Ectopic Lipid Deposition Is Associated With Insulin Resistance in Postmenopausal Women
Ectopic Lipid Deposition Is Associated With Insulin Resistance in Postmenopausal Women
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DOI：
10.1210/jc.2018-00554
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发表时间：
2018-09-01
影响因子：
5.8
通讯作者：
Lindegaard, Birgitte
中科院分区：
文献类型：
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作者：
Abildgaard, Julie;Danielsen, Else Rubaek;Lindegaard, Birgitte
背景：更年期与胰岛素抵抗和糖尿病的发病率增加有关。目的：本研究的目的是探讨绝经后和绝经前女性肝脏和骨骼肌中的脂质沉积，并调查其与胰岛素敏感性的关系。设计和背景：对 55 名 45 至 60 岁健康女性进行的单中心横断面研究。我们通过磁共振波谱测量了肝脏中的脂质沉积，通过 MRI 测量了肌肉内和腹腔内的脂质沉积，通过双能 X 射线吸收测量扫描测量了身体成分，并通过综合松田指数测量了胰岛素敏感性。结果测量：我们研究了绝经前和绝经后妇女的脂肪分布、异位脂质沉积和胰岛素敏感性之间的关联。结果：绝经后妇女肝脏中的脂质沉积增加 [0.68%] （0.44 至 0.99）对比 0.49%（0.38 至 0.64），P= 0.01] 和骨骼肌 [3%（2 至 4）对比 2%（1 至 3），P= 0.001]，并且在口服葡萄糖耐量试验期间松田胰岛素敏感性指数降低 28%（6.31 +/- 3.48 对比 8.78 +/- 4.67，P=0.05）与绝经前女性相比。与绝经前女性相比，总脂肪量和腿部脂肪量是异位脂质沉积的更强预测因子，内脏脂肪量是绝经后女性异位脂质沉积和胰岛素抵抗的更强预测因子。结论：对于给定的皮下和内脏脂肪库大小，与绝经前女性相比，绝经后女性表现出异位脂质沉积和胰岛素抵抗增加。有人认为，肝脏和骨骼肌中的脂质沉积可能代表脂肪库变化与绝经后胰岛素抵抗发生率增加之间的重要机制联系。
Context: Menopause is associated with an increased incidence of insulin resistance and diabetes.Objective: The aim of this study was to explore the lipid deposition in liver and skeletal muscle and investigate the association with insulin sensitivity in postmenopausal and premenopausal women.Design and Setting: Single-center cross-sectional study of 55 healthy women between 45 and 60 years of age. We measured lipid deposition in the liver with magnetic resonance spectroscopy, intramuscular and intra-abdominal lipid deposition with MRI, body composition with a dual-energy X-ray absorptiometry scan, and insulin sensitivity with the composite Matsuda Index.Outcome Measures: We studied the association between fat distribution, ectopic lipid deposition, and insulin sensitivity in pre- and postmenopausal women.Results: Postmenopausal women had an increased lipid deposition in the liver [0.68% (0.44 to 0.99) vs 0.49% (0.38 to 0.64), P= 0.01] and skeletal muscle [3% (2 to 4) vs 2% (1 to 3), P= 0.001] and had a 28% lower Matsuda insulin sensitivity index during an oral glucose tolerance test (6.31 +/- 3.48 vs 8.78 +/- 4.67, P= 0.05) compared with premenopausal women. Total fat mass and leg fat mass were stronger predictors of ectopic lipid deposition, and visceral fat mass was a stronger predictor of both ectopic lipid deposition and insulin resistance in postmenopausal women compared with premenopausal women.Conclusions: For a given subcutaneous and visceral fat depot size, postmenopausal women show increased ectopic lipid deposition and insulin resistance compared with premenopausal women. It is suggested that lipid deposition in liver and skeletal muscle may represent important mechanistic links between the changes in fat depots and the increased incidence of insulin resistance seen after menopause.