Longitudinal Study of the Menopause and Fat Patterning
Condition: Cardiovascular Diseases; Menopause; Heart Diseases
MeSH terms: Cardiovascular Diseases; Heart Diseases
Study type: Observational

Summary: 
      To study the natural history of the accumulation of intra-abdominal fat as women progress
      through the menopause.
    

Detailed description: 
      BACKGROUND:

      Menopause alters the risk for a variety of chronic diseases, including cardiovascular
      disease, which is the number one cause of mortality in older women. While the associations
      between menopause, increased total and intra-abdominal fat (IAF), and risk for coronary
      disease are well established, prospective studies describing the accumulation of IAF, the
      association with risk factors, and potential mechanistic aspects, are still lacking. This
      study has the potential to provide important information on the trajectory of IAF
      accumulation across the menopausal transition in minority and non-minority women.

      DESIGN NARRATIVE:

      The prospective study will be conducted on an intact biracial cohort of 868 women (419
      African Americans; 449 Caucasians) who are participating in a larger study (Women in the
      Southside Health [WISH] Project) of women undergoing the menopausal transition. This is a
      population-based cohort that was randomly selected from an existing census with a 72 percent
      participation rate, approximately equal distribution of socioeconomic status within the
      African American and Caucasian subgroups, and a dropout rate of only 1 percent/year. As part
      of the larger study, this cohort undergoes annual exams in which a variety of cardiovascular,
      hormonal, and lifestyle factors are tracked. These annual measurements consisting of a large
      number of relevant covariates, including demographics, anthropometrics, serum lipids, blood
      pressures, insulin, glucose, hormones, lifestyle, health and psychosocial status will be
      available from the parent study. For this study, two additional clinical tests will be added
      to the battery at the fourth or fifth annual exam for the 536 women who are expected to be
      eligible by virtue of not having had a hysterectomy or begun taking hormone therapy. The two
      tests will be a computed tomography scan for the assessment of intra-abdominal fat, and a
      dual energy X-ray absorptiometry (DEXA) scan for the assessment of total body fat. These
      tests will be repeated on an annual basis for the next three years. By the end of the study,
      it is projected that 462 transitions in menopausal status will have taken place. Random
      effects models will be used to estimate longitudinal changes in level and rate of
      intra-abdominal fat as one moves from one menopausal status to another.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The prospective study will be conducted on an intact biracial cohort of 868 women (419
        African Americans; 449 Caucasians) who are participating in a larger study (Women in the
        Southside Health [WISH] Project) of women undergoing the menopausal transition.