HORMONE REPLACEMENT AND METABOLIC CARDIOVASCULAR RISK

更年期的转变与显著增加有关。 有患心血管疾病的风险。激素替代疗法 绝经后妇女降低心血管疾病风险 疾病减少了大约50%，尽管机制 人们对此知之甚少。我们将研究以下影响： 激素替代治疗对代谢危险因素的影响 老年妇女的心血管疾病和未来健康。 我们的总体假设是荷尔蒙替代疗法在 绝经后早期减少中枢性蓄积 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。 共有88名女性将被招募参加这项为期两年的随机调查 双盲安慰剂对照纵向研究。我们会 测量体脂分布和胰岛素变化的结果 4次敏感度(基线、6个月、1年和2年 年)，在服用持续结合雌激素加 醋酸甲羟孕酮或安慰剂。我们的研究将提供 关于结果变化的时间序列的新信息 变量。 我们将使用：1)计算机断层扫描(CT)和双光子x- 射线吸收法(DEXA)扫描测量腹内面积 体脂和总体脂，以及2)正常血糖钳测量 胰岛素敏感性。 对这些数据的分析将提供对 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更高的风险 治疗心血管疾病。此外，我们的研究可能会允许 医生将针对患有特定疾病的女性进行激素替代 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.