Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Department of Obstetrics, Gynecology, and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Menopause. 2019 Apr;26(4):417-422. doi: 10.1097/GME.0000000000001250.
We tested the effects of weight loss on serum estradiol, estrone, testosterone, and sex hormone-binding globulin (SHBG) in overweight/obese women 18 months after completing a year-long, 4-arm, randomized-controlled dietary weight loss and/or exercise trial.
From 2005 to 2008, 439 overweight/obese, postmenopausal women (BMI >25 kg/m), 50 to 75 years, were randomized to a year-long intervention: diet (reduced calorie, 10% weight loss, N = 118), exercise (225 min/wk moderate-to-vigorous activity, N = 117), combined diet + exercise (N = 117), or control (N = 87). At 12 months, 399 women provided blood; of these, 156 returned at 30 months and gave a blood sample. Hormones and SHBG were measured by immunoassay. Changes were compared using generalized estimating equations, adjusting for confounders.
At 30 months, participants randomized to the diet + exercise intervention had statistically significant increases in SHBG levels versus controls (P = 0.001). There was no statistically significant change in SHBG in the exercise or diet intervention arms. Hormone levels did not vary by intervention arm from baseline to 30 months. Participants who maintained weight loss at 30 months had statistically significantly greater decreases in free estradiol and free testosterone (Ptrend = 0.02 and Ptrend = 0.04, respectively) and increases in SHBG (Ptrend < 0.0001) versus those who did not have sustained weight loss. Levels of other analytes did not vary by weight loss at 30 months.
Sustained weight loss results in reductions in free estradiol and testosterone and increases in SHBG 18-month post-intervention.
我们检测了超重/肥胖女性在完成为期一年的四臂随机对照饮食减肥和/或运动试验一年后，体重减轻对血清雌二醇、雌酮、睾酮和性激素结合球蛋白（SHBG）的影响。
2005 年至 2008 年，439 名超重/肥胖、绝经后妇女（BMI>25kg/m2），年龄 50-75 岁，随机分为一年干预组：饮食（减少热量，体重减轻 10%，N=118）、运动（225min/wk 中等至剧烈活动，N=117）、饮食+运动联合组（N=117）或对照组（N=87）。在 12 个月时，399 名女性提供了血液样本；其中 156 名女性在 30 个月时返回并提供了血液样本。激素和 SHBG 通过免疫测定法测量。使用广义估计方程比较变化，同时调整混杂因素。
30 个月时，与对照组相比，饮食+运动干预组的 SHBG 水平有统计学意义的升高（P=0.001）。运动或饮食干预组的 SHBG 水平没有统计学意义的变化。从基线到 30 个月，激素水平没有因干预组而变化。30 个月时保持体重减轻的参与者，游离雌二醇和游离睾酮的下降有统计学意义（Ptrend=0.02 和 Ptrend=0.04），SHBG 的增加有统计学意义（Ptrend<0.0001），而那些没有持续减肥的参与者则没有。30 个月时的其他分析物水平与体重减轻无关。
持续减肥导致游离雌二醇和睾酮减少，SHBG 在干预后 18 个月增加。
