Tchernof A, Poehlman E T
Department of Medicine, University of Vermont, Burlington 05405, USA.
Obes Res. 1998 May;6(3):246-54. doi: 10.1002/j.1550-8528.1998.tb00344.x.
The menopause transition increases cardiovascular and metabolic disease risk, partly because of the adverse effects of estrogen deficiency on the plasma lipid-lipoprotein profile and cardiovascular function. This increased cardiovascular and metabolic disease risk may also be partially mediated by increased body fat, increased intra-abdominal adipose tissue accumulation, or both. The objective of this mini-review is to summarize studies that have investigated the relationships among the menopause transition, body fatness, and body fat distribution.
A review of cross-sectional and longitudinal studies on menopause that examined body fatness and body fat distribution.
Cross-sectional reports show that the menopause transition is related to modest increases in body mass index or total fatness, although not all studies found significant effects. Increased central adiposity appears to be related to menopause, independent of advancing age, but these results are methodology dependent. An independent effect of menopause on central body fatness was noted by the use of techniques such as DEXA or computed tomography, whereas studies using circumference measures showed discrepant results. Longitudinal studies showed that the menopause transition accelerated the increase in central adiposity, although no studies quantified changes in intra-abdominal fat by imaging techniques.
Thus, additional longitudinal studies using more accurate measures of adiposity are needed to critically examine the effects of the menopause transition on total and central body fatness. Collectively, previous studies suggest that menopause is related to modest increase in total fatness and accelerated accumulation of central body fat that exceeds changes normally attributed to the aging process. These changes may increase the risk for cardiovascular and metabolic disease in aging women.
绝经过渡会增加心血管疾病和代谢疾病的风险，部分原因是雌激素缺乏对血浆脂质 - 脂蛋白谱和心血管功能产生不利影响。这种心血管疾病和代谢疾病风险的增加也可能部分由体脂增加、腹部脂肪组织堆积增加或两者共同介导。本综述的目的是总结研究绝经过渡、体脂和体脂分布之间关系的研究。
对研究绝经时体脂和体脂分布的横断面和纵向研究进行综述。
横断面报告显示，绝经过渡与体重指数或总体脂适度增加有关，尽管并非所有研究都发现显著影响。中心性肥胖增加似乎与绝经有关，与年龄增长无关，但这些结果取决于方法。通过使用双能X线吸收法（DEXA）或计算机断层扫描等技术，发现绝经对中心性体脂有独立影响，而使用周长测量的研究结果则不一致。纵向研究表明，绝经过渡加速了中心性肥胖的增加，尽管没有研究通过成像技术量化腹部脂肪的变化。
因此，需要更多使用更准确体脂测量方法的纵向研究，以严格检验绝经过渡对总体脂和中心性体脂的影响。总体而言，先前的研究表明，绝经与总体脂适度增加以及中心性体脂加速堆积有关，这种堆积超过了通常归因于衰老过程的变化。这些变化可能会增加老年女性患心血管疾病和代谢疾病的风险。
