绝经后妇女胰岛素敏感性下降的预测因子  

Predictors of worsening insulin sensitivity in postmenopausal women

作　　者：Goodrow G.J. L' Hommedieu G.D. Gannon B. Sites C.K. 张旸 

机构地区：[1]Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 340 OHB, 618 20th St South, Birmingham, AL 35249, United States Dr

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第9期6-7,共2页Core Journal in Obstetrics/Gynecology

摘　　要：Objective: The purpose of this study was to determine predictors of worsening insulin sensitivity in postmenopausal women. Study design: Seventy- one nonobese postmenopausal women were assigned randomly to receive hormone replacement therapy (conjugated estrogens, 0.625 mg, plus medroxyprogesterone acetate, 2.5 mg) or placebo daily for 1 year (34 women received hormone replacement therapy, and 37 women received placebo). At baseline and 12 months, the women received a computed tomography scan at the L4- L5 vertebral disk space, a dual x- ray absorptiometry scan, a euglycemic hyperinsulinemic clamp to measure insulin sensitivity, and a lipid profile. Declining insulin sensitivity was defined as the largest quartile change in insulin sensitivity in the women who received the placebo (- 1.42 mg/min/kg lean body mass). Results: By univariate analysis, we found that significant predictors of worsening insulin sensitivity were the use of hormone replacement therapy, baseline insulin sensitivity, a younger age, and < 10 years since menop-ause. By logistic regression, we determined that hormone replacement therapy use and higher baseline insulin sensitivity were independent predictors of worsening insulin sensitivity. Conclusion: The use of hormone replacement therapy and baseline insulin sensitivity are significant independent predictors of the development of worsening insulin sensitivity in postmenopausal women.Objective： The purpose of this study was to determine predictors of worsening insulin sensitivity in postmenopausal women. Study design： Seventy -one nonobese postmenopausal women were assigned randomly to receive hormone replacement therapy （conjugated estrogens, 0. 625 mg, plus medroxyprogesterone acetate, 2.5 mg） or placebo daily for 1 year （34 women received hormone replacement therapy, and 37 women received placebo） . At baseline and 12 months, the women received a computed tomography scan at the IA- L5 vertebral disk space, a dual x- ray absorptiometry scan, a euglycemic hyperinsulinemic clamp to measure insulin sensitivity, and a lipid profile. largest Declining insulin sensitivity was defined as the quartile change in insulin sensitivity in the women who received the placebo （ - 1.42 mg/min/kg lean body mass） Results： By univariate analysis, we found that significant predictors of worsening insulin sensitivity were the use of hormone replacement therapy, baseline insulin sensitivity, a younger age, and 〈 10 years since menopause. By logistic regression, we determined that hormone replacement therapy use and higher baseline insulin sensitivity were independent predictors of worsening insulin sensitivity. Conclusion： The use of hormone replacement therapy and baseline insulin sensitivity are significant independent predictors of the development of worsening insulin sensitivity in postmenopausal women.

关 键 词：胰岛素敏感性下降 独立预测因子 绝经后妇女 logistic回归分析 激素替代治疗 醋酸甲羟孕酮 结合型雌激素 双能X线吸收 

分 类 号：R587[医药卫生—内分泌]