The emergence of the metabolic syndrome with menopause
The emergence of the metabolic syndrome with menopause
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DOI：
10.1210/jc.2003-030242
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发表时间：
2003-06-01
影响因子：
5.8
通讯作者：
Carr, MC
中科院分区：
文献类型：
--
作者：
Carr, MC
患有代谢综合征（中枢性肥胖、胰岛素抵抗和血脂异常）的女性患心血管疾病（CVD）的风险特别高。代谢综合征的患病率随着更年期的增加而增加，这可能部分解释了更年期后心血管疾病的明显加速。从绝经前到绝经后的过渡与代谢综合征的许多特征的出现有关，包括1)中央（腹内）体脂肪增加；2)向更具有动脉粥样硬化性的脂质谱转变，低密度脂蛋白和甘油三酯水平增加，高密度脂蛋白减少，小而致密的低密度脂蛋白颗粒；葡萄糖和胰岛素水平升高。这些危险因素的出现可能是卵巢功能衰竭的直接结果，也可能是雌激素缺乏引起的中心脂肪再分配的代谢后果的间接结果。目前尚不清楚是所有女性进入更年期都会增加心血管疾病的风险，还是只有那些出现代谢综合征特征的女性才会增加。本文将综述雌激素缺乏引起的代谢综合征的特点。更好地了解更年期的这些代谢变化将有助于认识和治疗未来有心血管疾病风险的妇女，从而采取适当的干预措施。
Women with the metabolic syndrome ( central obesity, insulin resistance, and dyslipidemia) are known to be at especially high risk for cardiovascular disease (CVD). The prevalence of the metabolic syndrome increases with menopause and may partially explain the apparent acceleration in CVD after menopause. The transition from pre- to postmenopause is associated with the emergence of many features of the metabolic syndrome, including 1) increased central (intraabdominal) body fat; 2) a shift toward a more atherogenic lipid profile, with increased low density lipoprotein and triglycerides levels, reduced high density lipoprotein, and small, dense low density lipoprotein particles; 3) and increased glucose and insulin levels. The emergence of these risk factors may be a direct result of ovarian failure or, alternatively, an indirect result of the metabolic consequences of central fat redistribution with estrogen deficiency. It is unclear whether the transition to menopause increases CVD risk in all women or only those who develop features of the metabolic syndrome. This article will review the features of the metabolic syndrome that emerge with estrogen deficiency. A better understanding of these metabolic changes with menopause will aid in the recognition and treatment of women at risk for future CVD, leading to appropriate interventions.