Insulin sensitivity in postmenopausal women - Independent and combined associations with hormone replacement, cardiovascular fitness and body composition
Insulin sensitivity in postmenopausal women - Independent and combined associations with hormone replacement, cardiovascular fitness and body composition
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DOI：
10.2337/diacare.23.12.1731
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发表时间：
2000-12-01
期刊：
影响因子：
16.2
通讯作者：
Hagberg, JM
中科院分区：
文献类型：
--
作者：
Brown, MD;Korytkowski, MT;Hagberg, JM
目的：体力活动和激素替代疗法（HRT）对绝经后（PM）妇女胰岛素敏感性的影响尚不清楚。本研究的目的是验证以下假设：1）经过剧烈运动训练的PM女性比身体活动和PM的PM女性具有更高的胰岛素敏感性。久坐的妇女和2）使用HRT的PM妇女比不使用HRT的PM妇女具有更高的胰岛素敏感性。研究设计和方法-三组PM女性被分类为久坐（n = 18），身体活动（n = 19），和运动员（n = 23）进行胰岛素修饰的频繁采样静脉葡萄糖耐量试验，以确定胰岛素敏感性指数（S-1）结果：体力活动（P = 0.036）、HRT（P = 0.007）和空腹血浆胰岛素水平之间存在显著相关性。运动型PM女性的血浆胰岛素水平最低，而S-I水平最高。在所有体力活动水平中，使用HRT的PM女性（n = 29）与未使用HRT的PM女性（n = 31）相比具有显著更低的空腹血浆胰岛素水平和更低的S-I，HRT显著低于未使用HRT的PM女性（n = 31）。（P = 0.025）与静脉葡萄糖耐量（K-G）有关;未使用HRT的妇女比使用HRT的PM妇女具有更高的K-G（每分钟0.83 +/- 0.08对0.60 +/- 0.05%）。体脂百分比（r =-0.37，P = 0.004）和V-O2 max（r = 0.35，P = 0.007）是S-I的相似预测因子。结论-我们得出结论，尽管总体HRT与减弱的S-I相关，但剧烈运动训练与最大S-I独立相关。此外，使用HRT的PM女性可受益于具有较低的血浆胰岛素水平，但她们也可具有较低的S-I。
OBJECTIVE - The effects of combined physical activity and hormone replacement therapy (HRT) on insulin sensitivity in postmenopausal (PM) women are unclear. The purpose of the study was to test the following hypotheses: 1) PM women who have undergone vigorous exercise training have greater insulin sensitivity than PM women who are physically active and PM. women who are sedentary and 2) PM women using HRT have greater insulin sensitivity than PM women not using HRT. We also sought to determine whether body composition or cardiovascular fitness was the stronger predictor of insulin sensitivity in these women.RESEARCH DESIGN AND METHODS - Three groups of PM women classified as sedentary (n = 18), physically active (n = 19), and athletic (n = 23) underwent an insulin-modified frequently sampled intravenous glucose tolerance test to determine the insulin sensitivity index (S-l) and dual-energy X-ray absorptiometry to determine body composition.RESULTS - There was a significant association between both physical activity (P = 0.036) and HRT (P = 0.007) and Easting plasma insulin levels. The athletic PM women had the lowest plasma insulin levels and the highest S-l. Across all physical activity levels, PM women using HRT (n = 29) had significantly lower fasting plasma insulin levels and a lower S-l than PM women not using HRT (n = 31), HRT was significantly (P = 0.025) associated with intravenous glucose tolerance (K-G); the women not using HRT had a higher K-G than the PM women using HRT (0.83 +/- 0.08 vs. 0.60 +/- 0.05% per minute). Percent body fat (r = -0.37, P = 0.004) and V-O2max (r = 0.35, P = 0.007) were similar predictors of S-l.CONCLUSIONS - We conclude that, although overall HRT was associated with an attenuated S-l, vigorous exercise training was independently associated with the greatest S-l. In addition, PM women using HRT may benefit from having lower plasma insulin levels, but they may also have a lower S-l.