Rocha Thaís, Crespo Raiane P, Yance Viviane V R, Hayashida Sylvia A, Baracat Edmund C, Carvalho Filomena, Domenice Sorahia, Mendonca Berenice B, Gomes Larissa G
Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
J Endocr Soc. 2019 Apr 4;3(5):1087-1096. doi: 10.1210/js.2018-00405. eCollection 2019 May 1.
Data on prevalence of metabolic risk factors in hyperandrogenic postmenopausal women are limited. Also, the correlation between metabolic disorders and androgen excess in this scenario is poorly understood.
We aimed to assess the prevalence of obesity, hypertension, type 2 diabetes (T2D), and dyslipidemia (DLP) in postmenopausal women with hyperandrogenism of ovarian origin before and after surgical normalization of testosterone (T) levels, as well as the impact of androgen normalization on body mass index (BMI), glucose, and lipid metabolism.
Retrospective study.
Tertiary health center.
Twenty-four Brazilian women with postmenopausal hyperandrogenism who underwent bilateral oophorectomy between 2004 and 2014 and had histologically confirmed virilizing ovarian tumor (VOT) or ovarian hyperthecosis (OH) and T-level normalization after surgery were selected.
FSH, LH, total and calculated free T, BMI, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) serum levels were accessed before (n = 24) and 24 months after (n = 19) bilateral oophorectomy.
At baseline, the overall prevalence rates of obesity, T2D, DLP, and hypertension were 58.3%, 83.3%, 66.7%, and 87.5%, respectively. No significant difference in prevalence was found between patients with OH and VOTs. At follow-up, FSH, LH, and total and free T levels had returned to menopausal physiologic levels, but mean BMI and mean FPG, HbA1c, LDL-C, HDL-C, and TG levels did not differ from baseline.
Postmenopausal hyperandrogenism is associated with adverse metabolic risk. Long-term normalization of testosterone levels did not improve BMI, glucose, or lipid metabolism.
关于雄激素过多的绝经后女性代谢危险因素患病率的数据有限。此外，在这种情况下，代谢紊乱与雄激素过多之间的相关性也了解甚少。
我们旨在评估卵巢来源的雄激素过多的绝经后女性在睾酮（T）水平手术恢复正常前后肥胖、高血压、2型糖尿病（T2D）和血脂异常（DLP）的患病率，以及雄激素正常化对体重指数（BMI）、血糖和脂质代谢的影响。
回顾性研究。
三级医疗中心。
选取了24名巴西绝经后雄激素过多的女性，她们在2004年至2014年间接受了双侧卵巢切除术，术后经组织学证实为男性化卵巢肿瘤（VOT）或卵巢卵泡膜增生（OH）且T水平恢复正常。
在双侧卵巢切除术前（n = 24）和术后24个月（n = 19）测定促卵泡激素（FSH）、促黄体生成素（LH）、总睾酮和计算得出的游离睾酮、BMI、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）的血清水平。
基线时，肥胖、T2D、DLP和高血压的总体患病率分别为58.3%、83.3%、66.7%和87.5%。OH患者和VOT患者之间的患病率无显著差异。随访时，FSH、LH以及总睾酮和游离睾酮水平已恢复到绝经后的生理水平，但平均BMI以及平均FPG、HbA1c、LDL-C、HDL-C和TG水平与基线无差异。
绝经后雄激素过多与不良代谢风险相关。睾酮水平的长期正常化并未改善BMI、血糖或脂质代谢。
