Copyright @ 2007 The North American Menopause Society. Unauthorized reproduction of this article is prohibited. Menopause: The Journal of The North American Menopause Society Vol. 15, No. 1, pp. 112/118 DOI: 10.1097/gme.0b013e318068b285 * 2008 by The North American Menopause Society Oxidative stress, body fat composition, and endocrine status in pre- and postmenopausal women Francesco Pansini, MD, PhD, 1 Carlo Cervellati, PhD, 1,2 Angela Guariento, BSc, 2 Maria Antonella Stacchini, MD, 3 Cristina Castaldini, NRs, 1 Andrea Bernardi, MD, 1 Giuliana Pascale, MD, 4 Gloria Bonaccorsi, MD, 1 Alfredo Patella, MD, 4 Bruno Bagni, MD, 5 Gioacchino Mollica, MD, 4 and Carlo M. Bergamini, MD, PhD 2 Abstract Objective: To evaluate the role of menopause on the regional composition and distribution of fat in women and eventual correlations with the oxidative state. Design: In this observational clinical investigation, 90 women (classified for menopause status according to Stages of Reproductive Aging Workshop criteria) were evaluated for body mass composition and fat distribution by dual-energy x-ray absorptiometry and for oxidative status by determination of serum hydroperoxide levels and residual antioxidant activity. Results: Total body fat mass increases significantly in postmenopause (P G 0.05) by 22% in comparison with premenopause, with specific increases in fat deposition at the level of trunk (abdominal and visceral) (P G 0.001) and arms (P G 0.001). Concomitantly, the antioxidant status increases significantly (P G 0.001) by 17%. When data were adjusted for age by analysis of covariance, statistical significance disappeared for the increase in fat mass, but it was retained for antioxidant status (P G 0.05). Both antioxidant status and hydroperoxide level increased with trunk fat mass, as shown by linear correlation analysis (r = 0.46, P G 0.001 and r = 0.26, P G 0.05, respectively). Conclusions: The results of our investigation demonstrate that fat content increases in the upper part of the body (trunk and arms) in postmenopause and that age is the main determinant of this increase. During the comparison of premenopausal and postmenopausal women, we also detected a significant increase in antioxidant status. Apparently this change is mainly related to menopausal endocrine and fat changes. Key Words: Menopause Y Age Y Body mass composition Y Oxidative stress Y Antioxidant defense. M enopause is the period of a woman`s life that begins with the total cessation of menstruation due to the loss of the ovarian production of estrogens, particularly estradiol. This estrogenic decline is known to play an important role in the cause of many symptoms common in middle age 1 and may contribute to neurovegetative 2,3 and urogenital disturbances 4,5 along with chronic conditions such as postmenopausal osteoporosis 6,7 and cardiovascular disease (CVD). 8<10 In these past decades, clinicians` attention focused on the role of estrogens in the prevention of CVDs (in particular atherosclerosis and coronary heart disease), which currently represent the leading cause of death in women after menopause. Despite controversial evidence arising from the Women`s Health Initiative clinical trial on hormone therapy in women in late postmenopause, 11 many reports suggest a cardioprotective function of estrogens that might be partly explained by the important role of these hormones in the regulation of body fat distribution. 12,13 Indeed, the estrogen decline during the menopausal transition seems to accelerate overall, but more significant, there is an increase in abdominal/ visceral fat accumulation, 14<17 which has been associated with an increased risk of developing CVD and related morbid- ity. 18<20 Recent findings suggest that the preventive role of estrogens in CVD may also depend on their antioxidant effect. 21<23 More specifically, these hormones have shown the ability to protect low-density lipoprotein from oxidative modification, which is an important step in atherogenesis. 21 Conversely, the oxidation of low-density lipoprotein repre- sents one of the effects of an increased systemic production of oxidants, especially of reactive oxygen species, not adequately counteracted by stechiometric scavengers and Received January 2, 2007; revised and accepted April 4, 2007. From the 1 Menopause and Osteoporosis Centre and 2 Department of Biochemistry and Molecular Biology, University of Ferrara, Ferrara, Italy; 3 Laboratory Medicine Department, State Hospital, Republic of San Marino; 4 Gynaecologic-Obstetrics Clinic, University of Ferrara, Ferrara, Italy; and 5 Nuclear Medicine Department, University of Modena, Modena, Italy. Financial disclosure: None reported. Address correspondence to: Francesco Pansini, MD, PhD, Centro di Ricerca e Servizio, Via Boschetto 29, 44100-I Ferrara, Italy. E-mail: pan@unife.it 112 Menopause, Vol. 15, No. 1, 2008