Weill-Cornell Medical Center and Memorial Sloan-Kettering Cancer Center, New York 10065, USA.
Semin Reprod Med. 2010 Sep;28(5):426-34. doi: 10.1055/s-0030-1262902. Epub 2010 Sep 23.
The incidence of metabolic syndrome increases substantially during perimenopause and early menopause. Postmenopausal women are at a higher risk of hypertension, proatherogenic lipid changes, diabetes, and severe cardiovascular disease as compared with their premenopausal counterparts. Whether or not menopause has a causative contribution to the deteriorating metabolic profile that is independent of chronological aging has been a subject of many studies. Menopausal transition is associated with significant weight gain (2 to 2.5 kg over 3 years on average), which is not dissimilar to that in premenopausal women of like age. Concomitantly, there is an increase in abdominal adiposity and a decrease in energy expenditure, phenomena that have been postulated to explain the higher risk of metabolic syndrome and increases in cholesterol and triglycerides. Hypertension and diabetes become more prevalent with age and should be timely diagnosed and treated. Lifestyle changes including moderately decreased caloric intake and aerobic exercise could prevent proatherogenic changes and weight gain observed with aging. Accurate prediction of cardiovascular risk in midlife women is essential to help identify the subset of women who are likely to benefit from intensive management of metabolic risk factors. This review focuses on metabolic changes associated with menopausal transition, specifically alterations in weight, waist circumference, body fat distribution, energy expenditure, and circulating biomarkers including adipokines.
绝经前期和绝经早期，代谢综合征的发病率显著增加。与绝经前女性相比，绝经后女性患高血压、动脉粥样硬化前脂质变化、糖尿病和严重心血管疾病的风险更高。绝经是否对独立于年龄增长的代谢谱恶化有因果贡献一直是许多研究的主题。绝经过渡期与显著的体重增加（平均 3 年内增加 2 至 2.5 公斤）有关，与同龄的绝经前女性相似。同时，腹部脂肪增加，能量消耗减少，这些现象被认为可以解释代谢综合征风险增加以及胆固醇和甘油三酯升高的原因。随着年龄的增长，高血压和糖尿病变得更加普遍，应及时诊断和治疗。生活方式的改变，包括适度减少热量摄入和有氧运动，可以预防与衰老相关的动脉粥样硬化变化和体重增加。准确预测中年女性的心血管风险对于确定可能受益于代谢危险因素强化管理的女性亚组至关重要。本综述重点关注与绝经过渡期相关的代谢变化，特别是体重、腰围、体脂肪分布、能量消耗以及包括脂肪因子在内的循环生物标志物的变化。
