肥胖妇女绝经前后体脂分布及心血管病、糖尿病危险因素探讨

BODY FAT DISTRIBUTION AND CARDIOVASCULAR DISEASE AND DIABETES MELLITUS RISK FACTORS IN PRE-AND POST-MENOPAUSAL OBESE WOMEN WITH SIMILAR BMI

目的 :观察绝经前后肥胖妇女体脂分布及心血管病、糖尿病的危险因素变化。方法 :筛选肥胖( BMI>2 7kg/m2 )绝经前后妇女 ,其 BMI相似者 ( P>0 .0 5 )并除外接受激素替代治疗个体 ;胰岛素抵抗用HOMA公式计算 ,腹腔内脂肪含量 ( IAF)用公式 [( 0 .370×腹矢状径 ) - 4.85 ]计算。结果 :1 BMI相似而年龄不同绝经后妇女腰臀比、腹腔内脂肪含量、收缩压、血糖、甘油三酯、胆固醇明显升高 ,HDL-胆固醇明显降低 ,胰岛素与 HOMA值无明显变化 ;2年龄与 BMI都相似的个体 ,其上述各项指标无明显变化 ( P>0 .0 5 ) ;3较大年龄绝经妇女比较小年龄绝经妇女有较高的收缩压、腰臀比、血糖。结论 :BMI相似的肥胖妇女其绝经变化、绝经前后年龄差距增大 ,随年龄增大腹腔内脂肪含量增加 ,心血管病的危险因素增加 。

Objective:To study the body fat distribution,cardiovascular disease and diabetes mellitus risk factors in pre and post menopausal obese women.Methods:We selected pre and post menopausal obese women(BMI>27 kg/m 2) whose BMI was matched ( P >0 05) .None of them had hormone replacement therapy.Insulin resistance was evaluated by homeostasis model assessment (HOMA) formula.Intraabdominal fat volume was calculated by the following formula:IAF=0 370×abdominal sagittal diameter -4 85.Results:①In age different but BMI Matched post menopausal women,there were not significant differences in insulin and HOMA,but age,WHR and intraabdominal fat ,systolic and diastolic blood pressure,glucose,cholesterol,triglyceride were significantly higher and HDL cholesterol were lower( P <0 05) ;②In age matched pre and post menopausal women there were no significant differences in those mentioned above;③Older post menopausal women(>50 years) had higher systolic blood pressure,WHR,and glucose compared with the younger (<50 year) post menopausal.Conclusion:An increase in abdominal fat accumulation and unfavorable alteration in risk factor disturb post menopausal obese women even if BMI do not change,during menopause transition.Ageing,particular throughout the post menopausal years,has important effects on the detrimental changes associated with menopause.