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健康绝经后女性的身体成分、功能和激素参数与生活质量之间的关系。

Relations between body composition, functional and hormonal parameters and quality of life in healthy postmenopausal women.

作者信息

Lebrun Corinne E I, van der Schouw Yvonne T, de Jong Frank H, Pols Huibert A P, Grobbee Diederick E, Lamberts Steven W J

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands; Department of Internal Medicine, Erasmus University Medical Center Rotterdam, The Netherlands.

出版信息

Maturitas. 2006 Aug 20;55(1):82-92. doi: 10.1016/j.maturitas.2006.01.008. Epub 2006 Feb 23.

Abstract

OBJECTIVE

To investigate whether body composition, functional status and serum hormone levels are associated with quality of life in healthy postmenopausal women.

DESIGN

A cross-sectional study among 402 women aged 56-73 years, 8-30 years postmenopausal. Quality of life (QoL) was assessed using the questionnaire on life satisfaction (QLS), with two modules directed at general factors (QLS-general) and health factors (QLS-health). Muscle strength was measured using dynamometry. Functional ability was estimated by physical performance (PPS), physical activity during the preceding year, and impairment in activities of daily living (ADL). Bone mineral density, lean mass and fat mass were assessed by dual-energy X-ray absorptiometry. Fasting levels of serum oestradiol, oestrone, and sex hormone-binding globulin (SHBG), testosterone, cortisol, androstenedione, DHEA and DHEAS, insulin-like growth factor (IGF-1), its binding proteins (IGFBP-1 and -3) and insulin, were determined.

RESULTS

Both QLS modules did not decrease with age. The major positive predictor of QLS-general module was the presence of a partner. Higher physical performance and higher educational level of participants' partners were significantly related to higher QLS-general, while smoking and presence of co-morbidities were significantly associated with a lower QLS-general. The determinants studied were mostly related to the QLS-health module, the major negative predictor of QLS-health being the presence of co-morbidities, followed by physical activity, physical performance and grip strength. Higher educational level of participants was related with higher QLS-health module, while higher BMI, fat mass and presence of disability were associated with significantly lower QLS-health. No consistent relation was found between serum levels of hormones measured and both QLS modules.

CONCLUSIONS

The most important and specific determinant for psychological well-being was having a partner. Physical and psychological well-being are further strongly associated in this population of healthy postmenopausal women below 75 years of age, while increasing fat mass was related to decreased well-being. Our results suggest that in elderly and late postmenopausal women hormonal factors do not predict quality of life.

摘要

目的

探讨身体组成、功能状态和血清激素水平是否与健康绝经后女性的生活质量相关。

设计

对402名年龄在56 - 73岁、绝经8 - 30年的女性进行横断面研究。使用生活满意度问卷(QLS)评估生活质量(QoL),该问卷有两个模块,分别针对一般因素(QLS - 一般)和健康因素(QLS - 健康)。使用握力计测量肌肉力量。通过身体表现(PPS)、前一年的身体活动以及日常生活活动(ADL)受损情况来评估功能能力。采用双能X线吸收法评估骨矿物质密度、瘦体重和脂肪量。测定血清雌二醇、雌酮、性激素结合球蛋白(SHBG)、睾酮、皮质醇、雄烯二酮、脱氢表雄酮(DHEA)和硫酸脱氢表雄酮(DHEAS)、胰岛素样生长因子(IGF - 1)及其结合蛋白(IGFBP - 1和 - 3)以及胰岛素的空腹水平。

结果

两个QLS模块均未随年龄增长而下降。QLS - 一般模块的主要正向预测因素是有伴侣。参与者伴侣的身体表现较高和教育水平较高与较高的QLS - 一般显著相关,而吸烟和存在合并症与较低的QLS - 一般显著相关。所研究的决定因素大多与QLS - 健康模块相关,QLS - 健康的主要负向预测因素是存在合并症,其次是身体活动、身体表现和握力。参与者的教育水平较高与较高的QLS - 健康模块相关,而较高的BMI、脂肪量和残疾的存在与显著较低的QLS - 健康相关。在所测血清激素水平与两个QLS模块之间未发现一致的关系。

结论

心理幸福感的最重要且特定的决定因素是有伴侣。在这群75岁以下的健康绝经后女性中,身体和心理幸福感进一步密切相关,而脂肪量增加与幸福感降低相关。我们的结果表明,在老年和绝经后期女性中,激素因素不能预测生活质量。

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