HORMONE REPLACEMENT THERAPY AND METABOLIC CARDIOVASCULAR RISK

更年期转变与风险的显著增加有关。 心血管疾病。绝经后的激素替代疗法 女性患心血管疾病的风险降低了约50%， 尽管人们对其中的机制知之甚少。我们将研究 激素替代治疗对代谢危险因素的影响 影响老年妇女的心血管疾病和未来健康。 我们的总体假设是，早期的激素替代疗法 绝经后减少体内脂肪的中枢堆积和 改善胰岛素敏感性，从而减少代谢风险因素 心血管疾病。 共有72名女性将被招募参加这项为期2年的随机双 安慰剂对照的盲法纵向研究。我们将衡量结果 4例体脂分布和胰岛素敏感性的变化 (基线，6个月，1年和2年) 结合雌激素加醋酸甲羟孕酮或安慰剂。我们的 研究将评估结果变量变化的时间序列，以 洞察身体脂肪分布的变化是否先于 胰岛素敏感性的改变。 我们将使用：1)计算机断层扫描(CT)和双光子X光 吸光度(DEXA)扫描测量腹内脂肪和 全身脂肪，和2)正常血糖钳测量胰岛素敏感性。 对这些数据的分析将使我们了解 激素替代治疗中心性肥胖综合征与胰岛素 抵抗力，使女性易患心血管疾病。在……里面 此外，我们的研究可能允许医生针对激素替代 有特定身体成分的女性。

The menopause transition is associated with a pronounced increase in risk of cardiovascular disease. Hormone replacement therapy in postmenopausal women reduces the risk of cardiovascular disease by approximately 50%, although the mechanisms involved are poorly understood. We will examine the impact of hormone replacement therapy on metabolic risk factors affecting cardiovascular disease and future health in aging women. Our overall hypothesis is that hormone replacement therapy in the early postmenopausal period reduces the central accumulation of body fat and improves insulin sensitivity, thus reducing metabolic risk factors for cardiovascular disease. A total of 72 women will be recruited for this 2-year randomized double- blinded placebo- controlled longitudinal study. We will measure outcomes of changes in body fat distribution and insulin sensitivity on 4 occasions (baseline, 6 months, 1 year and 2 years) in women taking continuous conjugated estrogens plus medroxyprogesterone acetate or placebo. Our study will assess the temporal sequence of changes in outcome variables to provide insight into whether changes in body fat distribution precede alterations in insulin sensitivity. We will use: 1) computerized tomography (CT) and dual photon x-ray absorptiometry (DEXA) scanning to measure intra-abdominal body fat and total body fat, and 2) euglycemic clamps to measure insulin sensitivity. Analysis of these data will provide an understanding of the impact of hormone replacement on the syndrome of central obesity and insulin resistance, which predisposes women to cardiovascular disease. In addition, our study may allow physicians to target hormone replacement to women with specific body compositions.