POSTMENOPAUSAL HORMONE THERAPY AND INTRA ABDOMINAL FAT

背景：与更年期相关的激素和代谢变化 可能会增加患心血管疾病(CVD)的风险。数据表明 绝经后的月经周期与总的 中枢(“机器人”)身体脂肪；增加的致动脉粥样硬化成分 血脂谱；和糖耐量下降-所有 心血管疾病的危险因素。脂类和糖代谢的变化可能是 继发于中枢脂肪堆积，尤其是腹部脂肪堆积 脂肪(IAF)，与血脂异常和胰岛素有关的隔室 抵抗。激素替代疗法对血脂有积极作用 绝经后妇女的情况，并可能影响局部脂肪沉积。 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所介导的 为人所知。很少有研究研究激素替代的影响。 治疗对身体成分和脂肪分布的影响，但没有人研究过 外源性激素对IAF的影响--脂肪隔间最多 与疾病的增加密切相关。 目的：验证激素替代疗法(HRT， 雌激素和孕激素联合应用可减少绝经后妇女的疾病 限制IAF沉积的风险。拟议的研究将审查 激素替代疗法对总脂肪、局部脂肪和腹内脂肪沉积的影响 肥胖症、血脂谱和肥胖之间的关系 葡萄糖代谢。 设计：140名绝经后早期妇女的纵向队列研究 使用或不使用激素替代疗法。基线评估(在第一年内 将进行一次为期两年的后续评估。 全身脂肪将用双能X射线吸收测量仪进行评估， 水密度计量法和氚稀释；以及区域肥胖症(大腿、 腹部、腹内)将通过计算机断层扫描进行量化。 总胆固醇、高密度和低密度的循环水平 将测定脂蛋白胆固醇和甘油三酯。胰岛素 敏感性和葡萄糖耐量将用甲苯丁胺进行评估- 改良的、频繁采样的静脉葡萄糖耐量试验和 最小建模。 意义：激素替代疗法降低绝经后心血管疾病的风险和发病率 女人。这项研究将确定荷尔蒙替代疗法是否通过 影响脂肪分布，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 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.