Department of Medicine, Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan 48109-5429, USA.
J Womens Health (Larchmt). 2012 Aug;21(8):872-7. doi: 10.1089/jwh.2012.3549. Epub 2012 Jun 25.
No longitudinal studies have examined how iron measures change over menopause. Our objectives were to examine iron measures in individual women at premenopause and at postmenopause and, secondarily, to determine if any changes contributed to insulin resistance.
In a subset of participants (n=70) in a longitudinal study of menopause, we measured ferritin, transferrin, and soluble transferrin receptor (sTfR) once in the premenopause and once in the postmenopause. We also examined associations between menopausal status and change in iron markers after adjustment for age at menopause, race/ethnicity, and waist circumference. In linear regression models, we examined associations between premenopause iron measures and changes in iron markers over menopause with homeostasis model assessment of insulin resistance (HOMA-IR) changes over menopause, before and after adjustment for age at menopause, race/ethnicity, changes in waist circumference, C-reactive protein (CRP), and sex hormone-binding globulin (SHBG) levels.
Women had lower ferritin (p<0.01), higher sTfR:ferritin levels (p<0.01), lower HOMA-IR (p=0.022), and lower glucose (p=0.05) in premenopause compared to postmenopause. After adjustment, lower premenopausal iron levels (sTfR:ferritin levels β=11.0, 95% confidence interval [CI] 0.017-22.0) and larger increases in iron over menopause (changes in sTfR:ferritin β=13.6, 95% CI 0.93-26.3) were associated with larger increases in HOMA-IR.
From premenopause to postmenopause, women on average have increases in measures of iron stores. Women who had the greatest changes in iron over menopause (lower measures of premenopausal iron and greater increases in iron measures over the menopause) had the strongest associations between changes in iron and changes in insulin resistance.
没有纵向研究检查铁测量值在绝经后如何变化。我们的目的是检查绝经前和绝经后个体女性的铁测量值，其次是确定任何变化是否导致胰岛素抵抗。
在绝经纵向研究的一部分参与者（n=70）中，我们在绝经前和绝经后各测量一次铁蛋白、转铁蛋白和可溶性转铁蛋白受体（sTfR）。我们还检查了绝经状态与铁标志物变化之间的关联，这些变化在调整绝经年龄、种族/民族和腰围后进行了评估。在线性回归模型中，我们检查了绝经前铁测量值与绝经后铁标志物变化与绝经后稳态模型评估的胰岛素抵抗（HOMA-IR）变化之间的关联，在调整绝经年龄、种族/民族、腰围变化、C 反应蛋白（CRP）和性激素结合球蛋白（SHBG）水平后进行了评估。
与绝经后相比，女性在绝经前铁蛋白水平较低（p<0.01），sTfR:铁蛋白水平较高（p<0.01），HOMA-IR 较低（p=0.022），血糖较低（p=0.05）。调整后，较低的绝经前铁水平（sTfR:铁蛋白水平β=11.0，95%置信区间[CI]0.017-22.0）和绝经后铁水平升高更大（变化的 sTfR:铁蛋白β=13.6，95%CI 0.93-26.3）与 HOMA-IR 升高更大相关。
从绝经前到绝经后，女性的铁储存量平均增加。绝经后铁变化最大的女性（绝经前铁水平较低，绝经后铁水平升高更大），铁变化与胰岛素抵抗变化之间的关联最强。
