MENOPAUSE EFFECT ON OBESITY, ENERGY BALANCE AND INSULIN

更年期与身体成分的变化有关， 高加索妇女心血管危险因素增加， 关于更年期对非洲人的影响的信息较少- 美国女人 生殖激素水平的变化 更年期生理变化的核心，因为这些 激素与身体脂肪分布有关，很可能它们 在生命的这个时期，在身体脂肪相关的变化中发挥作用。 整体 这项建议的目的是评估更年期对身体的影响， 组成和脂肪分布，并确定其机制， 可能会影响体脂变化，在一个前瞻性随访队列中， 白人和非裔美国女性 概述的研究将 四个基本假设。 首先我们假设更年期 增加腹部脂肪总量和内脏脂肪。 二是 假设，身体成分和体重的变化， 绝经期是介导的，至少部分是由24小时能量的变化引起的。 支出、身体活动和/或食物摄入。 三是 假设绝经导致胰岛素敏感性降低， 可能使某些妇女在以后的生活中容易患上糖尿病。 这些 胰岛素作用的变化可能与肥胖的变化有关， 可能与激素变化独立相关。 最后我们 假设可能存在不同的反应， 非洲裔美国妇女的更年期变化， 肥胖、胰岛素敏感性和生殖能力的差异 绝经前的激素水平与白人女性相比。 由于非裔美国妇女的健康统计数据 比美国白人更糟糕，了解 绝经对非裔美国妇女危险因素的影响 公共卫生意义重大。 为了解决这些假设 与更年期的影响有关，建议进行一项长期研究 其中将评估47-52岁的绝经前女性 与老龄化有关的结果变量的变化， 将确定绝经状态。 主要结局变量 包括通过CT扫描腹内脂肪分布、身体组成 24小时能量消耗、食物摄入和活动以及胰岛素 最小模型法的灵敏度。 在这些优势中， 这种设计包括解决绝经期的机制 变化，因为将随着时间的推移在这些 结果变量。 强调了这项研究的重要性 国家老龄化研究所最近的一份共识报告中， 指出，“需要对妇女进行纵向（观察）， 时间...是必不可少的来增进我们对自然历史的了解 更年期”。

Menopause has been associated with changes in body composition and increased cardiovascular risk factors in Caucasian women, although less information is available on the effects of menopause in African- American women. Changing levels of reproductive hormones are central to the physiological changes at menopause and, since these hormones have been related to body fat distribution, its likely that they play a role in body fat-related changes at this time of life. The overall goal of this proposal is to assess the influence of menopause on body composition and fat distribution, and to determine mechanisms they may influence body fat changes, in a prospectively followed cohort of Caucasian and African-American women. the studies outlined will address 4 general hypotheses. First, we hypothesize that menopause increases both total and visceral abdominal fat. Second, we hypothesize that the changes in body composition and body weight at menopause are mediated, at least in part by changes in 24-hour energy expenditure, physical activity and/or food intake. Third, we hypothesize that menopause results in decreased insulin sensitivity that may predispose certain women to develop diabetes later in life. These changes in insulin action may be connected to changing adiposity or may be independently related to hormonal changes. finally, we hypothesize that there may be a differential responsiveness to menopausal changes in African-American women, who end to have differences inn adioposity, insulin sensitivity, and reproductive hormone levels premenopausally compared to Caucasian women. Since health statistics for African-american women are significantly worse than for the U.S. Caucasian population, understanding the effects of menopause on risk factors in african-American women is of great public health significance. In order to address these hypotheses related to the effects of menopause, a longtidudinal study is proposed where premenopausal women aged 47-52 year old will be assessed annually and changes in outcome variables in relation to aging and menopausal status will be determined. Major outcome variables include intra-abdominal far distribution by CT scan, body composition, 24-hr energy expenditure, food intake and activity, and insulin sensitivity by the Minimal Model method. Among the strengths of this design include the ability to address mechanisms of menopausal changes since sequential measurements will be taken over time in these outcome variables. The importance of this research was underscored in a recent consensus report from the National Institute on Ageing stating that "The need for longitudinal (observations) of women over time ... is essential ... to advance our knowledge of the natural history of menopause".