MENOPAUSE EFFECT ON OBESITY, ENERGY BALANCE AND INSULIN

更年期与身体成分的变化和 高加索女性心血管危险因素增加，尽管 关于非洲更年期的影响的信息较少- 美国女性。生殖激素水平的变化是 更年期生理变化的中心，因为这些 荷尔蒙与身体脂肪分布有关，很可能它们 在生命的这个时期，在与身体脂肪相关的变化中扮演一个角色。整体而言 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，并确定它们的机制 可能会影响身体脂肪的变化，在一项前瞻性的跟踪队列中 高加索和非裔美国女性。概述的研究将 阐述4个一般假设。首先，我们假设更年期 增加腹部总脂肪和内脏脂肪。第二，我们 假设人体成分和体重的变化在 更年期至少部分是通过24小时能量的变化来调节的 支出、体力活动和/或食物摄入量。第三，我们 假设绝经导致胰岛素敏感性降低 可能使某些女性在以后的生活中容易患上糖尿病。这些 胰岛素作用的改变可能与改变肥胖或 可能与荷尔蒙变化独立相关。最后，我们 假设可能有不同的反应 非洲裔美国女性的更年期变化，她们最终有了 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高加索女性相比。 由于非洲裔美国女性的健康统计数据显著 比美国高加索人口更糟糕的是，理解 绝经对非裔美国女性危险因素的影响 具有重大的公共卫生意义。为了解决这些假设 关于更年期的影响，建议进行一项纵向研究。 在那里，47-52岁的绝经前妇女将被评估 每年和结果变量的变化与老龄化和 更年期状态将被确定。主要结果变量 包括通过CT扫描腹内远侧分布、身体成分 24小时能量消耗、食物摄入量和活动量，以及胰岛素 用最小模型法进行灵敏度分析。在众多优势中， 该设计包括解决更年期机制的能力 更改，因为顺序测量将随时间推移在这些 结果变量。强调了这项研究的重要性。 在国家老龄研究所最近的一份共识报告中 声明“需要对妇女进行纵向(观察)” 时间..。是必不可少的..。增进我们对自然历史的了解 绝经期“。

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".