摘要
目的 探讨血清睾酮水平及绝经相关指标与绝经过渡期及绝经后女性代谢综合征（ metabolic syndrome,MS）的关系.方法 对2009年5月至2010年8月在中山大学孙逸仙纪念医院进行健康体检的911例年龄40～65岁的受检者按照不同绝经阶段进行分组：A组175例,绝经过渡期早期；B组112例,绝经过渡期晚期；C组161例,绝经后早期；D组132例,绝经后中期；E组88例,绝经后晚期；F组为对照组,243例月经周期规律者.根据国际糖尿病联盟（IDF） MS定义标准,分析绝经过渡期及绝经后女性MS与血清睾酮水平及相关指标的关系.结果 （1）中位血清睾酮水平A组1.03 nmol/L、B组0.91 nmol/L、C组0.91 nmol/L、D组0.87 nmol/L、E组0.83 nmol/L,分别与F组1.13 nmol/L比较,差异均有统计学意义（P＜0.01）；中位游离睾酮指数（FAI）A组1.33,B组1.56,F组1.69,A组与B、F组分别比较,差异均有统计学意义（P＜0.01）；睾酮/雌二醇水平C组0.042,D组0.040,E组0.042,F组0.010,C、D、E组与F组分别比较,差异均有统计学意义（P＜0.01）.（2）MS患者中性激素结合蛋白（SHBG）水平与腰围、空腹血糖（FBG）、甘油三酯水平呈负相关关系（r分别为-0.287、- 0.281、-0.224）；与高密度脂蛋白胆固醇（HDL-C）水平呈正相关关系（r=0.314）；MS相关因素的logistic回归分析的结果显示,SHBG与MS显著相关（OR=0.993,95％ CI为0.986 ～0.999,P=0.035）.（3）当血清SHBG水平以56.14 nmol/L为界值时,SHBG对受检者MS预测的敏感度为63.13％,特异度为69.45％.结论 绝经过渡期及绝经后受检者血清睾酮水平与MS密切相关.绝经后受检者的血清睾酮水平较绝经前升高,血清SHBG水平与MS存在一定的相关关系,可以作为预测女性MS的一个可选指标.
Objective To investigate the relationship between testosterone level and related index and metabolic syndrome（MS） of women in perimenopause or postmenopause period.Methods From May 2009 to August 2010,911 women aged 40 - 65 years underwent physical examination in the Memorial Hospital,Sun Yat-sen University were enrolled in this study,which were divided into 175 women with early perimenopause period in group A,112 women late perimenopause period in group B,161 women with early postmenopause period in group C,132 women with moderate postmenopause period in group D,88 women with late postmenopause period in group E,243 women with regular menstruation as control group （group F）.MS was defined according to the International Diabetes Federation （IDF） criteria.The relationship of free testosterone level and MS of women in different stage of menopause was analyzed.Results （1） Compared with 1.13 nmol/L in group F,median testosterone level of 1.03 nmol/L in group A,0.91 nmol/L in group B,0.91 nmol/L in group C,0.87 nmol/L in group D,0.83 nmol/L in group E decreased significantly at early peri-menopause period（P 〈0.01 ）.Median free androgen index（FAI） was 1.33 in group A,1.56 in group B,1.69 in group F.When compared median FAI in group A with those in group F or B,it all showed significantly difference （ P 〈 0.01 ） ; Testosterone （ T）/estradiol （ E2 ） were 0.042 in group C,0.040 in group D,0.042 in group E,0.010 in group A.When compared T/E2 in group C with group F,D and E,it all reached statistical difference （P 〈 0.01 ）.（2）There were negative correlation among waist circumference （WC,r =- 0.287 ）,fasting blood glucose （ FBG,r =- 0.281 ）,triglyceride （ TG,r =-0.224） and sex hormone-binding globulin （SHBG） and positive correlation with high density lipoprotein cholesterone （HDL-C,r =0.314）.The logistic regression analysis for MS showed that the MS was associated with SHBG significantly （ OR =0.993,95% CI：0.986 - 0.999,P =0.035 ）.（ 3 ） When cut-off value of SHBG was defined at 56.14 nmol/L,SHBG was used to predict MS with sensitivity of 63.13% and specificity of 69.45%.Conclusions Serum testosterone was associated with MS in women at perimenopausal and postmenopausal period,so window period of preventing MS was set at perimenopausal period.A serum testosterone level was elevated from premenopause to postmenopause period.Because there was an association between SHBG and MS,SHBG was a selectable parameter to predict MS.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2012年第2期115-120,共6页
Chinese Journal of Obstetrics and Gynecology
关键词
围绝经期
绝经后期
代谢综合征X
睾酮
性激素结合球蛋白
Perimenopause
Postmenopause
Metabolic syndrome X
Testosterone
Sex hormone-binding globulin
