绝经激素治疗与代谢综合征风险研究进展

doi:10.3969/j.issn.1006-7795.2014.04.001

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (4): 387-391.doi: 10.3969/j.issn.1006-7795.2014.04.001

• 更年期与妇科内分泌专题 • 上一篇下一篇

绝经激素治疗与代谢综合征风险研究进展

阮祥燕¹, 崔亚美¹, Diethelm Wallwiener², Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 德国图宾根大学妇产医院内分泌与绝经中心, 德国图宾根 D-72076

收稿日期:2014-06-10 出版日期:2014-08-21 发布日期:2014-07-22
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
国家自然科学基金（30872745），北京市自然科学基金（3082011），北京市卫生系统高层次卫生技术人才培养计划项目（2009-3-52），首都医科大学附属北京妇产医院、北京妇幼保健院学科带头人项目（2013-1）。

Menopause hormone therapy and risk of metabolic syndrome

Ruan Xiangyan¹, Cui Yamei¹, Diethelm Wallwiener², Alfred O. Mueck^1,2

1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Endocrinology, University Women's Hospital of Tubingen, Tubingen D-72076, Germany

Received:2014-06-10 Online:2014-08-21 Published:2014-07-22
Supported by:
This study was supported by National Natural Science Foundation of China(30872745), the Natural Science Foundation of Beijing(3082011), Beijing Municipality Health Technology High-level Talent(2009-3-52), Project of Discipline Leader, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital(2013-1).

摘要/Abstract

摘要：

代谢综合征（包括腹型肥胖、糖代谢异常、脂代谢紊乱、高血压等）因与心血管病风险因素密切相关，已成为全球公共健康的一个主要挑战。绝经后激素治疗的应用已有半个多世纪，但绝经后激素治疗（menopause hormone therapy，MHT）的适应证及理想候选适应证仍然不清楚。绝经妇女心血管病风险的增高是这组人群死亡的主要原因。雌激素的降低与许多围绝经与绝经后妇女总胆固醇、三酰甘油、低密度脂蛋白胆固醇的增加，胰岛素抵抗的增加及血压的升高相关。这些变化的参数是代谢综合征的主要组分。目前推荐MHT作为血管舒缩症状的金标准治疗，其对代谢综合征组分及心血管病风险的益处仍不清楚，本文将对MHT与代谢综合征组分的风险及益处进行综述。

关键词: 代谢综合征, 绝经激素治疗, 肥胖, 血脂异常, 高血糖, 高血压

Abstract:

The metabolic syndrome (including visceral obesity, dyslipidemia, hyperglycemia, and hypertension) has become one of the major public-health challenges worldwide. The menopause hormone therapy(MHT) is in use for more than a half of century, but the question of indications and ideal candidates for hormone replacement therapy(HRT) remains unclear. Postmenopausal women are a population with the increasing risks for cardiovascular diseases which are the main cause of death in this group. Decline in estrogen concentrations is linked to a number of changes in peri and postmenopause: increased total cholesterol, triglycerides, and low density lipoprotein, increased insulin resistance and increased blood pressure etc. These changes are the main components of metabolic syndrome. HRT is currently recommended as the gold standard for the management of vasomotor symptoms, but the benefit of MHT on components of metabolic syndrome and risk for cardiovascular events risk is still uncertain. This review will focus on MHT risk and benefit issues.

Key words: metabolic syndrome, menopause hormone therapy, obesity, dyslipidaemia, hyperglycaemia, hypertension

中图分类号:

R711

阮祥燕, 崔亚美, Diethelm Wallwiener, Alfred O. Mueck. 绝经激素治疗与代谢综合征风险研究进展[J]. 首都医科大学学报, 2014, 35(4): 387-391.

Ruan Xiangyan, Cui Yamei, Diethelm Wallwiener, Alfred O. Mueck. Menopause hormone therapy and risk of metabolic syndrome[J]. Journal of Capital Medical University, 2014, 35(4): 387-391.

