Increased systemic inflammation and altered distribution of T-cell subsets in postmenopausal women

Aim To investigate markers of systemic inflammation in pre- and postmenopausal women and identify possible predictors of systemic inflammation with menopause. Methods Cross-sectional study of 69 healthy women between 45- and 60 years. Blood samples were collected to assess leukocyte subsets and plasma cytokines. MRI and DXA scans were performed to assess body composition. Through uni- and multivariate analyses, follicle-stimulating hormone (FSH), visceral fat mass and age were evaluated as predictors of systemic inflammation in relation to menopause. Results Postmenopausal women tended to have higher leukocyte counts (5.4 x10(9)vs. 4.9 x10(9)cells/l, p = 0.05) reflected in increased total lymphocytes (1.8 x10(9)vs. 1.6 x10(9)cells/l, p = 0.01) and monocytes (0.5 x10(9)vs. 0.4 x10(9)cells/l, p = 0.02), compared to premenopausal women. Increased visceral fat mass was a strong predictor of high leukocyte subsets. Postmenopausal women had higher plasma TNF-alpha (2.24 vs. 1.91 pg/ml, p = 0.01) and IL-6 (0.45 vs. 0.33 pg/ml, p = 0.004) compared to premenopausal women and high FSH was a significant predictor of increased plasma TNF-alpha, IL-1 beta and IL-6. Menopause was further associated with increased T-cells (1,336 vs. 1,128 cells/mu l, p = 0.04) reflected in significantly higher counts of exhausted-, senescent-, and memory CD4+ T-cell subsets. Conclusions Menopause is associated with increased systemic inflammation as well as exhausted- and senescent T-cells. We suggest, that both increased visceral fat mass and declining sex hormone levels might contribute to postmenopausal systemic inflammation and calls for further large-scale studies to confirm these findings.