雄激素对40～60岁女性机体脂肪含量及分布的影响  

Impact of androgen level on body adipose tissue content and distribution in middle life women

作　　者：魏代敏[1] 张颖[2] 陈凤岭[2] 郁琦[2] 

机构地区：[1]山东大学附属生殖医院内分泌科,250021 [2]中国医学科学院北京协和医院妇产科,100730

出　　处：《中华妇产科杂志》2015年第5期346-351,共6页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：通过对40~60岁健康妇女的横断面调查，了解其体内雄激素水平及与机体脂肪含量及分布的关系。方法将222例40~60岁健康妇女按照月经状态分为生育期、绝经过渡期早期、绝经过渡期晚期及绝经后，测定体内脱氢表雄酮（DHEA）、总睾酮（TT）、性激素结合球蛋白（SHBG）水平，计算游离雄激素指数（FAI）。使用双能X线吸收骨密度仪测定机体脂肪含量及分布。结果在40~60岁妇女中，生育期妇女体内DHEA、TT水平分别为（12.3±4.1）、（0.56±0.22）nmol/L，FAI中位数为1.15；绝经过渡期早期妇女体内DHEA、TT水平分别为（12.0±3.4）、（0.56±0.24）nmol/L，FAI中位数为1.37；绝经过渡期晚期妇女体内DHEA、TT水平分别为（14.2±4.7）、（0.62±0.18）nmol/L，FAI中位数为1.38；绝经后妇女体内DHEA、TT水平分别为（11.6±3.5）、（0.45±0.22）nmol/L，FAI中位数为0.94。与生育期妇女相比，绝经过渡期妇女体内雄激素水平（DHEA、TT、FAI）均无差异（P〉0.05），绝经后妇女体内TT、FAI水平下降（P=0.001、0.014）。生育期、绝经过渡期早期、绝经过渡期晚期及绝经后妇女全身总脂肪组织百分比依次为（35±6）%、（35±5）%、（37±4）%及（37±5）%；“男性区域”脂肪百分比依次为（43±5）%、（43±4）%、（47±5）%及（46±5）%。不同月经状态妇女之间全身总脂肪组织百分比无明显差异（P=0.312）；但绝经过渡晚期及绝经后妇女“男性区域”脂肪百分比增加（P=0.026）。FAI高的妇女全身总脂肪组织含量增加（r=0.40，P＜0.01），中心性分布的脂肪百分比增加（r=0.28，P=0.003）。结论自绝经过渡期开始机体脂肪趋于中心性分布。雄激素与机体脂肪含量及分布相关，但可能不是导致中年女性机体脂肪分布改变的主要因素。Objective To investigate the relationship between androgen level and body adipose tissue content and distribution via a cross sectional survey in healthy women aged 40 to 60 years. Methods A total of 222 women were divided into 4 groups according menstruation status, i.e. reproductive stage, early perimenopausal stage, late perimenopausal stage and postmenopausal stage. Serum level of dehydroepiandrosterone （DHEA）, total testosterone （TT） and sex hormone binding globulin （SHBG） were measured. Free androgen index （FAI） was calculated. Body adipose tissue content and distribution were measured by dual-energy X-ray absorptiometry. Results In women aged 40 to 60 years, DHEA, TT and FAI level of reproductive stage women was （12.3±4.1） nmol/L, （0.56±0.22） nmol/L and 1.15 （quartile：0.71 to 1.85）, respectively. DHEA, TT and FAI level of early perimenopausal stage women was （12.0±3.4） nmol/L, （0.56 ± 0.24） nmol/L and 1.37 （quartile： 0.89 to 1.61）, respectively. DHEA, TT and FAI level of late perimenopausal stage women was （14.2 ± 4.7） nmol/L, （0.62 ± 0.18） nmol/L and 1.38 （quartile：1.12 to 1.63）. DHEA, TT and FAI level of postmenopausal stage women was （11.6±3.5） nmol/L, （0.45±0.22） nmol/L and 0.94 （quartile：0.47 to 1.49）. DHEA, TT and FAI level of perimenopausal stage women was comparable with＆amp;nbsp;those of reproductive stage women （P〉0.05）, however, TT and FAI level of postmenopausal women was significantly lower than those of reproductive stage women （P=0.001, 0.014）. The total adipose percentage of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were （35 ± 6）%, （35 ± 5）%, （37 ± 4）%and （37 ± 5）%. The adipose percentage in“android”area of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were （43±5）%, （43±4）%, （47±5）%and （46±5）%. The tot

关 键 词：雄激素类 脂肪组织 体脂分布 绝经前期 肥胖 腹部 去氢表雄酮 性激素结合球蛋白 

分 类 号：R711[医药卫生—妇产科学]