参考文献

[1] Milewicz A. Menopausal obesity and metabolic syndrome PolSenior Study[J]. Minerva Endocrinol, 2012,37(1):93-101.
[2] Yamakawa J, Moriya J, Takahashi T, et al. A kampo medicine, boi-ogi-to, inhibits obesity in ovariectomized rats[J]. Evid Based Complement Alternat Med, 2010,7(1):87-95.
[3] Zoth N, Weigt C, Laudenbach-Leschowski U, et al. Physical activity and estrogen treatment reduce visceral body fat and serum levels of leptinin an additive manner in a diet induced animal model of obesity[J]. J Steroid Biochem Mol Biol, 2010,122(1-3):100-105.
[4] Archer D F, Thorneycroft I H, Foegn M, et al. Long-term safety of drospirenone-estradiol for hormone therapy: a randomized, double-blind, multicenter trial[J]. Menopause, 2005,12(6):716-727.
[5] Yüksel H, Odabasi A R, Demircan S, et al. Effects of postmenopausal hormone replacement therapy on body fat composition[J]. Gynecol Endocrinol, 2007,23(2):99-104.
[6] Agirbasli M, Agaoglu N B, Orak N, et al. Sex hormones and metabolic syndrome in children and adolescents[J]. Metabolism, 2009,58(9):1256-1262.
[7] Barros R P, Gustafsson J A. Estrogen receptors and the metabolic network[J]. Cell Metab, 2011,14(3):289-299.
[8] Faulds M H, Zhao C, Dahlman-Wright K, et al. The diversity of sex steroid action: regulation of metabolism by estrogen signaling[J]. J Endocrinol, 2012,212(1):3-12.
[9] 张文韬,杨永秀.安今益用于绝经后妇女的激素补充治疗[J].中国计划生育和妇产科,2011,3(1):73-76.
[10] 阮祥燕,闫丹,张俊丽,等.绝经妇女代谢综合征干预措施的研究[J].首都医科大学学报,2013,34(4):519-524.
[11] 刘俊宝,刘晓军,郭晓娟.绝经期雌激素替代治疗对血脂的影响[J].中国妇幼保健,2010,25(21):3014-3015.
[12] 邢玉鉴.围绝经期妇女应用HRT对血脂及骨密度的影响[J].中国实验诊断学,2014,18(2):286-287.
[13] 刘世荣,姚红丽.更年期激素替代治疗对女性脂类代谢的影响[J].中国老年学杂志,2012,32(9):1836-1837.
[14] 田秀娟,盛敏佳,刘俊宝,等.激素替代治疗对绝经后女性心脑血管疾病的影响[J].中国老年学杂志,2009,29(18):2376-2377.
[15] Patrelli T S, Gizzo S, Franchi L, et al. A prospective, case-control study on the lipid profile and the cardiovascular risk of menopausal women on oestrogen plus progestogen therapy in a northern Italy province[J]. Arch Gynecol Obstet, 2013,288(1):91-97.
[16] Korljan B, Bagatin J, Kokic S, et al. The impact of hormone replacement therapy on metabolic syndrome components in perimenopausal women[J]. Med Hypotheses, 2010,74(1):162-163.
[17] Villa P, Suriano R, Ricciardi L, et al. Low-dose estrogen and drospirenone combination: effects on glycoinsulinemic metabolism and other cardiovascular risk factors in healthy postmenopausal women[J]. Fertil Steril, 2011,95(1):158-163.
[18] 朱旅云.内分泌代谢病学科发展现状及设想[J].解放军医药杂志,2013,25(6):1-5.
[19] Samsine G. HRT and cardiovascular disease[J]. Ann N Y Acad Sci, 2003,11(997):358-372.
[20] Salpeter S R, Walsh J M, Ormiston T M, et al. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women[J]. Diabetes Obes Metab, 2006,8(5):538-554.
[21] 中华医学会妇产科学分会绝经学组.绝经过渡期和绝经后期激素补充治疗临床应用指南(2009版)[J].中华妇产科杂志,2010,45(8):635-638.
[22] Gambacciani M, Rosano G, Cappagli B, et al. Clinical and metabolic effects of drospirenone-estradiol in menopausal women: a prospective study[J]. Climacteric, 2011,14(1):18-24.
[23] Rizzo M R, Leo S, De Franciscis P, et al. Short-term effects of low-dose estrogen/drospirenone vs low-dose estrogen/dydrogesterone on glycemic fluctuations in postmenopausalwomen with metabolic syndrome[J]. Age(Dordr), 2014,36(1):265-274.
[24] 梁鸿寅,王喆,甘立霞.雌激素对胰岛β细胞的作用及其机制[J].医学分子生物学杂志,2008,5(6):535-538.
[25] Langrish J P, Mills N L, Bath L E, et al. Cardiovascular effects of physiological and standard sex steroid replacement regimens in premature ovarian failure[J]. Hypertension, 2009,53(5):805-811.
[26] 杨帆,王广义,张海玉,等.雌激素对更年期大鼠血压的影响[J].中国老年医学杂志,2011,31(9):1615-1616.
[27] Fung M M, Poddar S, Bettencourt R, et al. A cross-sectional and 10-year prospective study of postmenopausal estrogen therapy and blood pressure, renal function, and albuminuria: the Rancho Bernardo Study[J]. Menopause, 2011,18(6):629-637.
[28] Archer D F. Drospirenone and estradiol: a new option for the postmenopausal woman[J]. Climacteric, 2007,10 Suppl 1:3-10.
[29] 殷冬梅,刘真,阮祥燕,等.激素治疗对更年期综合征患者生存质量的影响[J].首都医科大学学报,2013,34(3):428-431.
[30] Moser M. Update on the management of hypertension recent clinical trials and the JNC7[J]. J Clin Hypertens(Greenw ich), 2004,6(10 Suppl 12):4-13.
[31] White W B, Hanes V, Chauhan V B. Effects of a new hormone therapy, drospirenone and 17-β-estradiol in postmenopausal women with hypertension[J]. Hypertension, 2006,48(2):246-253.
[32] Gambacciani M, Rosano G, Cappagli B, et al. Clinical and metabolic effects of drospirenone-estradiol in menopausal women: a prospective study[J]. Climacteric, 2011,14(1):18-24.

