中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2015年
5期
346-351
,共6页
魏代敏%张颖%陈凤岭%郁琦
魏代敏%張穎%陳鳳嶺%鬱琦
위대민%장영%진봉령%욱기
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
雄激素類%脂肪組織%體脂分佈%絕經前期%肥胖,腹部%去氫錶雄酮%性激素結閤毬蛋白
웅격소류%지방조직%체지분포%절경전기%비반,복부%거경표웅동%성격소결합구단백
Androgens%Adipose tissue%Body fat distribution%Premenopause%Obesity,abdominal%Dehydroepiandrosterone%Sex hormone-binding globulin
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。
目的：通過對40~60歲健康婦女的橫斷麵調查，瞭解其體內雄激素水平及與機體脂肪含量及分佈的關繫。方法將222例40~60歲健康婦女按照月經狀態分為生育期、絕經過渡期早期、絕經過渡期晚期及絕經後，測定體內脫氫錶雄酮（DHEA）、總睪酮（TT）、性激素結閤毬蛋白（SHBG）水平，計算遊離雄激素指數（FAI）。使用雙能X線吸收骨密度儀測定機體脂肪含量及分佈。結果在40~60歲婦女中，生育期婦女體內DHEA、TT水平分彆為（12.3±4.1）、（0.56±0.22）nmol/L，FAI中位數為1.15；絕經過渡期早期婦女體內DHEA、TT水平分彆為（12.0±3.4）、（0.56±0.24）nmol/L，FAI中位數為1.37；絕經過渡期晚期婦女體內DHEA、TT水平分彆為（14.2±4.7）、（0.62±0.18）nmol/L，FAI中位數為1.38；絕經後婦女體內DHEA、TT水平分彆為（11.6±3.5）、（0.45±0.22）nmol/L，FAI中位數為0.94。與生育期婦女相比，絕經過渡期婦女體內雄激素水平（DHEA、TT、FAI）均無差異（P>0.05），絕經後婦女體內TT、FAI水平下降（P=0.001、0.014）。生育期、絕經過渡期早期、絕經過渡期晚期及絕經後婦女全身總脂肪組織百分比依次為（35±6）%、（35±5）%、（37±4）%及（37±5）%；“男性區域”脂肪百分比依次為（43±5）%、（43±4）%、（47±5）%及（46±5）%。不同月經狀態婦女之間全身總脂肪組織百分比無明顯差異（P=0.312）；但絕經過渡晚期及絕經後婦女“男性區域”脂肪百分比增加（P=0.026）。FAI高的婦女全身總脂肪組織含量增加（r=0.40，P＜0.01），中心性分佈的脂肪百分比增加（r=0.28，P=0.003）。結論自絕經過渡期開始機體脂肪趨于中心性分佈。雄激素與機體脂肪含量及分佈相關，但可能不是導緻中年女性機體脂肪分佈改變的主要因素。
목적：통과대40~60세건강부녀적횡단면조사，료해기체내웅격소수평급여궤체지방함량급분포적관계。방법장222례40~60세건강부녀안조월경상태분위생육기、절경과도기조기、절경과도기만기급절경후，측정체내탈경표웅동（DHEA）、총고동（TT）、성격소결합구단백（SHBG）수평，계산유리웅격소지수（FAI）。사용쌍능X선흡수골밀도의측정궤체지방함량급분포。결과재40~60세부녀중，생육기부녀체내DHEA、TT수평분별위（12.3±4.1）、（0.56±0.22）nmol/L，FAI중위수위1.15；절경과도기조기부녀체내DHEA、TT수평분별위（12.0±3.4）、（0.56±0.24）nmol/L，FAI중위수위1.37；절경과도기만기부녀체내DHEA、TT수평분별위（14.2±4.7）、（0.62±0.18）nmol/L，FAI중위수위1.38；절경후부녀체내DHEA、TT수평분별위（11.6±3.5）、（0.45±0.22）nmol/L，FAI중위수위0.94。여생육기부녀상비，절경과도기부녀체내웅격소수평（DHEA、TT、FAI）균무차이（P>0.05），절경후부녀체내TT、FAI수평하강（P=0.001、0.014）。생육기、절경과도기조기、절경과도기만기급절경후부녀전신총지방조직백분비의차위（35±6）%、（35±5）%、（37±4）%급（37±5）%；“남성구역”지방백분비의차위（43±5）%、（43±4）%、（47±5）%급（46±5）%。불동월경상태부녀지간전신총지방조직백분비무명현차이（P=0.312）；단절경과도만기급절경후부녀“남성구역”지방백분비증가（P=0.026）。FAI고적부녀전신총지방조직함량증가（r=0.40，P＜0.01），중심성분포적지방백분비증가（r=0.28，P=0.003）。결론자절경과도기개시궤체지방추우중심성분포。웅격소여궤체지방함량급분포상관，단가능불시도치중년녀성궤체지방분포개변적주요인소。
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 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 total adipose percentage was similar in 4 groups (P=0.312). Compared with reproductive stage women, adipose percentage of“android”area increased in late perimenopausal and postmenopausal women (P=0.026). Women with higher FAI level presented higher adipose tissue content and higher percentage of centrally distributed adipose tissue (r=0.28, P=0.003). Conclusions Body adipose tissue tends to distribute centrally from perimenopausal stage. Androgen level is related to body adipose tissue content and distribution, but may not be the main reason of changes of fat distribution in middle life women.
