绝经后女性促卵泡激素水平与血脂指标的关系

Relationships between follicle-stimulating hormone level and lipid profiles in post-menopausal women

目的:探讨绝经后女性促卵泡激素(FSH)水平与各项血脂指标的关系,为评估绝经后女性的血脂异常风险提供依据。方法:选取绝经1年以上女性129例,依据FSH中位数将研究对象分为低水平FSH组(FSH<57.6IU·L-1)和高水平FSH组(FSH≥57.6IU·L-1)。收集受试者身高、体质量、体质量指数(BMI)、年龄、绝经年龄、绝经年限、吸烟史和基础疾病史等资料,采用统一方法检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、雌二醇(E2)、FSH、静脉空腹血糖(FBG)和血尿酸(SUA)等指标。应用多因素Logistic回归分析FSH水平与血脂异常的关系。结果:纳入本研究的绝经后女性受试者平均年龄为(61.22±7.30)岁,绝经年龄为(49.97±4.00)岁,绝经年限为(11.16±7.98)年。绝经后女性受试者并发血脂异常的比例为65.9%(85/129),低水平FSH组和高水平FSH组受试者并发血脂异常的比例比较差异无统计学意义(P>0.05)。低水平FSH组受试者的TG水平高于高水平FSH组(P<0.01),而HDL-C水平低于高水平FSH组(P<0.01),2组间TC、LDL-C和non-HDL-C水平比较差异无统计学意义(均P>0.05)。多因素Logistic回归分析,校正E2水平、年龄、绝经年限、高血压病史、糖尿病史、有无脂肪肝和BMI等级因素后,FSH水平与TG升高(≥2.3mmol·L-1)呈负相关关系(P<0.05),FSH每升高10IU·L-1则TG升高的风险下降29.5%(95%CI:3.6%~48.5%),而FSH水平与TC升高(≥6.2mmol·L-1)、LDL-C升高(≥4.1mmol·L-1)、HDL-C降低(<1.0 mmol·L-1)和non-HDL-C升高(≥4.9 mmol·L-1)无明显相关性(均P>0.05)。结论:绝经后女性的FSH水平与TG升高呈明显负相关关系,提示低水平FSH是绝经后女性血脂异常的危险因素。

Objective:To explore the relationships between the follicle-stimulating hormone(FSH)level and the lipid profiles in the post-menopausal women,and to provide evidence for assessing the risk of dyslipidemia in the post-menopausal women.Methods:A total of 129 women with menopause for more than 1 year were selected as the subjects and divided into low FSH group(FSH<57.6 IU·L-1)and high FSH group(FSH≥57.6 IU·L-1)according to the median of FSH.The data including height,weight,body mass index(BMI),age,menopausal age,duration of menopause,history of smoking,chronic diseases history of the subjects were collected;the serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),non-density lipoprotein cholesterol(non-HDL-C),estradiol(E2),FSH,fasting blood glucose,serum uric acid of the subjects were detected with the same method.Multivariate Logistic regression analysis was applied to analyze the relationship between the FSH level and dyslipidemia.Results:The average age of the post-menopausal women was(61.22±7.30)years,the age of menopause was(49.97±4.00)years,and the duration of menopause was(11.16±7.98)years.The proportion of post-menopausal women with dyslipidemia was65.9%(85/129),and there was no significant difference between two groups(P>0.05).Compared with high FSH group,the TG level of the subjects in low FSH group was increased(P<0.01)and the HDL-C level was decreased(P<0.01).There were no significant differences in the TC,LDL-C and non-HDL-C levels between two groups.The Logistic regression analysis showed that after adjusting the E2 level,age,duration of menopause,hypertension history,diabetes history,fatty liver and the BMI grade,FSH level had a negative correlation with TG increase (≥2.3 mmol·L-1)(P<0.05).Each 10-unit increase in FSH was associated with a 29.5%lower risk of elevated TG(95% CI :3.5%-48.5%).FSH was not significantly associated with the elevated TC(≥6.2 mmol·L-1),elevated LDL-C (≥4.1 mmol·L-1),decreased HDL-C(<1.0 mmol·L-1)and elevated non-HDL-C.Conclusion:The FSH level is negatively associated with elevated TG in the post-menopausal women,suggesting that low FSH appears to be a risk factor of dyslipidemia in the post-menopausal women.