Markers of compromised gut epithelial barrier integrity increase during the menopause transition

BACKGROUNDIn female murine models, one source of inflammation is a menopause-related increase in gut permeability. We examined whether the menopause transition (MT) in women is associated with an increase in markers of gut epithelial dysfunction and gut microbial product translocation, signals of compromised gut epithelial barrier integrity.METHODSIn 964 women, we measured markers of gut epithelial dysfunction (fatty acid binding protein 2, FABP2) and gut microbial antigen translocation (soluble CD14, sCD14) using sera collected before, during, and after the MT. Multivariable mixed effects regressions fit piecewise linear models to repeated FABP2 or sCD14 measures relative to time from final menstrual period (FMP). Covariates were age at FMP, race and ethnicity, and BMI.RESULTSFABP2 and sCD14 did not change significantly until 2.5 years pre-FMP. At that point, FABP2 began rising; sCD14 began increasing 6 months later. FABP2 and sCD14 peaked 6 and 6.5 years after FMP, respectively; subsequent levels remained stable. During the ~9-year interval of MT-related gain in gut barrier compromise markers, annual FABP2 and sCD14 increases were 2.6% (95% CI: 1.7% to 3.4%) and 0.8% (95% CI: 0.6% to 1.1%), respectively, among White women with sample-average BMI and age at FMP. FABP2 and sCD14 change rates did not differ significantly by race and ethnicity, BMI, or age at FMP.CONCLUSIONThe MT is associated with a rise in markers of compromised gut barrier integrity, suggesting that this pathway of inflammation, previously described in animal models, occurs in humans.FUNDINGNIH U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, U19AG063720, 5R01AR081794, R01AR075729.