Adipokines, adiposity, and vasomotor symptoms during the menopause transition: findings from the Study of Women's Health Across the Nation

Objective: To test relationships between adipokines, adiposity, and vasomotor symptoms (VMS), including how these associations vary by menopause stage. Design: A subcohort of the longitudinal cohort Study of Women's Health Across the Nation completed questionnaires, physical measures, and a fasting blood draw annually for 8 years. Associations between a poorer adipokine profile (lower adiponectin, lower high-molecular-weight [HMW] adiponectin, higher leptin, lower soluble leptin receptor, higher monocyte chemoattractant protein 1 [MCP-1]) and VMS were tested with the use of generalized estimating equations adjusting for potential confounders. Interactions by menopause stage (pre-/early perimenopause, late peri-/postmenopause) were tested. Setting: Community. Patient(s): A total of 536 women ages 42-52 at baseline. Intervention(s): None. Main Outcome Measure(s): VMS. Result(s): Associations between adipokines and hot flashes varied by menopause stage, with a poorer adipokine profile associated with higher odds of hot flashes early in the transition (adiponectin(log): odds ratio [OR] 0.68, 95% confidence interval [CI] 0.51-0.90; HMW adiponectin(log): OR 0.70, 95% CI 0.58-0.85; leptin(log): OR 1.23, 95% CI 0.99-1.54; multivariable models including body mass index [BMI]), but not later in the transition. The direction of associations between BMI and VMS also varied by menopausal stage. Higher MCP-1 was associated with more night sweats (OR 1.37, 95% CI 1.06-1.76) across menopausal stages. Conclusion(s): An adverse adipokine profile was associated with more VMS, particularly early in the menopause transition. (C) 2013 by American Society for Reproductive Medicine.)