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[中年女性脂联素水平随绝经状态的变化及其与雄激素关系的研究]

[Investigation of the change of adiponectin level with menopause status in middle aged women and its relationship with androgen].

作者信息

Wu Yingchen, Zheng Chengyu, Chen Dongmei, Xie Meiqing

机构信息

Department of Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.

Department of Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 May;50(5):356-60.

Abstract

OBJECTIVE

To investigate the change of adiponectin level with menopause status in women aged 40 to 65, and its relationship with androgen.

METHODS

A cross-sectional study included woman (aged from 40 to 65) who were in hospital for routine check-up at the Sun Yat-sen Memorial Hospital from August to October in 2013. All subjects underwent laboratory examinations of adiponectin, sex hormone binding globulin (SHBG), dehydroepiandrosterone-sulfate (DHEA-S), total testosterone (TT), collected anthropometric measurements and then calculated free androgen index (FAI) and body mass index (BMI). According to their menstrual status, the subjects were divided into 4 groups: premenopausal group with 119 subjects, perimenopausal group with 60 subjects, early postmenopausal group with 62 subjects, late postmenopausal group with 64 subjects.

RESULTS

(1) Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory. When compared adiponectin levels in late postmenopausal group [(13 ± 5) mg/L] with those in perimenopausal [(8 ± 6) mg/L] or early postmenopausal group [(9 ± 6) mg/L], it all showed significantly difference (P < 0.05). (2) Both the adiponectin levels were negatively correlated with waistline in the 4 groups (premenopausal group, r = -0.276; perimenopausal group, r = -0.334; early postmenopausal group, r = -0.211; late postmenopausal group, r = -0.218; all P < 0.05). Levels of adiponectin were positively correlated with SHBG (r = 0.536, P < 0.05) and negatively with FAI (r = -0.363, P < 0.05) in menopausal transition, while in late postmenopausal group, negatively correlated with level of DHEA-S (r = -0.450, P < 0.05). When adjusted for age, BMI and waistline, the above correlations still exist.

CONCLUSIONS

Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory during the sequential menopause status transition in middle aged women. Low level of adiponectin in menopausal transition is closely associated with the relative excess androgen occurred during this stage.

摘要

目的

探讨40至65岁女性脂联素水平随绝经状态的变化及其与雄激素的关系。

方法

一项横断面研究纳入了2013年8月至10月在中山大学附属孙逸仙纪念医院住院进行常规检查的40至65岁女性。所有受试者均接受了脂联素、性激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEA-S)、总睾酮(TT)的实验室检查,进行了人体测量,然后计算游离雄激素指数(FAI)和体重指数(BMI)。根据月经状态,将受试者分为4组:绝经前组119例,围绝经期组60例,绝经早期组62例,绝经晚期组64例。

结果

(1)脂联素水平在绝经过渡期降至最低,绝经后逐渐升高,呈U形轨迹。绝经晚期组[(13±5)mg/L]与围绝经期组[(8±6)mg/L]或绝经早期组[(9±6)mg/L]的脂联素水平相比,均有显著差异(P<0.05)。(2)4组(绝经前组,r=-0.276;围绝经期组,r=-0.334;绝经早期组,r=-0.211;绝经晚期组,r=-0.218;均P<0.05)的脂联素水平均与腰围呈负相关。在绝经过渡期,脂联素水平与SHBG呈正相关(r=0.536,P<0.05),与FAI呈负相关(r=-0.363,P<0.05),而在绝经晚期组,与DHEA-S水平呈负相关(r=-0.450,P<0.05)。调整年龄、BMI和腰围后,上述相关性仍然存在。

结论

脂联素水平在绝经过渡期降至最低,绝经后逐渐升高,在中年女性绝经状态的连续转变过程中呈U形轨迹。绝经过渡期脂联素水平低与该阶段出现的相对雄激素过多密切相关。

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