围绝经期妇女肥胖与2型糖尿病发生的关系

[目的]了解围绝经期妇女腰围/臀围比值(WHR)与2型糖尿病(DM)的关系,探讨糖尿病防治新途径.[方法]选取城区健康普查妇女1236人,其中WHR≥0.85的围绝经期妇女268人为A组,WHR＜0.85的围绝经期妇女442人为B组,余下230人正常妇女为C组(对照组),分析各组DM发生率.[结果]A组比B组、C组DM发病率明显增高(P＜0.000 1),B组比C组DM发生率高(P＜0.005).[结论]围绝经期妇女糖尿病发生率明显高于非围绝经期妇女,特别是WHR≥0.85的围绝经期妇女糖尿病发病率更高.     

围绝经期2型糖尿病妇女前臂骨密度分析

围绝经期指从绝经前,出现与绝经相关的内分泌、生物学和临床特征起,至绝经后一年内的时间.城市妇女平均绝经年龄49.5岁,农村妇女为47.5岁.绝经后妇女约有25%患骨质疏松症、腰酸背痛、腿抽筋、肌肉关节疼痛等.糖尿病是一种全身代谢性疾病.其引起的并发症几乎累及机体各个组织,其中糖尿病骨质疏松(diabetic osteoporosis,DO)是糖尿病的慢性并发症之一[1].     

围绝经期妇女健康调查

为了解围绝经期妇女健康状况,探索围绝经期症状及相关因素,对600名40～60岁妇女进行了健康调查,结果显示绝经年龄为(48.67±3.01)岁。绝经年龄与妊娠次数、职业有关。围绝经期症状表现为月经失调、腰酸腿痛、乏力、潮热等,其程度与妊娠次数、教育程度、月经周期、身体状况有关,围绝经期妇女患病率28.3％。提示要加强围绝经期妇女的健康教育,提高妇女健康水平。     

围绝经期妇女抑郁状况研究

围绝经期是妇女自生育功能旺盛走向衰退的过渡时期,是指从接近绝经出现与绝经有关的内分泌学、生物学和临床特征起至绝经1年内的期间,即绝经过渡期至绝经后1年[1]。围绝经期抑郁症是在围绝经期发生的一种精神疾病,常发生在绝经前后,年龄大约在45～55岁之间,以情感忧郁、焦虑和紧张为主要临床表现,另外可有疑病、自     

社区妇女围绝经期保健指导

2003年2月至2004年3月,我们对辖区内的200名年龄在45—55岁的妇女进行了健康调查,结果显示：60名妇女有失眠症状,45名妇女有高脂血症,35名妇女常伴有阴道瘙痒不适,50名妇女有潮热、心烦不适,30名妇女有孤独感。针对存在的健康问题,在各社区站分别举行了8次健康教育讲座,60％以上的妇女感觉症状缓解,现将护理体会介绍如下：     

围绝经期妇女抑郁的相关因素

1994年WHO将围绝经期定义为由于卵巢功能衰退。从绝经前出现与绝经有关的内分泌、生物学和临床症状,至绝经后1年的这段时期。围绝经期妇女不仅出现潮热、盗汗、骨质疏松等躯体症状,心理症状也非常突出。围绝经期抑郁是发生于围绝经期的情感障碍性疾病,以情绪忧郁和焦虑紧张为主要表现,严重者有自杀倾向。影响妇女的生活质量,同时也成为家庭和社会的不稳定因素。Dennerstein等对438名45-55岁妇女进行的为期11年的前瞻性研究显示,24％的妇女发生了围绝经期抑郁。     

崇州市围绝经期妇女生殖健康状况调查

目的：通过对崇州市中老年妇女围绝经期生殖健康情况调查，为开展针对中老年妇女的生殖健康保健提供依据，方法：采用问卷形式对崇州市375名45岁以上妇女的一般情况和生殖健康状况进行调查。结果：祟州市妇女的平均绝经年龄是48.0岁。有54．7％的妇女在绝经前出现月经紊乱，1／3左右的绝经妇女在围绝经期出现潮热盗汗等围绝经症候群，但是，不足一半的妇女因此而就诊。所有妇女中仅58人服用过雌激素，主要因为潮热盗汗，睡眠障碍，泌尿道感染等。大多数妇女的服药时间少于一年。结论：中老年妇女在围绝经期和绝经后有许多绝经相关症状，需要我们为这 些妇女的生殖健康服务。     

社区围绝经期妇女心理健康的调查分析

目的 调查分析社区围绝经期妇女的心理健康状况，采取针对性的措施，促进其身心健康的发展。方法 采用问卷调查的方式，发放抑郁自评量表和焦虑自评量表对68例社区围绝经期妇女进行调查分析。结果 经量表测评后，社区围绝经期妇女的抑郁、焦虑得分，明显高于国内常模，比较有统计学意义（P〈0．01）。结论 社区围绝经期妇女心理承受了各方面的压力，社区应积极广泛开展围绝经期相关知识的系统保健教育，做好围绝经期妇女的身心健康指导，以提高社区妇女的生活质量。     

