Cui Y, Ruan X, Jin J, Jin F, Brucker S, Mueck A O
a Department of Gynecological Endocrinology, Beijing Obstetrics & Gynecology Hospital , Capital Medical University , Beijing , China ;
b University clinicum Center Tuebingen , Department of Women's Health , Germany.
Climacteric. 2016 Jun;19(3):292-8. doi: 10.3109/13697137.2015.1130694. Epub 2016 Jan 29.
Objective To investigate changes in levels of lipids and lipoproteins in Chinese women during perimenopause and postmenopause as primary study endpoints, for the first time including lipoprotein(a). Methods The retrospective study was performed in 1015 women without hormone therapy aged 34-76 years from 20 provinces of China who visited the Beijing Obstetrics & Gynecology hospital. Menopausal status was defined by the criteria of the 2011 Stages of Reproductive Aging Workshop. Results Levels of total cholesterol, triglycerides and low density lipoprotein (LDL) cholesterol increased and that of high density lipoprotein (HDL) cholesterol decreased in the postmenopausal compared to the perimenopausal group. In the women with body mass index (BMI) ≥ 25 kg/m(2), total cholesterol and LDL cholesterol increased, HDL cholesterol decreased and changes in triglyceride levels were not significant. In the women with BMI < 25 kg/m(2), the increase in triglyceride levels during the transition was significant. Changes in lipoprotein(a), apolipoprotein A1 and apolipoprotein B were not significant. Comparing the groups with BMI ≥ 25 kg/m(2) vs. BMI < 25 kg/m(2), only the differences for apolipoprotein A1 and for triglycerides were significant. Triglycerides correlated positively with follicle stimulating hormone and BMI, and total cholesterol correlated positively with follicle stimulating hormone and age (all p < 0.05). Conclusions Some changes in lipids can be related to menopausal status, some to increasing age, some to both; especially triglycerides and apolipoprotein A1 were found also to be related to BMI. Surprisingly lipoprotein(a) did not change either with increasing age or during the transition despite known possible interference with estrogenic status.
目的 首次将脂蛋白(a)纳入研究，以围绝经期和绝经后中国女性血脂和脂蛋白水平的变化作为主要研究终点。方法 对来自中国20个省份、年龄在34 - 76岁、未接受激素治疗且就诊于北京妇产医院的1015名女性进行回顾性研究。绝经状态根据2011年生殖衰老研讨会分期标准定义。结果 与围绝经期组相比，绝经后组总胆固醇、甘油三酯和低密度脂蛋白（LDL）胆固醇水平升高，高密度脂蛋白（HDL）胆固醇水平降低。在体重指数（BMI）≥25 kg/m²的女性中，总胆固醇和LDL胆固醇升高，HDL胆固醇降低，甘油三酯水平变化不显著。在BMI＜25 kg/m²的女性中，围绝经期过渡期间甘油三酯水平显著升高。脂蛋白(a)、载脂蛋白A1和载脂蛋白B的变化不显著。比较BMI≥25 kg/m²与BMI＜25 kg/m²的组，仅载脂蛋白A1和甘油三酯的差异显著。甘油三酯与促卵泡激素和BMI呈正相关，总胆固醇与促卵泡激素和年龄呈正相关（所有p＜0.05）。结论 血脂的一些变化与绝经状态有关，一些与年龄增长有关，一些与两者都有关；特别是甘油三酯和载脂蛋白A1也与BMI有关。令人惊讶的是，尽管已知脂蛋白(a)可能受雌激素状态干扰，但随着年龄增长或在围绝经期过渡期间其并未发生变化。
