POSTMENOPAUSAL HORMONE THERAPY AND INTRA ABDOMINAL FAT

绝经后激素治疗和腹部脂肪

• 批准号: 2837296
• 负责人: BARBARA A GOWER
• 金额: $ 8.67万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-01-01 至 2000-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2837296
• 关键词: adipose tissue; blood lipoprotein metabolism; body composition; cholesterol; clinical research; cortisol; estrogens; female; glucose tolerance; glucose tolerance test; hormone therapy; human subject; human therapy evaluation; insulin; insulinlike growth factor; longitudinal human study; postmenopause; progestins; tolbutamide; triglycerides; women's health

Background: Hormonal and metabolic changes associated with the menopause may confer increased risk for cardiovascular disease (CVD). Data indicate that the postmenopausal period is associated with increases in total and central ("android") body fat; increases in the atherogenic components of the blood lipid profile; and deterioration of glucose tolerance - all risk factors for CVD. Changes in lipid and glucose metabolism may be secondary to accumulation of central fat, particularly intra-abdominal fat (IAF), the compartment associated with dyslipidemia and insulin resistance. Hormone replacement therapy has positive effects on the lipid profile in postmenopausal women, and may affect regional fat deposition. However the extent to which the beneficial effects of hormone therapy on disease risk factors are mediated by changes in fat distribution is not known. Few studies have examined the effects of hormone replacement therapy on body composition and fat distribution, and none have examined the effect of exogenous hormones on IAF, the adipose compartment most closely associated with disease rise. Objective: To test the hypothesis that hormone replacement therapy (HRT, combined estrogen-progestin) in postmenopausal women decreases disease risk by limiting IAF deposition. The proposed research will examine the effect of HRT on total, regional, and intra-abdominal fat deposition, and on the relationships between adiposity, the plasma lipid profile, and glucose metabolism. Design: Longitudinal cohort study of 140 early post:menopausal women using or not using HRT. A baseline assessment (within the first year of hormone use) and one two-year follow-up assessment will be conducted. Total body fat will be assessed with dual-energy X-ray absorptiometry, hydrodensitometry, and deuterium dilution; and regional adiposity (thigh, abdominal, intra-abdominal) will be quantified with computed tomography. Circulating levels of total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides will be determined. Insulin sensitivity and glucose tolerance will be assessed with the tolbutamide- modified, frequently-sampled, intravenous, glucose tolerance test and minimal modeling. Significance: HRT reduces risk and incidence of CVD in postmenopausal women. This study will determine if HRT reduces disease risk by influencing fat distribution and decreasing IAF.

背景：与更年期相关的荷尔蒙和代谢变化 可能会增加患心血管疾病（CVD）的风险。数据表明 绝经后时期与总和的增加有关 中央（“机器人”）身体脂肪；致动脉粥样硬化成分增加 血脂状况；和葡萄糖耐量恶化 - 全部 CVD 的危险因素。脂质和葡萄糖代谢的变化可能是 继发于中央脂肪堆积，特别是腹部脂肪堆积 脂肪（IAF），与血脂异常和胰岛素相关的区室 反抗。激素替代疗法对血脂有积极作用 绝经后妇女的概况，并可能影响区域脂肪沉积。 然而，激素治疗的有益效果在多大程度上 疾病危险因素是由脂肪分布的变化介导的，而不是 已知。很少有研究探讨激素替代疗法的影响 身体成分和脂肪分布的治疗，并且没有人检查过 外源激素对 IAF 的影响最大的是脂肪室 与疾病的上升密切相关。 目的：检验激素替代疗法（HRT、 联合雌激素-孕激素）在绝经后妇女中可减少疾病 通过限制 IAF 沉积来降低风险。拟议的研究将检验 HRT 对总脂肪、局部脂肪和腹腔内脂肪沉积的影响，以及 肥胖与血脂之间的关系 葡萄糖代谢。 设计：140 名早期绝经妇女的纵向队列研究 使用或不使用 HRT。基线评估（第一年内 将进行一项为期两年的跟踪评估。 全身脂肪将通过双能 X 射线吸收测定法进行评估， 水密度测定法和氘稀释；和局部肥胖（大腿、 腹部、腹腔内）将通过计算机断层扫描进行量化。 高密度和低密度总胆固醇的循环水平 将测定脂蛋白胆固醇和甘油三酯。胰岛素 将用甲苯磺丁脲评估敏感性和葡萄糖耐量 改良的、频繁采样的、静脉内的、葡萄糖耐量试验和 最小建模。 意义：HR​​T 可降低绝经后 CVD 的风险和发病率 女性。这项研究将确定 HRT 是否可以通过以下方式降低疾病风险： 影响脂肪分布并减少 IAF。