雌激素对肥胖女性内皮依赖性血管舒张功能的保护作用

Estrogen protects the endothelial-dependent vasodilatation of obese women

目的探讨雌激素与肥胖女性内皮依赖性血管舒张功能(EDV)之间的关系。方法检测10例绝经前和10例绝经后肥胖女性EDV功能。评价外周组织对胰岛素的敏感性。测定血FFAs浓度、胰岛素刺激下一氧化氮产生量的变化(ΔNO%)、PAI-1活性。结果①经绝前后肥胖女性外周组织葡萄糖利用率(GDR)、空腹FFA浓度、胰岛素刺激下ΔNO%间的差异无统计学意义(P>0·05)。②经绝后肥胖女性EDV(8·0%±3·3%)较绝经前肥胖女性EDV(12·5%±2·5%)受损更明显(P=0·001)。③与绝经前肥胖女性比较,经绝后肥胖女性具有更高的PAI-1活性(0·87±0·04vs0·72±0·1活性单位,P=0·046)。④EDV与雌激素水平显著正相关(r=0·467,P=0·043),与FFA浓度显著负相关(r=-0·529,P=0·02)。结论两组胰岛素抵抗程度接近的肥胖女性,绝经后女性表现出更明显的EDV功能障碍和更高的PAI-1活性,雌激素对肥胖女性EDV具有一定的保护作用。

Objective To assess the relationship between the endogenous estrogen and endothelial-dependent vasodilatation （EDV） in simple obese women. Methods 10 healthy obese premenopausal women and 10 BMI-matched healthy obese postmenopausal women were included in this study. Subjects underwent measurements of insulin sensitivity and dilatation of brachial artery in response to blood flow EDV. All subjects also underwent the measurements of FFAs, PAI-1 and NO. Results Compared with the obese premenopausal women, the obese postmenopausal women had the same val- ues of glucose dispose rate, the fasting FFAs concentration, and the change of insulin-mediated nitric oxide release （all P 〉 0. 05 ）, hut had lower endothelium-dependent vasodilatation （8.0 ± 3.34 % vs 12.52±2.52%, P=0. 001） and higher PAI-1 activity （0.87±0.04 vs 0. 72±0.1 activity unite, P= 0. 046）. Partial regression analysis revealed a significant positive correlation between EDV and estro- gen （r=0. 467, P=0. 043）, significant negative correlation between EDV and FFAs （r=-0. 529, P =0. 02）. Conclusions Compared with premenopausal women, the postmenopausal women has more serious impaired EDV and higher PAI-1 activity although the two groups of obese women have the same insulin resistance. It seems that estrogen can protect the endothelial-dependent vasodilatation in obese women.