POST MENOPAUSAL HORMONE THERAPY AND INTRA ABDOMINAL FAT

背景：与绝经相关的激素和代谢变化 可能增加心血管疾病（CVD）的风险。 数据表明 绝经后时期与总的增加有关， 中央（“android”）体脂肪;动脉粥样硬化成分增加 血脂谱;和葡萄糖耐量恶化-所有风险 CVD的因素。脂质和葡萄糖代谢的变化可能是继发性的 中央脂肪的积累，特别是腹腔内脂肪（IAF）， 与血脂异常和胰岛素抵抗相关的隔室。 激素替代疗法对血脂有积极影响， 绝经后妇女，并可能影响区域脂肪沉积。 然而，在这方面， 激素治疗对疾病的有益效果 风险因素是由脂肪分布的变化介导的尚不清楚。 很少有研究检查激素替代疗法对 身体成分和脂肪分布，并没有检查的影响， 外源性激素对IAF的影响， 疾病风险。 目的：验证激素替代疗法（HRT， 联合雌激素-孕激素）降低绝经后妇女的风险， 限制IAF沉积。 拟议的研究将审查的影响， HRT对总脂肪、局部脂肪和腹腔内脂肪沉积的影响， 肥胖、血脂和血糖之间的关系 新陈代谢. 设计：对140名绝经早期妇女进行纵向队列研究， 或者不用激素替代疗法 基线评估（在激素治疗的第一年内） 使用），并将进行一次为期2年的随访评估。 全身 将用双能X射线吸收测定法评估脂肪， 氢密度测定法和氘稀释法;和局部肥胖（大腿， 腹部、腹内）将用计算机断层扫描定量。 总胆固醇、高密度脂蛋白和低密度脂蛋白的循环水平 胆固醇和甘油三酯。 胰岛素敏感性 并且葡萄糖耐量将用甲苯磺丁脲修饰的， 频繁采样，静脉葡萄糖耐量试验和最小 建模 意义：HRT可降低绝经后心血管疾病的风险和发生率 妇女这项研究将确定HRT是否通过以下方式降低疾病风险： 影响脂肪分布和降低IAF。

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 non have examined the effect of exogenous hormones on IAF, the adipose compartment most closely associated with disease risk. Objective: To test the hypothesis that hormone replacement therapy (HRT, combined estrogen-progestin) in postmenopausal women decreases 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 postmenopausal women using or not using HRT. A baseline assessment (within the first year of hormone use) and one 2-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 tolbutaminde-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.