribution (BFD) index (the ratio of the trunk fat mass to leg fat mass) are significantly higher in postmenopausal women than in premenopausal women (all p < 0.001). When adjusted for age, menopause was associated with higher total body fat percentage (adjusted beta = 1.082, 95% confidence interval [CI] 0.074-2.090, p = 0.035). In women with a body mass index < 25 kg/m(2), the higher BFD index was also independently associated with menopause (adjusted beta = 14.408, 95% CI 1.672-27.145, p = 0.027). After adjusting for age and body fat percentage, the BFD index showed significant and independent associations with systolic and diastolic blood pressure (adjusted beta = 0.060 and 0.042, all p < 0.001, respectively), fasting glucose (adjusted beta = 0.007, p < 0.001), total and high density lipoprotein cholesterol (adjusted beta = 0.001 and -0.002, p < 0.05 and p < 0.001, respectively), and triglyceride levels (adjusted beta = 0.007, p < 0.001- except for low density lipoprotein cholesterol. Conclusions: After menopause, women have not only higher total body fat percentage but also its different distribution, which independently correlates with cardiovascular disease risk factors. Therefore, this change in body fat may cause the sharp increase in cardiovascular disease incidence in middle-aged women, especially after menopause.