Menopause is defined as the absence of menstrual periods for twelve consecutive months. Although the onset may vary, natural menopause occurs between the ages of 45 and 55 and is considered a stage in the aging process for women. Menopause is a stage strongly conditioned by hormonal modulations with effects on the cardiovascular system associated with abdominal obesity, insulin resistance, decreased energy expenditure, endothelial dysfunction, hypertension, and dyslipidemia. Furthermore, an increase in the production of proinflammatory cytokines involved in numerous pathologies such as osteoporosis has been observed. The results of several studies suggest that intestinal microbiota (IM) profile may be related to menopause condition by several means, although the data are stil inconclusive. Estrogen reduction leads to a progressive loss of bone density, a reduction in the bone formation/resorption balance and an increased risk of bone fractures among postmenopausal women. Recently, the alternative to estrogen therapies to reduce the risk of fractures are nutritional strategies fundamentally based on the use of probiotics, whose effect are associated with beneficial modulations of IM. SHE-HEALTH is a study in which, in a cohort of postmenopausal women, metabolomics, transcriptomics and metagenomics will be combined with the analysis of usual anthropometric and clinical biomarkers and also with genetic and epigenetic analyses to identify population groups (clusters). This study will allow establishing solid scientific bases to define, in future projects, effective nutritional strategies based on group nutrition in postmenopausal women. The main objective of the present study is to obtain clusters of postmenopausal women, identifying metabotypes (similar metabolic profiles) and enterotypes (similar IM profiles), and combining complementary variables such as classical anthropometric, biochemical and clinical biomarkers. The secondary objectives of the study are to characterize: 1) The genetic profile of the study cohort; 2) The epigenetic profile of the study cohort; 3) The gene expression profile of the study cohort.
Cross-sectional observational study in which samples of blood, faeces, urine, hair and hair follicles will be collected to characterize the metabolic profile, intestinal microbiota (IM), gene expression profile, genetic and epigenetic profile of postmenopausal women. Data on lifestyle habits, anthropometric measurements and nutritional and hormonal status will also be collected. The study will be conducted in a cohort of 200 postmenopausal women. Each volunteer will make 2 visits: * A pre-selection visit (to check inclusion/exclusion criteria) (V0) and, if the inclusion criteria are met, * A study visit (V1) in which samples will be collected from faeces, urine, blood, hair and hair follicles. In V1, the participants must present themselves fasting for 8 hours to obtain blood and urine collected during the last 24 hours. In addition, during the visit the sample of hair and hair follicles will be collected. Participants are given a basic guide of healthy eating and lifestyle recommendations suitable for postmenopausal stage.
Study Type
OBSERVATIONAL
Enrollment
200
No intervention will be done
Eurecat
Reus, Spain
Metabolomics in serum
Non-targeted metabolomics of serum samples measured using proton nuclear magnetic resonance. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Metabolomics in erythrocytes
Non-targeted metabolomics of erythrocytes samples measured using proton nuclear magnetic resonance. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Metabolomics in urine
Non-targeted metabolomics of urine samples measured using proton nuclear magnetic resonance. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Metagenomics in faeces
Faecal intestinal microbiota analysis will be done by 16sRNA sequencing. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum hsCRP levels
Serum hsCRP levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum IL-6 levels
Serum IL-6 levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum TNFalpha levels
Serum TNFalpha levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum BALP levels
Serum BALP levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum osteocalcin levels
Serum osteocalcin levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum TRAP5b levels
Serum TRAP5b levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum CTX-I levels
Serum CTX-I levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum PINP levels
Serum PINP levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum FSH levels
Serum FSH levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum 17beta E2 levels
Serum 17beta E2 levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum inhibin B levels
Serum inhibin B levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum testosterone levels
Serum testosterone levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum AMH levels
