Obesity and reproductive hormone levels in the transition to menopause.
Obesity and reproductive hormone levels in the transition to menopause.
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DOI：
10.1097/gme.0b013e3181cec85d
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发表时间：
2010-07
期刊：
影响因子：
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通讯作者：
Gracia CR
中科院分区：
文献类型：
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作者：
Freeman EW;Sammel MD;Lin H;Gracia CR
估计女性从绝经前到绝经后状态的肥胖与生殖激素水平的相关性。这是一项在基于人群的Penn卵巢老化队列（N=436）中进行的纵向研究。在队列招募时，女性绝经前，年龄35-47岁，非裔美国人和白人人数相等。对人体测量、绝经状态和生殖激素测量进行了12年的评价。采用重复测量的广义线性回归模型，估计绝经过渡期人体测量与雌二醇、FSH和雌二醇B的相关性。肥胖和激素水平之间的关联因绝经状态而异，如每种激素和绝经阶段之间的显著相互作用所示。绝经前肥胖和超重女性的雌二醇水平显著低于非肥胖女性，与年龄、种族和吸烟无关（肥胖：32.8 pg/mL; 95% CI：30.6）。35.2与非肥胖者相比：39.8 pg/mL; 95% CI：37.0，42.8，P<0.001）。这些关联逆转了绝经后的情况，肥胖女性的雌二醇水平最高（肥胖：20.6 pg/mL; 95% CI：17.2，24.7 vs非肥胖：12.2 pg/mL; 95% CI：10.1，14.8，P<0.001）。抑制素B水平显着低于绝经前肥胖相比，非肥胖妇女，但逆转在后期过渡阶段。绝经后肥胖妇女的FSH水平最低，与非肥胖妇女相比（P<0.001）。腰围（中心性肥胖）和腰臀比的测量结果与BMI结果一致。肥胖是中年女性激素动力学的一个重要因素，与年龄、种族和吸烟无关，尽管其机制尚不清楚。
To estimate associations of obesity with reproductive hormone levels as women progress from premenopausal to postmenopausal status. This is a longitudinal study conducted in the population-based Penn Ovarian Aging Cohort (N=436). At cohort enrollment, the women were premenopausal, ages 35–47 years, with equal numbers of African Americans and Caucasians. Anthropometric measures, menopausal status and reproductive hormone measures were evaluated for 12 years. Associations of the anthropometric measures with estradiol, FSH and inhibin b in the menopausal transition were estimated using generalized linear regression models for repeated measures. Associations between obesity and hormone levels differed by menopausal status as indicated by significant interactions between each hormone and menopausal stage. Premenopausal obese and overweight women had significantly lower estradiol levels compared to non-obese women, independent of age, race and smoking (obese: 32.8 pg/mL; 95% CI: 30.6. 35.2 versus non-obese: 39.8 pg/mL; 95% CI: 37.0, 42.8, P<0.001). The associations reversed postmenopause, with obese women having the highest estradiol levels (obese: 20.6 pg/mL; 95% CI: 17.2, 24.7 versus non-obese: 12.2 pg/mL; 95% CI: 10.1, 14.8, P<0.001). Inhibin b levels were significantly lower in premenopausal obese compared to non-obese women but reversed in the late transition stage. FSH levels were lowest in postmenopausal obese compared to non-obese women (P<0.001). Measures of waist circumference (central adiposity) and waist/hip ratio paralleled the BMI results. Obesity is an important factor in hormone dynamics independent of age, race and smoking in mid-life women, although the mechanisms remain unclear.