长期激素替代治疗对绝经后妇女身体成分和体脂分布的影响

Effects of Hormone Replacement Therapy on Body Composition and Fat Distribution in Postmenopausal Women

目的：探讨长期激素替代治疗（ Ｈ Ｒ Ｔ）对绝经后妇女身体成分和体脂分布的影响。方法：３６ 例健康意大利绝经后妇女分成两组： Ｈ Ｒ Ｔ 组，１８ 例；非 Ｈ Ｒ Ｔ 组（对照组），１８ 例。 Ｈ Ｒ Ｔ 组妇女每月经皮给予雌二醇（５０ ｎｇ／ｄ）和口服安宫黄体酮（１０ ｍ ｇ／ｄ），连续１２ ｄ。治疗时间３～１０ 年，平均３．９ 年。身体测量包括身高、体重、胸围、臀围、腰围与臀围比率（ Ｗ Ｈ Ｒ）。使用生物电阻抗法（ Ｂ Ｉ Ｍ）测定身体成分（体脂％ 及水分％ ）。日常活动情况按每天坐、立、行走、睡眠、体力活动时间（小时数）分成４ 个等级。结果：除 Ｈ Ｒ Ｔ 组妇女腰围明显小于对照组妇女（ Ｐ＜ ００５）外，其它身体测量值、年龄及日常活动强度两组间均无明显差异。结论：长期雌孕激素联合治疗既不能预防也不能加重绝经后妇女体重、体脂的增加，但却可减少体脂从外周向中心的转移。

Objective: To evaluate the effects of hormone replacement therapy(HRT)on body composition and fot distribution in Italian postmenopausal women. Methods: Thirty six Italian postmenopausal women (48~65 years old) consisted of two groups: HRT group, 18 subjects and control group (non HRT), 18 subjects. The women in HRT group were treated for 3 to 10 years, average 3.9 years by transdermic estradial 50 ng/d and oral medroxyprogestrerone acetate (MPA) 10 mg/d for 12 consecutive days permaonth. Anthropometric measurements included height, weight, BNI, waist circumference, hip circumference and waist to hip ratio. The body composition (the percentage of body fot and water) estimated by means of bioelectrical impedance (BIM). Physical activities were classified to four levels. Results: We found that long term estrogen progesterone therapy prevented the increase in abdominal fat after menopause (P<0.05), whereas it did not have a statistically significant influence on total body fat mass. Conclusion: These results indicate that continuous daily estrogen and progesterone replacement therapy neither prevents nor increases postmenopausal weight gain and fat accumulation. However, it does minimize the shift from peripheral to central fat distribution.