绝经激素治疗与代谢综合征风险研究进展

Menopause hormone therapy and risk of metabolic syndrome

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	左颖婷, 吴寿岭, 陈朔华, 田雪, 胥芹, 张怡君, 张晓丽, 王安心. 糖代谢异常人群中不同高血压亚型的心脑血管疾病风险[J]. 首都医科大学学报, 2023, 44(1): 42-48.
[2]	苏志燕, 刘薇, 史婷婷. 老年2型糖尿病患者血尿酸浓度与代谢综合征的相关性分析[J]. 首都医科大学学报, 2023, 44(1): 137-142.
[3]	张瑾, 池晶晶, 张蕊, 张小燕, 白文佩. 孕前肥胖及超重女性的孕期管理模式探讨及肥胖相关胎盘因子分析[J]. 首都医科大学学报, 2022, 43(5): 774-781.
[4]	修双玲, 付俊玲, 穆志静, 孙丽娜, 赵蕾. 老年2型糖尿病患者体脂率对肌力和躯体功能的影响[J]. 首都医科大学学报, 2022, 43(4): 641-646.
[5]	赵越, 阮祥燕, 程姣姣, 谷牧青, 许新, 王月姣. 乳腺癌中PGRMC1表达与临床病理参数的相关性[J]. 首都医科大学学报, 2022, 43(3): 350-356.
[6]	苗祖霈, 张迎花, 肖克令, 司瑾, 张浩宇, 李静. 肥胖程度对急性ST段抬高型心肌梗死患者预后的影响[J]. 首都医科大学学报, 2022, 43(2): 192-198.
[7]	杨柳青, 田红梅, 石汉平. 三种饮食模式与慢性疾病研究进展[J]. 首都医科大学学报, 2022, 43(2): 311-320.
[8]	李健, 白文佩, 江波, 白栎然, 吴凤云. 生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响[J]. 首都医科大学学报, 2021, 42(6): 1021-1025.
[9]	柳瑾, 齐新, 齐延芳, 冯娇娇, 彭金玲. 天津社区老年高血压患者心血管疾病危险因素分析[J]. 首都医科大学学报, 2021, 42(5): 804-809.
[10]	王虎生, 阮祥燕, 程姣姣, Alfred O. Mueck. 肥胖型多囊卵巢综合征的氧化应激与脂代谢关系的研究[J]. 首都医科大学学报, 2021, 42(4): 540-546.
[11]	刘真, 殷冬梅, 战思恩, 阮祥燕. 黄连素改善多囊卵巢综合征患者代谢异常的系统评价[J]. 首都医科大学学报, 2021, 42(4): 588-595.
[12]	来璇, 张爱华. 代谢综合征对慢性肾脏病患者生存预后的影响[J]. 首都医科大学学报, 2021, 42(4): 609-614.
[13]	张爽, 马向科, 刘思维. 高血压脑出血合并肺部感染危险因素分析及防治[J]. 首都医科大学学报, 2021, 42(4): 660-663.
[14]	李健, 吴凤云, 张能维, 廉东波, 樊庆, 许光中, 杜德晓, 孙志鹏, 杜燕敏, 白文佩. 微创减重手术对重度肥胖女性月经周期及生育功能的影响[J]. 首都医科大学学报, 2021, 42(2): 200-203.
[15]	谭静, 李静, 张迎花, 左雪冰. 冠状动脉早期粥样硬化症患者冠状动脉钙化的影响因素分析[J]. 首都医科大学学报, 2020, 41(6): 978-981.