Effects of ovarian failure and X-chromosome deletion on body composition and insulin sensitivity in young women
Effects of ovarian failure and X-chromosome deletion on body composition and insulin sensitivity in young women
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DOI：
10.1097/01.gme.0000248702.25259.00
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发表时间：
2006-11-01
影响因子：
2.7
通讯作者：
Bondy, Carolyn A.
中科院分区：
文献类型：
--
作者：
Corrigan, Emily C.;Nelson, Lawrence M.;Bondy, Carolyn A.
目的：更年期与内脏肥胖增加和胰岛素敏感性降低有关。目前尚不清楚这些变化主要是由于卵巢衰竭还是衰老造成的。本研究的目的是阐明卵巢衰竭对年轻女性身体成分和胰岛素敏感性的影响。设计：在一项横断面研究中，我们比较了三组的主要结果指标（体重指数、双能 X 射线吸收测定法测定的身体成分以及定量胰岛素敏感性检查指数测定的胰岛素敏感性）：患有 46,XX 卵巢早衰 (POF) 的女性、患有 45,X 或特纳综合征 (TS) 相关卵巢早衰的女性以及正常对照女性 (NC)。参与者于 2000 年至 2005 年间参加美国国立卫生研究院临床中心方案。 结果：POF 女性 (n = 398) 的平均体重指数 (+/- SD) 较低：24.3 +/- 5 kg/m(2)，而 TS 女性 (n = 131) 为 27.8 +/- 7，对照 (n = 73) 为 26.6 +/- 4（均 P < 0.001）。只有 33% 的 POF 女性超重或肥胖，而 TS 女性的超重或肥胖比例为 56%，NC 女性的这一比例为 67%（两者 P < 0.0001）。尽管肥胖程度较低，但与 TS 女性（0.378 +/- 0.03，P = 0.003）和 NC 女性（0.376 +/- 0.03，P = 0.04）相比，POF 女性的胰岛素敏感性较低（0.367 +/- 0.03）。在年龄和体重指数相似的分组中，患有 POF 的女性 (n = 89)、患有 TS 的女性 (n = 48) 和 NC 女性 (n = 40) 的全身和躯干肥胖程度相似。调整年龄和躯干肥胖后，POF 女性的胰岛素敏感性显着低于 TS 女性 (P = 0.03) 和 NC 女性 (P = 0.049)。结论：与中年绝经后女性的观察结果相反，年轻女性的卵巢功能衰竭与总肥胖或中心肥胖的增加无关。事实上，患有 TS 的女性与 NC 女性相似，而患有 POF 的女性则更瘦。 POF 女性中观察到的较低的胰岛素敏感性值得进一步研究。
Objective: Menopause is associated with increased visceral adiposity and reduced insulin sensitivity. It remains unclear whether these changes are due primarily to ovarian failure or aging. The aim of this study was to clarify the impact of ovarian failure on body composition and insulin sensitivity in young women. Design: In a cross-sectional study, we compared main outcome measures (body mass index, body composition by dual-energy x-ray absorptiometry, and insulin sensitivity by Quantitative Insulin Sensitivity Check Index) in three groups: women with 46,XX premature ovarian failure (POF), women with premature ovarian failure associated with 45,X or Turner syndrome (TS), and normal control women (NC). Participants were enrolled in National Institutes of Health Clinical Center protocols between years 2000 and 2005. Results: Mean body mass index (+/- SD) was lower in women with POF (n = 398): 24.3 +/- 5 kg/m(2) versus 27.8 +/- 7 for women with TS (n = 131) and 26.6 +/- 4 for controls (n = 73) (both P < 0.001). Only 33% of women with POF were overweight or obese, compared with 56% of those with TS and 67% of NC women (P < 0.0001 for both). Despite less obesity, women with POF had lower insulin sensitivity (0.367 +/- 0.03) compared with those with TS (0.378 +/- 0.03, P = 0.003) and NC women (0.376 +/- 0.03, P = 0.04). In groups selected for similar age and body mass index, women with POF (n = 89), women with TS (n = 48), and NC women (n = 40) had similar total body and trunk adiposity. After adjustment for age and truncal adiposity, women with POF had significantly lower insulin sensitivity than women with TS (P = 0.03) and NC women (P = 0.049). Conclusions: In contrast to observations in middle-aged postmenopausal women, ovarian failure in young women is not associated with increased total or central adiposity. In fact, women with TS were similar to NC women, whereas women with POF were leaner. The lower insulin sensitivity observed in women with POF deserves further investigation.