绝经特异性脂肪分布改变与代谢风险因子的关系  

Association of menopausal specific fat distribution changes with metabolic risk factors

作　　者：傅晓华[1] 裘胜春[1] 陈正云[2] 吴香丽[1] 舒静[1] 

机构地区：[1]浙江省人民医院生殖内分泌科,浙江杭州310014 [2]浙江大学附属妇产科医院妇科,浙江杭州310006

出　　处：《浙江大学学报（医学版）》2014年第3期327-332,共6页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省自然科学基金（LQ13H040002）.

摘　　要：目的：探讨绝经相关脂肪分布改变与代谢风险因子之间的关系,以期为绝经后肥胖相关代谢疾病的预防以及早期干预提供思路.方法：选择2012年10月至2013年8月在浙江省人民医院接受健康检查的女性200例,年龄20 ～ 65岁,其中绝经前女性110例,绝经后女性90例.全身及局部脂肪含量采用双能量X线吸收仪测量.采用协方差比较绝经前后局部脂肪分布的变化,建立logistic回归方程进一步分析绝经相关脂肪分布改变与代谢风险因子之间的关系.结果：绝经后女性较绝经前女性总体脂肪含量及男性型脂肪含量增高,校正总体脂肪含量的影响后,绝经后局部脂肪的变化主要表现为女性型脂肪含量的降低.多元logistic回归分析显示调整一系列重要变量后,男性型脂肪积累与代谢风险增加相关（OR=1.8～3.7,P＜0.05）,女性型脂肪与代谢风险因子之间呈负相关（OR=0.4～0.5,P＜0.05）.交互模型分析进一步提示绝经后女性型脂肪的保持对代谢的保护作用较绝经前更显著（P＜0.05）,而绝经在男性型脂肪对代谢的影响中无显著作用（P＞0.05）.结论：绝经后表现为男性型脂肪含量增加和女性型脂肪含量减少.相对于男性型脂肪积累对代谢的影响,女性型脂肪的保留与代谢风险呈负相关,并且这种保护作用在绝经后更为显著.Objective：To investigate the association of menopausal specific fat distribution with metabolic risk factors.Methods：Two hundred Chinese women including 110 premenopausal women aged 39.7 ± 9.2 y and 90 postmenopausal women aged 55.4 ± 4.6 years were enrolled.Total and regional fat depots including android fat and gynoid fat were measured by dual-energy X-ray absorptiometry.The differences of regional fat depot between pre-and post menopausal women were compared by covariate analysis.The association of regional fat changes with metabolic risk factors were analyzed by logistic models.Results：Gynoid fat was significantly decreased in postmenopausal women after accounting for total fat changes.After adjusting covariates （including age,BMI,and % BF）,the inverse associations of gynoid fat with metabolic risk factors still remained （OR =1.8-3.7,P 〈 0.05）.Furthermore,the interaction between menopause and gynoid fat was significantly in all logistic models （P 〈 0.05）.Conclusion：Android fat was increased whereas gynoid fat was decreased after menopause.Opposite to the detrimental effects of android fat,gynoid fat was inversely associated with metabolic risk factors,especially in postmenopausal women.

关 键 词：绝经期 体脂分布 脂肪类 代谢 脂肪组织 代谢 脂类 代谢疾病 病因学 Logistic模型 

分 类 号：R589[医药卫生—内分泌]