Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women
Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women
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DOI：
10.1046/j.1365-2796.1997.120129000.x
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发表时间：
1997-05-01
影响因子：
11.1
通讯作者：
Bosello, O
中科院分区：
文献类型：
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作者：
Turcato, E;Zamboni, M;Bosello, O
目标.评估局部体脂分布与性激素之间的关系以及减肥后性激素的变化。设置。所有受试者均在维罗纳大学内科研究所住院。26名绝经前（年龄33.7+/-10.2岁）和15名绝经后（年龄57.9+/-5.9岁）肥胖女性。在极低能量饮食4周前后评估体重、体重指数、腰围和臀围、计算机断层扫描内脏脂肪和性激素。绝经前妇女的体重指数高于绝经后妇女，但差异不显著。总睾酮和游离睾酮在绝经前组明显高于绝经后组（P < 0.001）.年龄与总睾酮（r = -0.65; P < 0.001）、游离睾酮（r = -0.54; P < 0.001）、雄烯二酮（r = -0.46; P < 0.01）和尿皮质醇排泄量（r = -0.50; P < 0.01）呈显著负相关。内脏脂肪与总睾酮呈负相关（r = -0.41; P < 0.01）。在调整年龄后，总睾酮和内脏脂肪之间的负相关性在整个受试者组和绝经前妇女中不再显著，而内脏脂肪和性激素结合球蛋白（SHBG）之间存在显著的负相关性。（r = -0.56;当使用逐步回归分析来评估年龄、绝经状态、人体测量和代谢变量对性激素的联合作用时，年龄是预测总睾酮、游离睾酮和雄烯二酮水平的最有力的独立变量，而更年期状态是预测FSH和LK水平的最有力的预测因素。在绝经前和绝经后的妇女中分别分析VLED后激素的变化。在绝经后组中，VLED后除FSH值外，其他激素均无显著变化。绝经前组VLED后LH、游离睾酮和尿皮质醇排泄量显著降低。我们的数据表明，年龄，在更大程度上比内脏脂肪，似乎是负相关的类固醇性激素。体重减轻似乎只与绝经前妇女的性激素变化有关。
Objectives. Relationships between regional body fat distribution and sex hormones as well as changes in sex hormones after weight loss were evaluated.Setting. All subjects were hospitalized in the Institute of Internal Medicine of the University of Verona.Subjects. Twenty-six premenopausal (age 33.7+/-10.2 years) and 15 postmenopausal (age 57.9+/-5.9 years) obese women.Interventions. Body weight, body-mass index, waist and hip circumferences, visceral fat by computed tomography and sex hormones were evaluated before and after 4 weeks on a very low energy diet.Results. Body-mass index was higher in pre- than in postmenopausal women, although the difference was not significant. Total and free testosterone were significantly higher in the pre- than in the postmenopausal group (P < 0.001). Significant negative correlations were found between age and total testosterone (r = -0.65; P < 0.001), free testosterone (r = -0.54; P < 0.001), androstenedione (r = -0.46; P < 0.01) and urinary cortisol excretion (r = -0.50; P < 0.01). A negative correlation was found between visceral fat and total testosterone (r = -0.41; P < 0.01). After adjusting for age, the negative correlation between total testosterone and visceral fat encountered both in the subject group as a whole and in premenopausal women was no longer significant, whilst a significant negative association between visceral fat and sex hormone binding globulin (SHBG) (r = -0.56; P < 0.001) was always found. When step-down regression analysis was used to evaluate the joint effect of age, menopausal status, and anthropometric and metabolic variables on sex hormones, age was the most powerful independent variable for predicting total testosterone, free testosterone and androstenedione levels, whilst menopausal status was the most powerful predictor of FSH and LK levels. Changes in hormones after VLED were analysed separately in pre- and postmenopausal women. None of the hormones changed significantly after VLED in the postmenopausal group, except for FSH values. LH, free testosterone and urinary cortisol excretion values decreased significantly after VLED in the premenopausal group.Conclusions. Our data show that age, to a greater extent than visceral fat, seems to be negatively associated with steroid sex hormones. Weight loss seems to be associated with changes in sex hormones only in premenopausal women.