Lebrun Corinne E I, van der Schouw Yvonne T, de Jong Frank H, Grobbee Diederick E, Lamberts Steven W
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Menopause. 2006 May-Jun;13(3):474-81. doi: 10.1097/01.gme.0000222331.23478.ec.
Few studies have investigated the relationships between body composition, functional ability, and age-related disability in postmenopausal women. We investigated the relative role of fat mass, lean mass, and muscle strength in the development of disability in a group of healthy postmenopausal women younger than 75 years.
We performed a cross-sectional study among 396 independently living women aged 56-73 years, randomly selected between 8 and 30 years after menopause. Lean mass and fat mass were assessed by dual-energy x-ray absorptiometry. Muscle strength (grip and leg extensors) was assessed using dynamometry. Functional ability was estimated by Physical Performance Score, physical activity during the preceding year, and impairment in activities of daily living.
Of the participants, 43.7 % were overweight (25 > or = BMI < 30 kg/m2), and 17.7% were obese (BM I > or = 30 kg/m2). Higher muscle strength was observed with increasing lean body mass, and participants with higher muscle strength scored better in the physical performance score and activities of daily living. Higher fat mass was significantly associated with a lower physical performance score, lower physical activity, and a higher frequency of disability. Increasing fat mass was associated with increasing lean mass and decreasing lean/fat ratio. The increase in lean mass and muscle strength associated with higher fat mass was mainly localized in the legs.
Our results support the role of fat mass as the primary risk marker for disability, which might later accelerate by the age-related decrease in lean mass and the development of sarcopenia after the age of 75 years.
很少有研究调查绝经后女性的身体成分、功能能力与年龄相关残疾之间的关系。我们研究了一组年龄小于75岁的健康绝经后女性中，脂肪量、瘦体重和肌肉力量在残疾发展中的相对作用。
我们对396名年龄在56 - 73岁之间独立生活的女性进行了横断面研究，这些女性是在绝经后8至30年随机选取的。通过双能X线吸收法评估瘦体重和脂肪量。使用测力计评估肌肉力量（握力和腿部伸肌力量）。通过身体表现评分、前一年的身体活动以及日常生活活动能力受损情况来评估功能能力。
参与者中，43.7%超重（25≤体重指数<30kg/m²），17.7%肥胖（体重指数≥30kg/m²）。随着瘦体重增加，观察到肌肉力量增强，肌肉力量较高的参与者在身体表现评分和日常生活活动中的得分更高。较高的脂肪量与较低的身体表现评分、较低的身体活动水平以及较高的残疾发生率显著相关。脂肪量增加与瘦体重增加和瘦/脂比降低相关。与较高脂肪量相关的瘦体重和肌肉力量增加主要集中在腿部。
我们的结果支持脂肪量作为残疾主要风险标志物的作用，在75岁以后，随着年龄相关的瘦体重下降和肌肉减少症的发展，这种风险可能会加速。
