Midlife CRP increases track fat mass rather than menopause
Adjusted for body mass, menopause stage showed no link to CRP, whereas each kg/m² increase in fat mass index raised CRP by 23%.
Research Square
In a multi-ethnic cohort of 1,681 women followed for over two decades from 1996 to 2018, researchers investigated the drivers of midlife increases in C-reactive protein (CRP), a circulating marker of chronic inflammation. Using individual fixed effects analysis across repeated measurements, the authors found that menopause stage was not associated with changes in CRP after adjusting for body mass index (BMI).
Instead, rising CRP levels were driven by gains in body mass and adiposity. Every 1 kg/m² within-woman increase in BMI was linked to a 16% rise in serum CRP, while each 1 kg/m² increase in fat mass index was tied to a 23% rise. The association between fat mass index and CRP did not differ by race or ethnicity, though it was modestly smaller in natural (20%) and surgical postmenopause (15%) compared with premenopause (22%).
Why it matters
Systemic chronic inflammation increases with age and contributes to midlife cardiovascular risk. These results suggest that midlife inflammatory surges in women are primarily driven by changes in adiposity rather than the hormonal stages of reproductive aging.
Caveats
The findings rely on observational cohort data, which cannot establish causality, and the study is a preprint that has not yet undergone peer review.
The paper
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Samar El Khoudary, Sherri-Ann Burnett-Bowie, Carrie Karvonen-Gutierrez, Sybil Crawford,University of California, Los Angeles
Research Square · 29 Sep 2026 · Preprint, not peer-reviewed