单纯性肥胖女性绝经前后血管内皮功能和胰岛素抵抗的变化

摘要

Objective To investigate the changes of endothelial function, insulin resistance and other related factors in pre-and post-menopausal obese women. Methods 113 healthy obese pre-menopausal women and 84 BMI-matched obese post-menopausal women were included in this study. Flow-mediated endothelium-dependent dilation and nitroglycerin-mediated dilation, body fat depots and distribution, blood pressure, endothelial-1 (ET-1) and nitric oxide (NO), blood glucose, insulin, lipid profile and insulin resistance index (HOMA IR) were analyzed in all subjects. Results The endothelium-dependent dilation in post-menopausal women was lower than that in premenopausal women (5.7 + 5.2 % vs 7.8 + 5.7 %, P ＜ 0.05 ), and partial regression analysis revealed significant positive correlation between endothelium-dependent dilation and waist-hip ratio ( r = 0. 325, P ＜ 0. 05 ), ET-1 ( r = 0.228 ,P＜0.05), significant negative correlation between endothelium-dependent dilation and NO (r = -0. 263 ,P＜0.05). HOMA IR showed no significant difference between two groups. Conclusion The endothelium-dependent dilation in post-menopausal women was lower than that in pre-menopausal women, the visceral obesity and the levels of ET-1 and NO are main risk factors for endothelial function.%目的 探讨单纯性肥胖女性绝经前后血管内皮功能和胰岛素抵抗的变化及其影响因素.方法 单纯性肥胖女性197例分为绝经前组113例和绝经后组84例,测定两组血管内皮依赖性舒张功能(血流介导)和内皮非依赖性舒张功能(硝酸甘油介导),并测定体脂、血压、血糖、血脂和胰岛素抵抗指数(HOMA-IR)等指标进行对比分析.结果 绝经后内皮依赖性舒张功能降低较绝经前更明显[分别为(5.7±5.2)%和(7.8±5.7)%,P＜0.05],并且与腰臀比和血浆内皮素(ET-1)呈显著正相关(分别为r=0.325和r=0.228,均P＜0.05),与血清NO显著负相关(r=-0.263,P＜0.05).2组HOMA-IR无统计学意义.结论 绝经后肥胖女性血管内皮功能较绝经前显著降低;绝经前后胰岛素抵抗无变化.