Turcato E, Zamboni M, De Pergola G, Armellini F, Zivelonghi A, Bergamo-Andreis I A, Giorgino R, Bosello O
Institute of Internal Medicine, University of Verona, Policlinico of Borgo Roma, Italy.
J Intern Med. 1997 May;241(5):363-72. doi: 10.1046/j.1365-2796.1997.120129000.x.
Relationships between regional body fat distribution and sex hormones as well as changes in sex hormones after weight loss were evaluated.
All subjects were hospitalized in the Institute of Internal Medicine of the University of Verona.
Twenty-six premenopausal (age 33.7 +/- 10.2 years) and 15 postmenopausal (age 57.9 +/- 5.9 years) obese women.
Body weight, body-mass index, waist and hip circumferences, visceral fat by computed tomography and sex hormones were evaluated before and after 4 weeks on a very low energy diet.
Body-mass index was higher in pre-than in postmenopausal women, although the difference was not significant. Total and free testosterone were significantly higher in the pre- than in the postmenopausal group (P < 0.001). Significant negative correlations were found between age and total testosterone (r = -0.65; P < 0.001), free testosterone (r = -0.54; P < 0.001), androstenedione (r = -0.46; P < 0.01) and urinary cortisol excretion (r = -0.50; P < 0.01). A negative correlation was found between visceral fat and total testosterone (r = -0.41; P < 0.01). After adjusting for age, the negative correlation between total testosterone and visceral fat encountered both in the subject group as a whole and in premenopausal women was no longer significant, whilst a significant negative association between visceral fat and sex hormone binding globulin (SHBG) (r = -0.56; P < 0.001) was always found. When step-down regression analysis was used to evaluate the joint effect of age, menopausal status, and anthropometric and metabolic variables on sex hormones, age was the most powerful independent variable for predicting total testosterone, free testosterone and androstenedione levels, whilst menopausal status was the most powerful predictor of FSH and LH levels. Changes in hormones after VLED were analysed separately in pre- and postmenopausal women. None of the hormones changed significantly after VLED in the postmenopausal group, except for FSH values. LH, free testosterone and urinary cortisol excretion values decreased significantly after VLED in the premenopausal group.
Our data show that age, to a greater extent than visceral fat, seems to be negatively associated with steroid sex hormones. Weight loss seems to be associated with changes in sex hormones only in premenopausal women.
评估局部体脂分布与性激素之间的关系以及减肥后性激素的变化。
所有受试者均在维罗纳大学内科研究所住院。
26名绝经前（年龄33.7±10.2岁）和15名绝经后（年龄57.9±5.9岁）肥胖女性。
在极低能量饮食4周前后评估体重、体重指数、腰围和臀围、通过计算机断层扫描测量的内脏脂肪以及性激素。
绝经前女性的体重指数高于绝经后女性，尽管差异不显著。绝经前组的总睾酮和游离睾酮显著高于绝经后组（P<0.001）。年龄与总睾酮（r=-0.65；P<0.001）、游离睾酮（r=-0.54；P<0.001）、雄烯二酮（r=-0.46；P<0.01）和尿皮质醇排泄量（r=-0.50；P<0.01）之间存在显著负相关。内脏脂肪与总睾酮之间存在负相关（r=-0.41；P<0.01）。在调整年龄后，在整个受试者组和绝经前女性中，总睾酮与内脏脂肪之间的负相关不再显著，而内脏脂肪与性激素结合球蛋白（SHBG）之间始终存在显著负相关（r=-0.56；P<0.001）。当使用逐步回归分析评估年龄、绝经状态以及人体测量和代谢变量对性激素的联合作用时，年龄是预测总睾酮、游离睾酮和雄烯二酮水平的最有力自变量，而绝经状态是促卵泡激素（FSH）和促黄体生成素（LH）水平的最有力预测因素。在绝经前和绝经后女性中分别分析了极低能量饮食（VLED）后激素的变化。绝经后组除FSH值外，VLED后激素均无显著变化。绝经前组VLED后LH、游离睾酮和尿皮质醇排泄量显著降低。
我们的数据表明，年龄比内脏脂肪在更大程度上似乎与甾体性激素呈负相关。减肥似乎仅与绝经前女性的性激素变化有关。
