Reproductive Hormones and Obesity: 9 Years of Observation From the Study of Women's Health Across the Nation
Reproductive Hormones and Obesity: 9 Years of Observation From the Study of Women's Health Across the Nation
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DOI：
10.1093/aje/kwq049
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发表时间：
2010-06-01
影响因子：
5
通讯作者：
Matthews, Karen
中科院分区：
文献类型：
--
作者：
Sutton-Tyrrell, Kim;Zhao, Xinhua;Matthews, Karen
在1996-1997年全国多种族妇女健康研究中招募的3,260名美国妇女，对生殖激素变化和更年期对肥胖症（体重指数>= 30 kg/m(2)）和严重肥胖（体重指数>= 35 kg/m(2)）的影响进行了为期9年的评估。9年后，肥胖和重度肥胖的累计发病率分别达到21.8%和12.3%。在多变量分析中，激素变化、慢性健康状况、体力活动减少、种族/民族和年龄与肥胖事件和/或严重肥胖显著相关。手术绝经后发生严重肥胖的几率增加(优势比(OR) = 5.07, 95%可信区间（CI）： 2.29, 11.20；P < 0.001)和闭经前12个月开始激素治疗（OR = 2.94, 95% CI: 1.14, 7.58; P = 0.03）。肥胖的预测因子包括游离雄激素指数增加（OR = 1.37, 95% CI: 1.12, 1.68; P = 0.002）和性激素结合球蛋白减少（OR = 0.60, 95% CI: 0.45, 0.80; P = 0.0005）。在严重肥胖人群中也发现了类似的结果。肥胖率因种族而异，但没有观察到激素与种族的相互作用。这些纵向数据表明，高雄激素水平、低性激素结合球蛋白水平、手术绝经和早期激素治疗可预测进入更年期的多种族女性的肥胖和/或严重肥胖。
The effect of change in reproductive hormones and menopause on incident obesity (body mass index >= 30 kg/m(2)) and severe obesity (body mass index >= 35 kg/m(2)) was evaluated over 9 years in 3,260 US women recruited in the multiethnic Study of Women's Health Across the Nation in 1996-1997. After 9 years, cumulative incidences of obesity and severe obesity reached 21.8% and 12.3%, respectively. In multivariate analysis, hormone changes, chronic health conditions, lower physical activity, race/ethnicity, and age were significantly associated with incident obesity and/or severe obesity. The odds of incident severe obesity increased with surgical menopause (odds ratio (OR) = 5.07, 95% confidence interval (CI): 2.29, 11.20; P < 0.001) and initiation of hormone therapy prior to 12 months of amenorrhea (OR = 2.94, 95% CI: 1.14, 7.58; P = 0.03). Predictors of obesity included an increase in free androgen index (OR = 1.37, 95% CI: 1.12, 1.68; P = 0.002) and a decrease in sex hormone-binding globulin (OR = 0.60, 95% CI: 0.45, 0.80; P = 0.0005). Similar results were found for severe obesity. Obesity rates varied by race, but no hormone-by-race interactions were observed. These longitudinal data demonstrate that higher androgens, lower sex hormone-binding globulin, surgical menopause, and early hormone therapy use predict incident obesity and/or severe obesity in a multiracial cohort of women transitioning into menopause.