不同绝经状态女性性激素、血脂变化及关系研究

Changes of FSH,E2,T and blood lipid in women at different menopausal stages

目的研究女性不同绝经阶段促卵泡生成素(FSH)、雌二醇(E2)、睾酮(T)、血脂的变化。方法研究2012年7月-2013年7月在嘉兴市妇幼保健院体检的40岁以上女性,专人搜集人员资料并检测FSH、E2、T以及血脂等指标。结果体检人员的平均初潮年龄为(15.75±1.79)岁;绝经过渡期早期平均年龄为(45.60±4.57)岁;绝经后E2较绝经前明显下降(P<0.01),FSH较绝经前明显上升(P<0.01),T在绝经前后未见明显统计学差异;低密度脂蛋白胆固醇(LDL)在绝经后有明显上升;血脂异常组E2明显低于血脂正常组。E2与甘油三酯(TG)、LDL负相关,与高密度脂蛋白胆固醇(HDL)正相关。FSH对于预测绝经过渡期价值较E2高,FSH的cut off值为15.80 IU/L。结论绝经后E2、FSH变化与血脂代谢紊乱相关,提示E2可能参与了血脂紊乱的多个环节,从而为激素补充治疗升高雌激素来改善血脂提供依据。

Objective To study the changes of follicle stimulating hormone（ FSH）,estradiol（ E2）,testosterone（ T）,and blood lipid in women at different menopausal stages. Methods From July 2012 to July 2013,714 women over 40 years old undergoing physical examination in Jiaxing maternity and child health care hospital were selected to detect the height,weight,the menstruation,follicle stimulating hormone（ FSH）,estradiol（ E2）,testosterone（ T）,blood lipid. Results The average age of menarche was（ 15. 75 ± 1. 79） years old in these women,and the age of early period of menopausal transitional was（ 45. 60 ± 4. 57） years old. E2significantly decreased in postmenopausal stage,while FSH increased in postmenopausal women（ P〈 0. 01）; T had no significant difference in the perimenopausal and postmenopausal stages. Low density lipoprotein cholesterol（ LDL） increased obviously in postmenopausal women. E2was significantly lower in the dyslipidemia group. There is a negative correlation between E2and triglyceride（ TG）,LDL,while a positive correlation between E2and high density lipoprotein cholesterol（ HDL）. FSH showed higher warning value in predicting menopausal transition period than E2. The cutoff calue of FSH was 15. 80 IU/ L. Conclusion The levels of E2and FSH are related with lipid metabolism disorders in postmenopausal stage. E2may be involved in many aspects of lipid disorder,providing basis for using hormone replacement therapy to regulate the blood lipids.