Tamakoshi Koji, Yatsuya Hiroshi, Wada Keiko, Matsushita Kunihiro, Otsuka Rei, Yang Pei Ou, Sugiura Kaichiro, Hotta Yo, Mitsuhashi Hirotsugu, Takefuji Seiko, Kondo Takaaki, Toyoshima Hideaki
Department of Public Health/Health Information Dynamics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Clin Endocrinol (Oxf). 2007 Jan;66(1):65-71. doi: 10.1111/j.1365-2265.2006.02687.x.
To evaluate the influence of menopausal status on the serum adiponectin concentration and investigate whether the contribution of adiponectin to insulin resistance is modified by menopausal status.
We conducted a population-based, cross-sectional study of 207 premenopausal and 206 postmenopausal Japanese women.
Data on anthropometric characteristics, fasting serum adiponectin, glucose and insulin concentrations were used. Insulin resistance (homeostasis model assessment of insulin resistance: HOMA-IR) was calculated.
Postmenopausal women had significantly higher HOMA-IRs than premenopausal women [1.50 (1.42, 1.59) vs 1.18 (1.12, 1.24), geometric mean (1 standard error range), P = 0.005]. Paradoxically, adiponectin levels in postmenopausal women were also significantly higher than those in premenopausal women [10.3 (9.95, 10.7) vs 9.04 (8.71, 9.39), P = 0.028]. Multiple regression analysis showed that body mass index (BMI) was the only significantly independent predictor [standardized partial regression coefficients (sbeta) = 0.319, P < 0.001] for HOMA-IR among premenopausal women, whereas both BMI and adiponectin were the significant predictors among postmenopausal (sbeta = 0.334 and -0.141, P < 0.001 and < 0.05, respectively). When the subjects were restricted to those without metabolic disorders including high blood pressure, hypertriglyceridaemia, hypo-HDL cholesterolaemia and high fasting glucose, adiponectin (sbeta = -0.249, P < 0.05) was the only significant predictor for HOMA-IR among postmenopausal women but BMI was not significant (sbeta = 0.223, P = 0.075).
The transition to menopause increases serum adiponectin concentrations. And the significant and negative association between adiponectin and HOMA-IR was observed only after menopause. Therefore, adiponectin may play a role in the improvement of an incipient insulin-resistant state after, rather than before, menopause.
评估绝经状态对血清脂联素浓度的影响，并研究脂联素对胰岛素抵抗的作用是否因绝经状态而改变。
我们对207名绝经前和206名绝经后日本女性进行了一项基于人群的横断面研究。
使用人体测量特征、空腹血清脂联素、血糖和胰岛素浓度的数据。计算胰岛素抵抗（胰岛素抵抗稳态模型评估：HOMA-IR）。
绝经后女性的HOMA-IR显著高于绝经前女性[1.50（1.42，1.59）对1.18（1.12，1.24），几何平均数（1个标准误差范围），P = 0.005]。矛盾的是，绝经后女性的脂联素水平也显著高于绝经前女性[10.3（9.95，10.7）对9.04（8.71，9.39），P = 0.028]。多元回归分析显示，体重指数（BMI）是绝经前女性中HOMA-IR唯一显著的独立预测因素[标准化偏回归系数（sbeta）= 0.319，P < 0.001]，而在绝经后女性中，BMI和脂联素都是显著的预测因素（sbeta分别为0.334和 -0.141，P < 0.001和< 0.05）。当受试者仅限于没有包括高血压、高甘油三酯血症、低高密度脂蛋白胆固醇血症和高空腹血糖在内的代谢紊乱的人群时，脂联素（sbeta = -0.249，P < 0.05）是绝经后女性中HOMA-IR唯一显著的预测因素，但BMI不显著（sbeta = 0.223，P = 0.075）。
向绝经的转变会增加血清脂联素浓度。并且脂联素与HOMA-IR之间的显著负相关仅在绝经后才观察到。因此，脂联素可能在绝经后而非绝经前改善初期胰岛素抵抗状态中发挥作用。
