习惯性体力活动对接受激素治疗的早绝经后妇女身体成分、脂肪分布和代谢变量的影响。

Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.

Eur J Obstet Gynecol Reprod Biol. 2010 May;150(1):52-6. doi: 10.1016/j.ejogrb.2010.02.007. Epub 2010 Feb 26.

OBJECTIVE

To determine whether there is an association between the level of habitual physical activity, body composition and anthropometric and metabolic variables in postmenopausal patients before and after hormone replacement therapy (HRT).

STUDY DESIGN

Thirty-four healthy, recent postmenopausal women (50+/-2.7 years; 23.8+/-10 months since menopause) consulting for symptoms of estrogen deficiency were included in the study. Anthropometric assessment, percent of body fat (BF) estimated by skinfold measures, and metabolic evaluation were performed before and 4 months after the start of HRT, which included non-oral or low-dose oral preparations. The status of physical activity was defined by counting steps with a pedometer. Patients were stratified as active (6000 steps ore more per day) or inactive (fewer than 6000 steps per day). Results are expressed as mean+/-SD or median and interquartile range. log 10 transformation was used to normalize the distribution of non-Gaussian variables. ANOVA for repeated measures was performed for the active and inactive groups, before and after HT. Pearson correlation coefficient was used to investigate the relationship between anthropometric and metabolic variables and habitual physical activity.

RESULTS

BMI and BF did not change with HRT in comparison with baseline. In contrast, a decline was observed in waist circumference (WC) and waist to hip ratio (WHR) after HRT in both active and inactive women (P<0.01). While triglycerides and glucose did not change after HRT, total and LDL-cholesterol decreased from baseline. In contrast, after HRT, active patients were found to have lower BF than inactive women (active: 25.4+/-2.5; inactive: 26.6+/-2, P=0.01). There was a significant negative correlation between habitual physical activity (number of steps per day) and BF (r=-0.36, P=0.04). After HRT, when only active patients were considered, a significant negative correlation was found between the number of steps and WC (r=-0.42, P=0.04) and WHR (r= -0.58, P=0.03).

CONCLUSION

Habitual physical activity plays a major role in preserving a favorable cardiovascular profile in postmenopausal patients using HRT.

目的

确定绝经后妇女在接受激素替代疗法（HRT）前后，习惯性体力活动水平、身体成分以及人体测量学和代谢变量之间是否存在关联。

研究设计

本研究纳入了 34 名健康、近期绝经的妇女（50+/-2.7 岁；绝经后 23.8+/-10 个月），她们因雌激素缺乏症状就诊。在开始 HRT 前和 4 个月时进行人体测量评估、皮褶厚度估计的体脂肪百分比（BF）和代谢评估。HRT 包括非口服或低剂量口服制剂。通过计步器计算步数来定义体力活动状态。患者分为活跃组（每天 6000 步或更多）或不活跃组（每天少于 6000 步）。结果以平均值+/-标准差或中位数和四分位距表示。对非正态分布变量进行对数 10 转换。对活跃组和不活跃组进行重复测量方差分析，比较 HRT 前后的结果。采用 Pearson 相关系数分析人体测量学和代谢变量与习惯性体力活动之间的关系。

结果

与基线相比，HRT 并未导致 BMI 和 BF 发生变化。相反，在活跃和不活跃的女性中，HRT 后腰围（WC）和腰臀比（WHR）均下降（P<0.01）。HRT 后甘油三酯和血糖没有变化，但总胆固醇和 LDL 胆固醇从基线开始下降。相反，HRT 后，活跃患者的 BF 低于不活跃女性（活跃：25.4+/-2.5；不活跃：26.6+/-2，P=0.01）。习惯性体力活动（每天步数）与 BF 之间存在显著负相关（r=-0.36，P=0.04）。HRT 后，仅考虑活跃患者时，每天步数与 WC（r=-0.42，P=0.04）和 WHR（r=-0.58，P=0.03）之间存在显著负相关。