Body composition in the Study of Women Entering and in Endocrine Transition (SWEET): A perspective of African women who have a high prevalence of obesity and HIV infection Nicole G. Jaff a, b, ⁎ , Shane A. Norris a , Tracy Snyman b , Marketa Toman b , Nigel J. Crowther b a MRC/Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg b Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg ARTICLE INFO ABSTRACT Article history: Received 26 March 2015 Accepted 17 May 2015 Objectives. Little data are available for sub-Saharan African women on changes in body composition in menopause transition (MT). The study aimed to determine whether there are differences in body adiposity, lean muscle mass, and bone mineral density (BMD) across MT groups in urban African women, who have a high prevalence of obesity and HIV infection, and if this is related to an altered hormonal milieu. Design. Participants were 702 black urban women. Menopause stage was defined using STRAW+10 criteria. Levels of follicle stimulating hormone (FSH), estradiol (E2), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone (T) and sex hormone blinding globulin (SHBG) were measured. Body composition was measured with dual-energy X-ray absorptiometry (DXA) and ultrasound scans. Results. Whole body lean mass (p = 0.002) and BMD (p < 0.0005) were significantly lower in postmenopausal compared to premenopausal groups. Estradiol (p < 0.0005), SHBG (p < 0.0005) and DHEAS (p = 0007) were significantly lower in post- than premenopausal groups, while FSH was higher (p < 0.0005). FSH correlated negatively (β = - 2.06, p < 0.0005) with total lean mass while E2 correlated positively (β = 20.0, p = 0.002) with BMD. Use of antiretroviral therapy (ART) correlated negatively with total fat mass (β = - 2.92, p = 0.008) and total bone mineral content (BMC; β = - 78.8, p = 0.003). Conclusions. The MT in this population is characterized by lower whole body lean mass and BMD in post- compared to premenopausal subjects but there are minimal differences in fat mass. Lower lean mass and BMD were associated with higher FSH and lower E2 serum levels, respectively. Use of ART was associated with lower fat mass and BMC. © 2015 Published by Elsevier Inc. Keywords: Body composition Obesity Menopause Lean muscle mass HIV-infection METABOLISM CLINICAL AND EXPERIMENTAL XX (2015) XXX – XXX Abbreviations: MT, menopause transition; BMD, bone mineral density; BMI, body mass index; BMC, bone mineral content; VAT, visceral adipose tissue; SAT, subcutaneous adipose tissue; FSH, follicle-stimulating hormone; E2, estradiol; DHEA, dehydroepiandrosterone; DHEAS, dehydroepiandrosterone sulfate; T, testosterone; SHBG, sex hormone-binding globulin; STRAW+10, stages of reproductive aging workshop; ART, antiretroviral therapy. ⁎ Corresponding author at: Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Johannesburg 2193, South Africa. Tel.: +27 11 885 1498, +27 82 852 485 (mobile); fax: +27 11 786 3169. E-mail address: nrj1@mweb.co.za (N.G. Jaff). http://dx.doi.org/10.1016/j.metabol.2015.05.009 0026-0495/© 2015 Published by Elsevier Inc. Available online at www.sciencedirect.com Metabolism www.metabolismjournal.com Please cite this article as: Jaff NG, et al, Body composition in the Study of Women Entering and in Endocrine Transition (SWEET): A perspective of African women who have a hig..., Metabolism (2015), http://dx.doi.org/10.1016/j.metabol.2015.05.009