绝经妇女体成分与糖代谢相关关系的研究  

Study of correlation between body composition and glucose metabolism in postmenopausal women

作　　者：金婧[1] 阮祥燕[1] 

机构地区：[1]首都医科大学附属北京妇产医院内分泌科,北京100026

出　　处：《中国骨质疏松杂志》2013年第9期907-913,共7页Chinese Journal of Osteoporosis

基　　金：北京市自然科学基金资助项目(3082011);首都医学发展基金重点支持项目(2007-2045)

摘　　要：目的探讨绝经妇女体成分与空腹血糖及胰岛素抵抗指数（HOMA-IR）的相关关系，寻求预测绝经妇女空腹血糖异常的体成分敏感指标及其临界值，从而对绝经后骨质疏松的高危人群起警示作用。方法选取2009年8月-2011年7月来北京妇产医院体检并被确诊为自然绝经的妇女200名。年龄41～60（51．30±4．58）岁，绝经年限1～9（2．96±1．87）年。测量研究对象的身高、体重、腰围、臀围、腹部矢状径及全身脂肪含量，测定研究对象的测定空腹血清血糖、空腹胰岛素、促卵泡生成素、促黄体生成素、雌二醇，计算胰岛素抵抗指数HOMA—IR。结果（1）绝经妇女全身性肥胖率为37．5％（BMI≥25kg／m。）或88％（脂肪含量≥30％），中心型肥胖率为48．5％。（2）空腹血糖与年龄、绝经年限及体成分指标（体重指数、腰围、腰臀比、腹部矢状径、脂肪含量）均具有明显的正相关关系（P〈0．05），与E2水平无明显相关关系。消除年龄、绝经年限、E2水平的影响，空腹血糖与体成分指标（体重指数、腰围、腰臀比、腹部矢状径、脂肪含量）均具有明显的偏相关关系（P〈0．05）。HOMA—IR与年龄及体成分指标具有明显的正相关关系（P〈0．05），与绝经年限及E2无明显相关关系。（3）体成分指标（体重指数、腰围、腹部矢状径、脂肪含量）预测绝经妇女发生空腹血糖异常的切割点分别为25．80kg／m^2、82．50cm、18．55cm、36．92％。（4）体成分指标（体重指数、腰围、腹部矢状径、脂肪含量）与年龄、绝经年限均有明显的正相关关系（P〈0．05）；E2水平与年龄及绝经年限具有明显的负相关关系（P〈0．05），与体成分指标无明显相关关系。（5）体成分指标（体重指数、腰围、腰臀比、腹部矢状径、脂肪含量）间均具有明显的正相关关系（P〈0．05）。对绝经妇女的脂肪�Objective To investigate the correlation between body composition and fasting blood glucose and the correlation between body composition and insulin resistance index （HOMA-IR） in postmenopausal women, and to explore the optimal body composition index to predict the abnormal fasting blood glucose in postmenopausal women, which is also a warning to the postmenopausal women with high risk of osteoporosis. Methods A total of 200 postmenopausal women, who came to Beijing Obstetrics and Gynecology Hospital for health examination from August 2009 and July 2011, were recruited. Their age ranged from 41 to 60 years old, and their postmenopausal period had lasted for 1-9 years. The clinical and biochemical parameters were measured, including body height, body weight, waist circumference （WC）, the hip circumference, sagittal abdominal diameter, follicle stimulating hormone, luteinizing hormone, estradiol, fasting plasma glucose, fasting insulin, and body fat （BF）. Results The prevalence of overall obesity, which was defined as BMI I〉 25kg/m= or BF i〉30% , was 37.5% and 88% , respectively. And the prevalence of central obesity, which was defined as WC 380 cm, was 48.5%. Fasting blood glucose had a positive correlation with age, the years since menopause, and body composition indices （body mass index, waist circumference, waist-hip ratio, sagittal abdominal diameter, and body fat） （P 〈 0.05） , but no correlation with the level of estradiol. Through partial correlation analysis, fasting blood glucose had a positive correlation withbody composition indices independent of age, the years since menopause, and the level of estradiol （ P 〈 0.05 ）. HOMA-IR had a positive correlation with age and body composition indices, but no correlation with the years since menopause and the level of estradiol （P 〈 0.05 ）. Body composition indices and critical value of them used to predict the abnormal fasting blood glucose in postmenopausal women were as follows： body mass index ≥25.80 kg/m2 , waist circu

关 键 词：绝经 体成分 体重指数 雌激素 血糖 胰岛素抵抗 骨代谢 

分 类 号：R683[医药卫生—骨科学]