Mandrup Camilla M, Egelund Jon, Nyberg Michael, Lundberg Slingsby Martina H, Andersen Caroline B, Løgstrup Sofie, Bangsbo Jens, Suetta Charlotte, Stallknecht Bente, Hellsten Ylva
Department of Biomedical Sciences, University of Copenhagen, Denmark.
Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark.
Am J Obstet Gynecol. 2017 Apr;216(4):384.e1-384.e11. doi: 10.1016/j.ajog.2016.12.017. Epub 2016 Dec 23.
Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors contribute to the deterioration of cardiometabolic health in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardiometabolic adaptations to exercise in postmenopausal women add to the adverse health profile.
We sought to evaluate risk factors for type 2 diabetes and cardiovascular disease in late premenopausal and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training.
A 3-month high-intensity aerobic training intervention, involving healthy, nonobese, late premenopausal (n = 40) and early postmenopausal (n = 39) women was conducted and anthropometrics, body composition, blood pressure, lipid profile, glucose tolerance, and maximal oxygen consumption were determined at baseline and after the intervention.
At baseline, the groups matched in anthropometrics and body composition, and only differed by 4.2 years in age (mean [95% confidence limits] 49.2 [48.5-49.9] vs 53.4 [52.4-54.4] years). Time since last menstrual period for the postmenopausal women was (mean [95% confidence limits] 3.1 [2.6-3.7] years). Hormonal levels (estrogen, follicle stimulation hormone, luteinizing hormone) confirmed menopausal status. At baseline the postmenopausal women had higher total cholesterol (P < .001), low-density lipoprotein-cholesterol (P < .05), and high-density lipoprotein-cholesterol (P < .001) than the premenopausal women. The training intervention reduced body weight (P < .01), waist circumference (P < .01), and improved body composition by increasing lean body mass (P < .001) and decreasing fat mass (P < .001) similarly in both groups. Moreover, training resulted in lower diastolic blood pressure (P < .05), resting heart rate (P < .001), total cholesterol (P < .01), low-density lipoprotein-cholesterol (P < .01), total cholesterol/high-density lipoprotein-cholesterol index (P < .01), and improved plasma insulin concentration during the oral glucose tolerance test (P < .05) in both groups.
Cardiovascular risk factors are similar in late premenopausal and early postmenopausal women, matched by age and body composition, with the exception that postmenopausal women have higher high- and low-density lipoprotein-cholesterol levels. A 3-month intervention of high-intensity aerobic training reduces risk factors for type 2 diabetes and cardiovascular disease to a similar extent in late premenopausal and early postmenopausal women.
绝经与心血管疾病风险增加相关，其因果因素被认为是雌激素丧失及随后激素环境的改变。然而，绝经后女性心脏代谢健康恶化的促成因素存在争议，因为绝经过渡也与年龄增长和脂肪量增加有关。此外，绝经后女性对运动的心脏代谢适应性降低的迹象也加重了不良健康状况。
我们试图评估接近绝经后期和绝经早期女性（按年龄和身体成分匹配）患2型糖尿病和心血管疾病的风险因素，并研究高强度训练的效果。
对健康、非肥胖的接近绝经后期女性（n = 40）和绝经早期女性（n = 39）进行了为期3个月的高强度有氧训练干预，并在基线和干预后测定了人体测量学指标、身体成分、血压、血脂谱、葡萄糖耐量和最大耗氧量。
在基线时，两组在人体测量学指标和身体成分方面相匹配，仅年龄相差4.2岁（平均值[95%置信区间]49.2[48.5 - 49.9]岁对53.4[52.4 - 54.4]岁）。绝经后女性距上次月经的时间为（平均值[95%置信区间]3.1[2.6 - 3.7]年）。激素水平（雌激素、卵泡刺激素、黄体生成素）证实了绝经状态。在基线时，绝经后女性的总胆固醇（P < .001）、低密度脂蛋白胆固醇（P < .05）和高密度脂蛋白胆固醇（P < .001）均高于绝经前女性。训练干预使两组体重（P < .01）、腰围（P < .01）均降低，且通过增加瘦体重（P < .001）和减少脂肪量（P < .001）改善了身体成分。此外，训练使两组舒张压（P < .05）、静息心率（P < .001）、总胆固醇（P < .01）、低密度脂蛋白胆固醇（P < .01）、总胆固醇/高密度脂蛋白胆固醇指数（P < .01）降低，口服葡萄糖耐量试验期间的血浆胰岛素浓度改善（P < .05）。
按年龄和身体成分匹配的接近绝经后期和绝经早期女性，心血管危险因素相似，不同之处在于绝经后女性的高密度和低密度脂蛋白胆固醇水平较高。为期3个月的高强度有氧训练干预在接近绝经后期和绝经早期女性中，对2型糖尿病和心血管疾病危险因素的降低程度相似。
