Chunlin Dong,1,2,* Ding Ma,1– 3,* Ke Gu,4,* Yaying Lin,1 Jing Song,1 Yuan Wang,1 Jinjin Yu,1 Yanjun Zhou4 

1Department of Obstetrics and Gynecology, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China; 2Wuxi Medical College, Jiangnan University, Wuxi, People’s Republic of China; 3Key Laboratory of the Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 4Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yanjun Zhou, Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, People’s Republic of China, Email zyjmed@yeah.net Jinjin Yu, Department of Obstetrics and Gynecology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, People’s Republic of China, Email yujjwx@126.com

Purpose: The menopausal transition is accompanied by metabolic changes in women. This study explores the Chinese visceral adiposity index (CVAI) as a potential indicator of menopausal status to aid in disease prevention.
Patients and Methods: A cohort of 404 premenopausal Chinese women aged 45 years and above, from the China Health and Retirement Longitudinal Study (CHARLS), was included. CVAI was calculated from the 2011 survey data, menopausal status was collected in the 2018 survey, representing a 7-year longitudinal follow-up. The cross-sectional study cohort from the National Health and Nutrition Examination Survey (NHANES) included 3577 women aged 40– 60 with CVAI and self-reported menopausal status from 2003 to 2020. Logistic regression models were estimated the odds ratio (OR) of the menopause data and 95% confidence intervals (CIs).
Results: In the CHARLS cohort, the adjusted OR for menopause in the fourth quartile of CVAI compared to the first quartile was 5.23 (95% CI: 1.59, 17.17; P for trend: 0.005). Additionally, a significant difference in the association between menopausal status and CVAI was found between rural and urban populations (P for interaction = 0.029). Moreover, in the NHANES cohort, the CVAI and the menopausal status were associated after adjustment (OR: 1.02, 95% CI: 1.002, 1.037, P: 0.029). In the stratified analysis, the association of CVAI with the status of menopause was observed among other ethnicities which including Asians (OR: 1.092, 95% CI: 1.012, 1.178, P: 0.025). Finally, a nomogram was developed to facilitate the clinical assessment of menopause based on the CVAI.
Conclusion: The CVAI demonstrated a significant association with the odds of menopausal status in both Chinese and the US populations, suggesting its potential as a correlative marker for menopausal status, but the associational strength may vary by population.

Keywords: change of life, visceral adiposity, abdominal obesity, central obesity, menopausal transition, fat distribution