Serum AMH levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum SHBG levels
Serum SHBG levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum triglycerides levels
Serum triglycerides levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum total cholesterol levels
Serum total cholesterol levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum LDL-cholesterol levels
Serum LDL-cholesterol levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum HDL-cholesterol levels
Serum HDL-cholesterol levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum glucose levels
Serum glucose levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum insulin levels
Serum insulin levels will be measured by Cobas Mira Plus autoanalyzer (Roche Diagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Homeostatic Model Assessment from Insulin Resistance index (HOMA-IR)
HOMA-IR will be calculated using serum glucose and insulin levels. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum ALT levels
Serum ALT levels will be measured by Cobas Mira Plus autoanalyzer (RocheDiagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum AST levels
Serum AST levels will be measured by Cobas Mira Plus autoanalyzer (RocheDiagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum creatinine levels
Serum creatinine levels will be measured by Cobas Mira Plus autoanalyzer (RocheDiagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum uric acid levels
Serum uric acid levels will be measured by Cobas Mira Plus autoanalyzer (RocheDiagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Serum urea levels
Serum urea levels will be measured by Cobas Mira Plus autoanalyzer (RocheDiagnostics Systems, Madrid, Spain). Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Urine 8-OHdG levels
Urine 8-OHdG levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Urine F2-isoprostanes levels
Urine F2-isoprostanes levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Urine NTX levels
Urine NTX levels will be measured by human ELISA kits. Data will be analysed together with the other primary outcomes for cluster identification. Data will be scaled using unit variance scaling. Principal components analysis, Partial Least-Squares Discriminant Analysis and hierarchical clustering will be used to identify clusters and to detect differences among metabotypes. The quality of the model will be judged by the goodness-of-fit parameter, the predictive ability parameter and cross-validation test.
Time frame: At day 1
Body weight
Body weight measured by TANITA SC 330 S portable scale (Peroxfarma, Barcelona, Spain) .
Time frame: At day 1
Height
Height measured by TANITA Leicester Portable (Tanita Corp., Barcelona, Spain)
Time frame: At day 1
Body mass index
Weight and height will be combined to report body mass index in kg/m\^2
Time frame: At day 1
Waist circumference
Waist circumference will be measured using a 150 cm anthropometric steel measuring tape
Time frame: At day 1
Blood pressure (in mmHg)
Systolic and diastolic pressure will be measured twice after 2-5 minutes of patient respite, seated, with one minute interval in between, using an automatic sphygmomanometer (OMRON HEM-907; Peroxfarma, Barcelona, Spain).
Time frame: At day 1
Waist circumference to height ratio
Waist circumference and height will be combined to report waist circumference to height ratio.
Time frame: At day 1
Body composition
Body fat mass and body lean mass will be measured using TANITA SC 330 S Body Composition Analyzer (Peroxfarma, Barcelona, Spain)
Time frame: At day 1
Dietary intake
Dietary intake will be measured using 3-day dietary record.
Time frame: At day 1
Transcriptomics analysis in hair follicles.
Transcriptomics analysis in hair follicles samples will be done by RNA-seq.
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Time frame: At day 1
Transcriptomics analysis in total blood.
Transcriptomic analysis will be performed with blood samples collected in PAXgene tubes by microarray technology (Agilent Technologies). This analysis will be carried out with a sub-cohort of post-menopausal women from each of the different clusters obtained with a total of 64 samples.
Time frame: At day 1
MicroRNAs analysis in total blood.
MicroRNAs will be analyzed in blood samples collected in PAX gene tubes using RNA-seq technology. This analysis will be carried out with a sub-cohort of post-menopausal women from each of the different clusters obtained with a total of 64 samples.
Time frame: At day 1
DNA methylation analysis in total blood.
DNA methylation analysis will be performed with blood samples collected in PAXgene tubes by bisulfite conversion of the DNA combined with targeted amplification of regions of interest, library construction and next-generation sequencing. This analysis will be carried out with a sub-cohort of post-menopausal women from each of the different clusters obtained with a total of 64 samples.
Time frame: At day 1