滨州市围绝经期妇女体脂肥胖外在影响因素分析

目的:探讨围绝经期体脂肥胖情况及外在影响因素,为制定有效的群体保健措施提供依据。方法:选取到本院体检的45～55岁围绝经期妇女132例作为研究对象,采用生物电阻抗法测定脂肪百分比及腰臀比,并随即进行问卷,对其生活习惯及工作予以分型。结果:132例研究对象中,脂肪>30%者94例,占71.21%;腰臀比>0.85者115例,占87.12%;体脂肥胖与运动规律与否、饮食饮水调节重视程度、夫妻性生活及工作类型有关,各组差异均有统计学意义(P<0.01)。结论:围绝经期妇女体脂肥胖及腹部脂肪堆积很普遍,应当引起人们高度重视,督促该人群构建规律有效的运动模式、合理搭配膳食及饮水、保持夫妻性生活和谐,长久坐立的脑力劳动者更应加强体育锻炼。     

围绝经期妇女保健问题探析

选取2010年9月～2012年4月参与抽样调查的120例围绝经妇女,对其健康影响因素进行分析,并采取有效应对措施。结果 120例妇女中,月经改变者59例,尿失禁者26例,特征性出汗者22例,骨质疏松者13例,在绝经后5年内的表现更为显著。通过加强保健干预,对于提高其生活质量帮助较大。围绝经期妇女由于生理改变使得其容易出现各种疾病,对此需要加强保健指导,以更好的满足其工作与生活需求。     

Relationship between impaired glucose tolerance, non-insulin-dependent diabetes mellitus and obesity

Plasma glucose concentration is the best predictor for the development of non-insulin-dependent diabetes mellitus (NIDDM). However, obesity is also a recognized risk factor for development of the disease, and is easier to track over time. Thus obesity could be of considerable clinical importance as a predictor of diabetes. Studies have shown that the degree of overweight, the change in weight and the duration of overweight are all separate predictors of diabetes. The British Regional Heart Study showed that an increasing body mass index (BMI) was associated with increased risk of developing diabetes, even at BMI values not considered obese. A separate study showed that weight gain increased the risk of diabetes independently of BMI, while weight loss decreased the risk. The duration of obesity was also an important factor in developing NIDDM. A long duration increased the risk of diabetes, irrespective of the final BMI value. The effects of obesity on insulin action have also been investigated. Studies have shown that insulin sensitivity is inversely related to insulin secretion, with a disproportionate increase in insulin secretion seen with decreasing sensitivity. A recent European study showed that the prevalence of both insulin hypersecretion and insulin resistance increased with increasing BMI. Thus, in obesity, higher insulin levels are necessary to maintain glucose tolerance, leading to increased stress on the β-cells. In obese individuals, weight loss improved insulin sensitivity in proportion to the degree of weight loss, leading to decreased insulin secretion. Weight loss can therefore, at least in the short term, act to decrease the risk of developing diabetes by reducing insulin resistance, and thus relieving β-cell stress, the factor ultimately responsible for hyperglycaemia in predisposed individuals.     

Relationship between obesity and the increased risk of major complications in non-insulin-dependent diabetes mellitus

Obesity and non-insulin-dependent diabetes mellitus (NIDDM) are closely linked. They frequently occur together in patients, and body mass index (BMI) is the strongest risk factor for the development of NIDDM. Both obesity and NIDDM are also major causes of morbidity and mortality from atherogenic macrovascular disease, and they are independent risk factors for coronary heart disease. The risk of developing NIDDM and cardiovascular disease is affected by the regional distribution of body fat. Visceral obesity is associated with a higher degree of risk than peripheral obesity. The metabolic and circulatory changes associated with visceral obesity lead to the development of insulin resistance and increased lipoprotein synthesis. For example, the change in the population profile of lipoproteins in the blood, and alterations in the levels of oxidative stress lead to an increased cardiovascular and macrovascular risk. The changes in lipid metabolism also affect haemorrheological function. They have been linked to decreased fibrinolysis (a serious cardiovascular risk factor) through elevated levels of plasminogen activator inhibitor factor, high blood viscosity, and increased erythrocyte aggregability. Increased BMI also appears to be associated with endothelial dysfunction, which is a major factor in atheroma plaque formation and development of thrombosis. Visceral obesity therefore adds a significant burden to the already increased cardiovascular risk inherent in NIDDM. However, even moderate weight loss may successfully reverse the majority of changes seen with visceral obesity.     

