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miR-34a is less highly expressed in the liver than miR-122 but is upregulated in the liver of MASLD patients compared to controls [296, 297]
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Beyond hormonal changes, several interconnected factors may contribute to perimenopausal weight gain: Metabolic slowdown : Basal metabolic rate naturally decreases with age, meaning the body burns fewer calories at rest Muscle mass loss : Sarcopenia (age-related muscle loss) accelerates during perimenopause, further reducing metabolic rate Sleep disruption : Night sweats and insomnia, common perimenopausal symptoms, interfere with hormones regulating appetite and glucose metabolism Mood changes : Anxiety, depression, and stress during this transition may lead to emotional eating patterns Reduced physical activity : Fatigue, joint pain, and other symptoms may decrease exercise tolerance Research suggests women may gain weight gradually during perimenopause, though individual experiences vary considerably
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