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脂滴蓄积产物(LAP)与绝经后妇女的雄激素性和心血管危险因素有关。

Lipid accumulation product (LAP) is related to androgenicity and cardiovascular risk factors in postmenopausal women.

机构信息

Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.

出版信息

Maturitas. 2011 Dec;70(4):395-9. doi: 10.1016/j.maturitas.2011.09.012. Epub 2011 Oct 22.

Abstract

OBJECTIVES

To investigate whether lipid accumulation product (LAP) is related to androgen and sex hormone binding globulin (SHBG) levels and to cardiovascular risk factors in postmenopausal women with no evidence of established cardiovascular disease.

STUDY DESIGN

Cross-sectional study.

MAIN OUTCOME MEASURES

LAP (waist-58 × triglycerides [nmol/L]), LAP ≥ arbitrary cutoff point of 34.5, serum testosterone, SHBG, ultrasensitive C-reactive protein (us-CRP).

RESULTS

Forty-nine women (mean age 55±5 years; median amenorrhea time 5.5 years [3-8]) were studied: 14% had the metabolic syndrome and 24.5% were hypertensive. Compared with LAP<34.5, LAP ≥ 34.5 (n=29, 59%) was associated with higher testosterone (p=0.021) and free androgen index (FAI) (p=0.003) and lower SHBG levels (p=0.013). Us-CRP (p=0.012), total cholesterol (p=0.041), glucose (p=0.020) and homeostasis model assessment (HOMA) (p=0.019) were higher, and high-density lipoprotein cholesterol (HDL-C) (p=0.001) was lower with LAP ≥ 34.5. LAP was positively correlated with total testosterone (r=0.349, p=0.014), FAI (rs=0.470, p=0.001), us-CRP (r=0.315, p=0.042), systolic (r=0.318, p=0.028) and diastolic (r=0.327, p=0.023) blood pressure, total cholesterol (r=0.498, p<0.001) and glucose (rs=0.319, p=0.026). LAP was negatively correlated with SHBG (rs=-0.430, p=0.003) and HDL-C (r=-0.319, p=0.026).

CONCLUSIONS

LAP index seems to be associated with androgens and SHBG and with cardiovascular risk factors in postmenopausal women. Also, LAP seems to be a suitable method to screen for cardiovascular risk in postmenopause.

摘要

目的

探讨脂联素(LAP)与雄激素和性激素结合球蛋白(SHBG)水平及绝经后无明确心血管疾病女性心血管危险因素的关系。

研究设计

横断面研究。

主要观察指标

LAP(腰围-58×甘油三酯[nmol/L])、LAP≥任意截断点 34.5、血清睾酮、SHBG、超敏 C 反应蛋白(us-CRP)。

结果

共 49 名女性(平均年龄 55±5 岁;中位绝经时间 5.5 年[3-8])纳入研究:14%患有代谢综合征,24.5%为高血压。与 LAP<34.5 相比,LAP≥34.5(n=29,59%)与更高的睾酮(p=0.021)和游离雄激素指数(FAI)(p=0.003)以及更低的 SHBG 水平相关(p=0.013)。us-CRP(p=0.012)、总胆固醇(p=0.041)、葡萄糖(p=0.020)和稳态模型评估(HOMA)(p=0.019)升高,高密度脂蛋白胆固醇(HDL-C)(p=0.001)降低。LAP 与总睾酮(r=0.349,p=0.014)、FAI(rs=0.470,p=0.001)、us-CRP(r=0.315,p=0.042)、收缩压(r=0.318,p=0.028)和舒张压(r=0.327,p=0.023)、总胆固醇(r=0.498,p<0.001)和葡萄糖(rs=0.319,p=0.026)呈正相关。LAP 与 SHBG(rs=-0.430,p=0.003)和 HDL-C(r=-0.319,p=0.026)呈负相关。

结论

LAP 指数似乎与绝经后女性的雄激素和 SHBG 以及心血管危险因素相关,同时,LAP 似乎是绝经后筛查心血管风险的一种合适方法。

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