J Menopausal Med.  2016 Apr;22(1):14-19. 10.6118/jmm.2016.22.1.14.

The Association between Body Mass Index and Hot Flash in Midlife Women: A Meta-analysis

• Shobeiri F
• Jenabi E
• Poorolajal J
• Hazavehei

• KMID: 2200915
• DOI: http://doi.org/10.6118/jmm.2016.22.1.14

Abstract

OBJECTIVES
The association between body mass index (BMI) and hot flash risk has not been specifically clarifies yet. This meta-analysis was, therefore, conducted to estimate the association between overweight and obesity and hot flash risk.
METHODS
We searched PubMed, Web of Science, and Scopus for observational studies addressing the association between BMI and hot flash until August 2015. Data were independently extracted and analyzed using 95% odds ratio (OR), and confidence intervals (CI) based on the random-effects models.
RESULTS
We identified 2,244 references and conducted seven studies with 4,219 participants. The association between hot flash and overweight was estimated 1.13 (95% CI: 0.97-1.32) and that of obesity was estimated 1.79 (95% CI: 1.52-2.11). No evidence of heterogeneity and publication bias was observed.
CONCLUSION
This meta-analysis demonstrated that, though not to a great extent, obesity does increase the risk of hot flash. The findings from this meta-analysis indicated that obesity is associated with an increased risk of hot flash. Further large prospective cohort studies are required to provide convincing evidence as to whether or not BMI is associated with an increased risk of hot flashes.

Keyword

Body mass index; Case-control studies; Cohort studies; Hot flashes; Meta-analysis

MeSH Terms

Body Mass Index*
Case-Control Studies
Cohort Studies
Female
Hot Flashes
Humans
Obesity
Odds Ratio
Overweight
Population Characteristics
Prospective Studies
Publication Bias

Figure

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  Fig. 1 Flow of information through the different phases of the meta-analysis.

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  Fig. 2 Forest plot of the association between hot flash and overweight. CI: confidence interval.

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  Fig. 3 Forest plot of the association between hot flash and obesity. CI: confidence interval.

Reference

1. Whiteman MK, Staropoli CA, Benedict JC, Borgeest C, Flaws JA. Risk factors for hot flashes in midlife women. J Womens Health (Larchmt). 2003; 12:459–472.

2. Tan MN, Kartal M, Guldal D. The effect of physical activity and body mass index on menopausal symptoms in Turkish women: a cross-sectional study in primary care. BMC Womens Health. 2014; 14:38.

3. Freeman EW, Sherif K. Prevalence of hot flushes and night sweats around the world: a systematic review. Climacteric. 2007; 10:197–214.

4. Gallicchio L, Miller SR, Kiefer J, Greene T, Zacur HA, Flaws JA. Risk factors for hot flashes among women undergoing the menopausal transition: baseline results from the Midlife Women\'s Health Study. Menopause. 2015; 22:1098–1107.

5. Gold EB, Block G, Crawford S, Lachance L, FitzGerald G, Miracle H, et al. Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women\'s Health Across the Nation. Am J Epidemiol. 2004; 159:1189–1199.

6. Schilling C, Gallicchio L, Miller SR, Langenberg P, Zacur H, Flaws JA. Relation of body mass and sex steroid hormone levels to hot flushes in a sample of mid-life women. Climacteric. 2007; 10:27–37.

7. Whiteman MK, Staropoli CA, Langenberg PW, McCarter RJ, Kjerulff KH, Flaws JA. Smoking, body mass, and hot flashes in midlife women. Obstet Gynecol. 2003; 101:264–272.

8. Miller SR, Gallicchio LM, Lewis LM, Babus JK, Langenberg P, Zacur HA, et al. Association between race and hot flashes in midlife women. Maturitas. 2006; 54:260–269.

9. Freeman EW, Sammel MD, Grisso JA, Battistini M, Garcia-Espagna B, Hollander L. Hot flashes in the late reproductive years: risk factors for Africa American and Caucasian women. J Womens Health Gend Based Med. 2001; 10:67–76.

10. Gallicchio L, Miller SR, Kiefer J, Greene T, Zacur HA, Flaws JA. Change in body mass index, weight, and hot flashes: a longitudinal analysis from the midlife women's health study. J Womens Health (Larchmt). 2014; 23:231–237.

11. Gallicchio L, Visvanathan K, Miller SR, Babus J, Lewis LM, Zacur H, et al. Body mass, estrogen levels, and hot flashes in midlife women. Am J Obstet Gynecol. 2005; 193:1353–1360.

12. Bauman WA, Korsten MA, Radulovic M, Schilero GJ, Wecht JM, Spungen AM. 31st g. Heiner sell lectureship: secondary medical consequences of spinal cord injury. Top Spinal Cord Inj Rehabil. 2012; 18:354–378.

13. Schünemann HJ, Brożek J, Guyatt G, Oxman AD. GRADE handbook for grading quality of evidence and strength of recommendations. Orlando, FL: The GRADE Working Group;2013. cited by 2013 Oct 30. Available from: www.guidelinedevelopment.org/handbook.

14. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003; 327:557–560.

15. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315:629–634.

16. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50:1088–1101.

17. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986; 7:177–188.

18. Gallicchio L, Miller SR, Visvanathan K, Lewis LM, Babus J, Zacur H, et al. Cigarette smoking, estrogen levels, and hot flashes in midlife women. Maturitas. 2006; 53:133–143.

19. Gordis L. Epidemiology: with STUDENT CONSULT online access. 5th ed. Philadelphia, PA: Saunders;2014.

20. Klinga K, von Holst T, Runnebaum B. Influence of severe obesity on peripheral hormone concentrations in pre- and postmenopausal women. Eur J Obstet Gynecol Reprod Biol. 1983; 15:103–112.

21. Rice VM, Williams VR, Limback SD, Terranova PF. Tumour necrosis factor-alpha inhibits follicle-stimulating hormoneinduced granulosa cell oestradiol secretion in the human: dependence on size of follicle. Hum Reprod. 1996; 11:1256–1261.

22. Zachow RJ, Magoffin DA. Direct intraovarian effects of leptin: impairment of the synergistic action of insulin-like growth factor-I on follicle-stimulating hormone-dependent estradiol-17 beta production by rat ovarian granulosa cells. Endocrinology. 1997; 138:847–850.

23. Thurston RC, Sowers MR, Sutton-Tyrrell K, Everson-Rose SA, Lewis TT, Edmundowicz D, et al. Abdominal adiposity and hot flashes among midlife women. Menopause. 2008; 15:429–434.

24. Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015; 175:531–539.

25. Szmuilowicz ED, Manson JE. Menopausal vasomotor symptoms and cardiovascular disease. Menopause. 2011; 18:345–347.