중년 여성에서 폐경여부가 체지방 분포 , 혈청 지질 및 호르몬 농도에 미치는 영향 = Body Fat Distribution and Serum Levels of Lipids and Hormones in Pre- and Post- Menopausal Wonen

다국어 초록 (Multilingual Abstract)

Background: The purpose of this study was to compare body fat distribution and serum levels of lipids and hormones in pre- and post-menopausal healthy women with similar degree of obesity. Body fat distribution was measured using waist to hip circumference ratio(WHR) and computerized tomography(CT) scan.
Methods: Body weight, body mass index, WHR and abdominal fat areas by CT scan at the umbilical level were measured in 134 pre- and 62 post-menopausal women. Fasting serum levels of lipids and hormones were determined and an oral glucose tolerance test(OGTT) was performed.
Results: There was no significant difference between the two groups in body weight, body mass index, percentage of total body fat and subcutaneous fat area, even though post-menopausal women showed an increase in age and WHR. Total abdominal fat area, visceral fat area and visceral to subcutaneous fat area ratio were higher in post-menopausal women than pre-menopausal women. Serum levels of LDL, total cholesterol and triglyceride, basal levels of glucose and free fatty acid, and sums of serum glucose and free fatty acid during OGTT were higher in post-menopausal women, while serum concentration of HDL-cholesterol was lower in post-menopausal women. No difference was found between two groups in basal levels and sums of serum C-peptide and insulin during OGTT. Post-menopausal women showed a decrease in serum levels of estradiol, testosterone and insulin like growth factor-1 but an increase in serum levels of luteinizing hormone and follicle stimulating hormone. No significant difference was observed in free androgen index and serum levels of sex hormone-binding globulin and growth hormone. There was a significant correlation between anthropometric parameters and metabolic variables in both pre- and post-menopausal women. When stepwise -multiple regression analysis was used to evaluate the joint effect of anthropometric variables on metabolic variables, visceral fat area proved to be the primary determinant for the serum levels of LDL, total cholesterol and triglyceride and sums of serum glucose and insulin during OGTT.
Conclusion: Our results suggest that an increase in visceral fat area after menopause may constitute a greater risk in cardiovascular and metabolic disorders than a simple degree of obesity alone. In addition, both aging and increased release of free fatty acid from visceral adipocytes in post-menopausal women may result in a reduction in the secretion of growth hormone, which could accelerate visceral fat accumulation.