绝经激素治疗与代谢综合征风险研究进展

Menopause hormone therapy and risk of metabolic syndrome

代谢综合征(包括腹型肥胖、糖代谢异常、脂代谢紊乱、高血压等)因与心血管病风险因素密切相关,已成为全球公共健康的一个主要挑战。绝经后激素治疗的应用已有半个多世纪,但绝经后激素治疗(menopause hormone therapy,MHT)的适应证及理想候选适应证仍然不清楚。绝经妇女心血管病风险的增高是这组人群死亡的主要原因。雌激素的降低与许多围绝经与绝经后妇女总胆固醇、三酰甘油、低密度脂蛋白胆固醇的增加,胰岛素抵抗的增加及血压的升高相关。这些变化的参数是代谢综合征的主要组分。目前推荐MHT作为血管舒缩症状的金标准治疗,其对代谢综合征组分及心血管病风险的益处仍不清楚,本文将对MHT与代谢综合征组分的风险及益处进行综述。

The metabolic syndrome （ including visceral obesity , dyslipidemia , hyperglycemia , and hypertension ） has become one of the major public-health challenges worldwide .The menopause hormone therapy （ MHT） is in use for more than a half of century , but the question of indications and ideal candidates for hormone replacement therapy （ HRT ） remains unclear .Postmenopausal women are a population with the increasing risks for cardiovascular diseases which are the main cause of death in this group .Decline in estrogen concentrations is linked to a number of changes in peri and postmenopause： increased total cholesterol , triglycerides , and low density lipoprotein, increased insulin resistance and increased blood pressure etc .These changes are the main components of metabolic syndrome . HRT is currently recommended as the gold standard for the management of vasomotor symptoms , but the benefit of MHT on components of metabolic syndrome and risk for cardiovascular events risk is still uncertain .This review will focus on MHT risk and benefit issues .