Precedence of the shift of body-fat distribution over the change in body composition after menopause

Aim: This study investigated the sequence of certain phenomena after menopause: decrease in bone mineral density (BMD), change in body composition (lean and fat components), and the shift toward upper body fat distribution. Methods: Subjects were 188 postmenopausal women aged 50-65 years old. They were divided into four subgroups based on 4-year increments in age. Regularly menstruating women (n = 51) aged 50-53 years old served as controls. Age, height, weight, and years since menopause were recorded. Body fat mass, percentage of body fat (%fat), lean body mass (LBM), lumbar spine (L2-4), total body BMD, and the trunk-leg fat mass ratio were measured by dual-energy X-ray absorptiometry. Results: In postmenopausal women (n = 42) aged 50-53 years, BMD was lower compared to age-matched controls (P < 0.05), while other variables did not differ. Trunk-leg fat mass ratio in women aged 54-57 years or more was significantly higher than that in control. LBM was significantly lower while percentage fat was significantly higher in women aged 58-61 years old or more. Conclusion: An initial event during the menopausal process is BMD loss, which is followed by body fat distribution shift, then LBM loss and reciprocal increase in body fat mass.