Schianca G P Carnevale, Castello L, Rapetti R, Limoncini A, Bartoli E
Internal Medicine, Dipartimento di Scienze Mediche, Università del Piemonte Orientale A. Avogadro, Ospedale Maggiore della Carità, Via Solaroli, 17, 28100 Novara, Italy.
Nutr Metab Cardiovasc Dis. 2006 Jul;16(5):339-44. doi: 10.1016/j.numecd.2005.05.004. Epub 2005 Oct 6.
To verify whether age and the perimenopausal state may herald the onset of the metabolic syndrome (MS) in females as compared to age-matched males, we studied subjects with normal glucose tolerance, according to ADA definition.
In 368 eligible subjects subdivided into three age groups we measured insulin sensitivity by ISI-glycaemia, resistance by HOMA-IR, computed, during OGTT, from fasting and 2-h post-load plasma insulin and glucose concentrations. The significance of differences was tested between different age groups and between males and females within corresponding age groups. Insulin sensitivity fell slightly and insulin resistance rose significantly in the perimenopausal group as compared to younger and older female patients, and compared to men of the same age. This pattern remains after excluding patients with high blood pressure, and after adjusting for WHR and BMI by multivariate analysis. HOMA-IR averaged 2.9+/-1.8 in females, 2.2+/-1.2 in men aged 45-54 years (p<0.02), while in the other age groups insulin resistance was higher in men.
The onset of MS during the menopause is associated with a physiological shift in insulin resistance occurring even in normal glucose tolerant subjects, suggesting that it may depend upon critical metabolic changes occurring specifically in that age period.
为了验证与年龄匹配的男性相比，年龄和围绝经期状态是否可预示女性代谢综合征（MS）的发病，我们根据美国糖尿病协会（ADA）的定义，对糖耐量正常的受试者进行了研究。
在368名符合条件的受试者中，将其分为三个年龄组，我们通过血糖胰岛素敏感指数（ISI-血糖）测量胰岛素敏感性，通过稳态模型评估胰岛素抵抗（HOMA-IR）来计算胰岛素抵抗，在口服葡萄糖耐量试验（OGTT）期间，根据空腹和负荷后2小时的血浆胰岛素和葡萄糖浓度进行计算。对不同年龄组之间以及相应年龄组内的男性和女性之间的差异显著性进行了检验。与年轻和年长的女性患者相比，以及与同年龄的男性相比，围绝经期组的胰岛素敏感性略有下降，胰岛素抵抗显著上升。在排除高血压患者后，以及通过多变量分析对腰臀比（WHR）和体重指数（BMI）进行校正后，这种模式仍然存在。45 - 54岁的女性HOMA-IR平均为2.9±1.8，男性为2.2±1.2（p<0.02），而在其他年龄组中，男性的胰岛素抵抗更高。
绝经期间MS的发病与胰岛素抵抗的生理变化有关，即使在糖耐量正常的受试者中也是如此，这表明它可能取决于在该特定年龄阶段发生的关键代谢变化。
