Obstet Gynecol Sci.  2022 Sep;65(5):468-476. 10.5468/ogs.22001.

Body fat distribution and insulin resistance among Korean middle-aged women: a Korean National Health and Nutrition Examination Survey

  • 1Department of Obstetrics and Gynecology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • 2Department of Biostatistics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea


To evaluate menopause-related changes in body fat distribution and their relationship with insulin resistance in middleaged Korean women.
We analyzed women aged 40-60 years using data from the National Health and Nutrition Examination Survey conducted from 2008 to 2011. Body fat was measured using dual-energy X-ray absorptiometry. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR).
Among 3,468 participants, menopausal women (n=1,489) had a higher body mass index (BMI) and higher trunk, arm, and head fat percentages than premenopausal women (n=1,979). However, no significant difference was found in the leg fat percentage according to menopausal status. Multivariable regression analysis for HOMA-IR showed that trunk fat percentage, BMI, and waist circumference positively correlated with insulin resistance and leg fat percentage negatively correlated after adjusting for several confounding factors, whereas menopausal status was not associated with HOMAIR.
Middle-aged women not only have different body weights and BMI but also have different body fat distributions according to menopausal status. Each fat percentage change in the trunk and leg is differently associated with metabolic health, particularly insulin resistance. To evaluate the metabolic health of middle-aged women, BMI is generally noted; however, body fat distribution, which can be easily assessed using dual-energy X-ray absorptiometry, should also be considered.


Body fat distribution; Absorptiometry; dual-energy X-ray; Insulin resistance; The homeostatic model assessment index; Menopause


  • Fig. 1 Comparison of body fat percentages between premenopausal and postmenopausal middle-aged Korean women. *P-value <0.05.



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