HORMONE REPLACEMENT AND METABOLIC CARDIOVASCULAR RISK

更年期的过渡与显著增加 心血管疾病的风险。 激素替代疗法 降低了绝经后妇女患心血管疾病的风险 大约50%的疾病，虽然机制 参与者知之甚少。 我们将研究 激素替代治疗对影响代谢危险因素 老年妇女的心血管疾病和未来健康。 我们的总体假设是， 绝经后早期减少了 身体脂肪和改善胰岛素敏感性，从而减少 心血管疾病的代谢危险因素。 共招募88名女性参与这项为期2年的随机化研究。 双盲安慰剂对照纵向研究。 我们将 测量身体脂肪分布和胰岛素变化的结果 4种情况下的敏感性（基线、6个月、1年和2 持续服用结合雌激素加 醋酸甲羟孕酮或安慰剂。 我们的研究将提供 关于结果变化时间顺序的新信息 变量 我们将使用：用途：1）计算机断层扫描（CT）和双光子X-射线成像（Dual Photon X-ray）。 X线吸收测定法（DEXA）扫描测量腹腔内 体脂肪和总体脂肪，和2）正常血糖钳夹测量 胰岛素敏感性 对这些数据的分析将有助于了解 激素替代治疗对中心性肥胖综合征的影响 和胰岛素抵抗，这使女性更容易患上 治疗心血管疾病 此外，我们的研究可能会使 医生将激素替代疗法的目标定位于患有特定 身体成分

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 percent, 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, thereby reducing a metabolic risk factor for cardiovascular disease. A total of 88 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 provide new information on the temporal sequence of changes in outcome variables. 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 increased risk for cardiovascular disease. In addition, our study may allow physicians to target hormone replacement to women with specific body compositions.