摘要
目的:观察绝经前后肥胖和非肥胖女性血清性激素结合球蛋白水平的变化,并分析其与血浆纤溶酶原激活物抑制物1及血管内皮细胞功能的关系。方法:观察于2003-11/2004-04在青岛大学医学院附属医院内分泌科完成。选择2期临床药物试验的初选未服药者及健康查体者101例作为观察对象,均为女性,填写知情同意书。其中绝经后女性58例,绝经前女性43例。分别根据体质量指数分为两组:①绝经后女性:肥胖组31例,非肥胖组27例。②绝经前女性:肥胖组23例,非肥胖组20例。应用ELISA法测定血清性激素结合球蛋白、血浆纤溶酶原激活物抑制物1水平;应用全自动生化分析法测定血脂、血糖及血尿酸水平,同时应用全自动电化学免疫分析法测定真胰岛素水平,真胰岛素敏感性指数=1/空腹血糖×空腹真胰岛素。结果:101例观察对象全部进入结果分析,无脱落。①女性性激素结合球蛋白水平由低到高依次为:绝经后肥胖组、绝经前肥胖组、绝经后非肥胖组及绝经前非肥胖组,且绝经后肥胖组明显低于绝经前非肥胖组及绝经后非肥胖组(P<0.01),绝经后肥胖组与绝经前肥胖组相比差异无显著性意义(P>0.05)。②女性纤溶酶原激活物抑制物1水平由高到低依次为:绝经后肥胖组、绝经前肥胖组、绝经后非肥胖组及绝经前非肥胖组,其中绝经后肥胖组明显高于绝经前肥胖组及绝经后非肥胖组(P<0.05～0.01)。③以性激素结合球蛋白为因变量的逐步回归分析结果:体质量指数(负相关)、低密度脂蛋白胆固醇(负相关)、真胰岛素敏感性指数(负相关)均进入回归模型(T=-2.29,-2.16,-2.31,P<0.05)。④以纤溶酶原激活物抑制物1为因变量的逐步回归分析结果:腰臀比(正相关)、真胰岛素敏感性指数(正相关)、性激素结合球蛋白(负相关)均进入回归模型(T=3.89,2.93,-11.16,P<0.01)。结论:绝经后肥胖妇女性血清激素结合球蛋白水平明显降低,血浆纤溶酶原激活物抑制物1水平明显升高,提示绝经使肥胖女性血管内皮细胞功能障碍进一步加重。
AIM： To observe the change of serum sex hormone binding globulin （SHBG） between postmenopausal and pre-menopausal, between obese and non-obese women, and analyze its relationship with plasminogen activator inhibitor 1 （PAI-l） and vascular endothelial cell function.
METHODS： The experiment was carried out in the Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College from November 2003 to April 2004. A total of 58 postmenopausal women （31 obese and 27 non-obese） and 43 pre-menopausal women （23 obese and 20 non-obese）, including healthy examinees and those not administrated in the second phase of clinical drug trials, were randomly selected as the objects, with their informed consents. The levels of SHBG and PAI-1 were determined using ELISA while true insulin was detected with automatic electrochemiluminescence immunoassay. At the same time, blood lipid, glucose and uric acid were assayed by automatic biochemical analyzer. True insulin sensitivity index （ISI）=l/fasting blood glucose×fasting true insulin.
RESULTS： Totally 101 objects were involved in the result analysis without any drop. （1）In the order of the postmenopausal obese, the pre-menopausal obese, the postmenopausal non-obese and the pre-menopausal non-obese, the level of SHBG in women was increasing. And SHBG in the postmenopausal obese women was significantly lower than that in the postmenopausal non-obese and the pre-menopausal non-obese groups （P 〈 0.01）. There was no significance in SHBG between the pre- menopausal obese and the postmenopausal obese grotJps （P 〉 0.05）. （2）On the contrary, in the order of the postmenopausal obese, the pre-menopausal obese, the postmenopausal non-obese and the pre-menopausal non-obese, the level of PAI-1 in women was decreasing. And PAI-1 in the postmenopausal obese was significantly higher than that in the postmenopausal non-obese and the pre-menopausal obese （P 〈 0.05-0.01）. （3）Stepwise regression analysis with SHBG as dependent variable showed that body mass index （BMI, negative correlation）, low density lipoprotein cholesterol （negative correlation） and true ISI （negative correlation） entered into the regression model （T=-2.29, -2.16, -2.31, P 〈 0.05）. （4）Stepwise regression analysis with PAI-1 as dependent variable revealed that BMI （positive correlation）, true ISI （positive correlation） and SHBG （negative correlation） entered into the regression model （T=3.89, 2.93, -11.16, P 〈 0.01）. CONCLUSION： The level of SHBG is significantly lower but the level of PAI-1 is significantly higher in postmenopausal obese women, suggesting that menopause can aggravate the dysfunction of vascular endothelial cell in obese women.
出处
《中国临床康复》
CSCD
北大核心
2006年第44期19-21,共3页
Chinese Journal of Clinical Rehabilitation
基金
青岛市科技发展计划课题第一批55~~
