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体重指数相似的绝经前和绝经后肥胖女性的体脂分布与心血管疾病风险因素

Body fat distribution and cardiovascular disease risk factors in pre- and postmenopausal obese women with similar BMI.

作者信息

Ozbey Nese, Sencer Ergin, Molvalilar Senay, Orhan Yusuf

机构信息

Department of Internal Medicine, Istanbul Faculty of Medicine, Capa, Turkey.

出版信息

Endocr J. 2002 Aug;49(4):503-9. doi: 10.1507/endocrj.49.503.

Abstract

The aim of this study is to determine the body fat distribution and cardiovascular disease risk factors in pre- and postmenopausal obese women matched for weight, height and body mass index (BMI). Study group consisted of 405 premenopausal overweight/obese (BMI > 27 kg/m2, mean 37.83 +/- 6.91 kg/m2) and 405 postmenopausal overweight/obese (BMI > 27 kg/m2), BMI-matched (mean 37.77 +/- 6.84 kg/m2) women. None of the women were on hormone replacement therapy. Insulin resistance was evaluated by "homeostasis model assessment" (HOMA) formula. Intraabdominal fat volume was calculated according to the following formula: IAF (L) = [(0.370 x abdominal sagittal diameter) - 4.85]. Age, waist circumference, waist to hip ratio (WHR) and intraabdominal fat volume were significantly higher in postmenopausals compared with BMI-matched premenopausal women (p < 0.001). Systolic and diastolic blood pressure, glucose, uric acid, cholesterol and triglyceride were significantly higher (p < 0.001) and HDL-cholesterol was significantly lower (p < 0.05) in postmenopausals. No significant differences were observed with respect to insulin and HOMA. When age-matched pre- and postmenopausal women were compared, only total cholesterol was significantly higher in the postmenopausal group. However, older postmenopausal women (> 50 years) had significantly higher systolic blood pressure, waist circumference, WHR, glucose and uric acid concentrations compared with younger (< or = 50 years) postmenopausals. It is concluded that an increase in abdominal fat accumulation and unfavorable alterations in risk factors disturb postmenopausal obese women even if total body weight and BMI do not change during menopause transition. Ageing, particularly throughout the postmenopausal years, has important effects on the detrimental changes associated with menopause.

摘要

本研究的目的是确定体重、身高和体重指数(BMI)相匹配的绝经前和绝经后肥胖女性的体脂分布及心血管疾病风险因素。研究组由405名绝经前超重/肥胖(BMI>27kg/m²,平均37.83±6.91kg/m²)和405名绝经后超重/肥胖(BMI>27kg/m²)、BMI相匹配(平均37.77±6.84kg/m²)的女性组成。所有女性均未接受激素替代疗法。采用“稳态模型评估”(HOMA)公式评估胰岛素抵抗。根据以下公式计算腹内脂肪量:IAF(L)=[(0.370×腹部矢状径)-4.85]。与BMI相匹配的绝经前女性相比,绝经后女性的年龄、腰围、腰臀比(WHR)和腹内脂肪量显著更高(p<0.001)。绝经后女性的收缩压和舒张压、血糖、尿酸、胆固醇和甘油三酯显著更高(p<0.001),而高密度脂蛋白胆固醇显著更低(p<0.05)。胰岛素和HOMA方面未观察到显著差异。当比较年龄相匹配的绝经前和绝经后女性时,仅绝经后组的总胆固醇显著更高。然而,与年龄较小(≤50岁)的绝经后女性相比,年龄较大(>50岁)的绝经后女性的收缩压、腰围、WHR、血糖和尿酸浓度显著更高。研究得出结论,即使在绝经过渡期总体重和BMI没有变化,但腹部脂肪堆积增加和风险因素的不利改变仍会困扰绝经后肥胖女性。衰老,尤其是在整个绝经后时期,对与绝经相关的有害变化具有重要影响。

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