Relationship between menopausal symptoms and menopausal status in Australian and Japanese women: preliminary analysis

The main aim of the present study was to explore the midlife experience for women living in Australia and Japan. The specific objectives of the study included: (i) comparing menopausal symptoms between the two groups; and (ii) comparing the factor structure of symptoms and exploring their relationship to menopausal status. Postal questionnaires were distributed to two structured, random population based samples of midlife women aged 45-60 years; consisting of 712 women living in Australia and 1502 women living in Japan. Analysis showed significant differences in menopausal symptoms related to psychological symptoms (P < 0.001), including anxiety (P < 0.001) and depression (P < 0.001), somatic symptoms (P < 0.001), and vasomotor symptoms (P < 0.01). The analysis, which excluded hormone replacement therapy (HRT) users, found that there were significant differences seen across menopausal status in the following symptoms: difficulty in sleeping (P < 0.01), difficulty in concentrating (P < 0.01), feeling dizzy or faint (P < 0.001), loss of interest in most things (P < 0.01) and loss of feeling in hands or feet (P < 0.001). In the postmenopausal stage specifically, significant differences were seen in the areas of feeling tense or nervous (P < 0.01), feeling unhappy or depressed (P < 0.01), parts of body feeling numb or tingling (P < 0.05), headaches (P < 0.01), and sweating at night (P < 0.05). Our analysis revealed that the experience of menopause for women is different between Australian and Japanese women.     

Relationship between menopausal symptoms and sexual dysfunction among married Turkish women in 40–65 age group

This was a cross‐sectional study to analyse the relationship between menopausal symptoms and sexual dysfunction among 229 married Turkish women in the 40–65 age group. The study was carried out at a menopause clinic of a state hospital between 1 October and 31 December 2010. Data were collected with Personal Characteristics Form, Menopause Rating Scale (MRS) and the Arizona Sexual Experience Scale (ASEX). The average age of the women was 52.33 (SD = 4.80) years. The average MRS total score was 20.13(SD = 9.20). The ASEX mean score was 19.97 (SD = 5.44). It was determined that there is a positive meaningful relationship between ASEX mean score, MRS total mean score and the sub‐score of women. From the results obtained from this study, it can be said that women have differing levels of menopausal symptoms, and as the severity of menopausal symptoms increases, there is an increase in sexual dysfunction.     

2型糖尿病患者自我效能与生活质量的相关性研究

目的 探讨2型糖尿病患者自我效能与生活质量之间的关系.方法 采用2型糖尿病管理自我效能量表和糖尿病患者特异性量表,以方便抽样方法调查116例住院的2型糖尿病患者,并对结果进行分析.结果 2型糖尿病患者自我效能与生活质量不够理想;不同类型2型糖尿病患者自我效能与生活质量得分比较,差异有统计学意义;2型塘尿病患者自我效能与生活质量呈中等程度正相关(r=0.43,P＜0.01).结论 在临床实践中,必须注重2型糖尿病患者自我效能和生活质量水平的提高,应以自我效能理论为依据,采用各种方法调动患者的自身潜能,以增加自我效能,提高患者的生活质量.     

老年人糖尿病与失眠的关系

[目的]探讨老年人糖尿病与失眠之间的关系。[方法]选择122例老年糖尿病病人和133例无糖尿病老年人,采用国际公认的失眠量表（Athens）进行问卷调查。[结果]老年糖尿病病人中可疑失眠和失眠的发生率分别为29.5%和45.1%,而对照人群为18.1%和26.3%,二者比较有统计学意义（P〈0.01）。[结论]老年人糖尿病与失眠有相关性。     

老年人糖尿病与失眠的关系

[目的]探讨老年人糖尿病与失眠之间的关系。[方法]选择122例老年糖尿病病人和133例无糖尿病老年人,采用国际公认的失眠量表(Athens)进行问卷调查。[结果]老年糖尿病病人中可疑失眠和失眠的发生率分别为29.5%和45.1%,而对照人群为18.1%和26.3%,二者比较有统计学意义(P<0.01)。[结论]老年人糖尿病与失眠有相关性。     

2型糖尿病患者血清瘦素与胰岛素抵抗关系的研究

目的探讨2型糖尿病患者血清瘦素水平与胰岛素抵抗的相关关系。方法以稳态模型胰岛素抵抗指数（HOMA-IR）作为评估胰岛素抵抗程度的指标。采用放射免疫法测定74例2型糖尿病患者的血清瘦素水平。结果女性瘦素水平比男性高，肥胖者比非肥胖者高（P〈0．05）。多元逐步回归分析提示性别、脂肪百分比、胰岛素抵抗指数是影响瘦素水平的独立预测因素（β分别为-1．572、0．128、1．179，均P〈0．05）。结论2型糖尿病患者血清瘦素水平与胰岛素抵抗有明显的关系，且瘦素与2型糖尿病的发病有关。     

2型糖尿病患者两种胰岛素强化治疗效果的比较

目的比较胰岛素泵持续皮下注射胰岛素（CSII）与多次皮下注射胰岛素（三餐前超短效胰岛素＋甘精胰岛素,MSII）对短病程的2型糖尿病（T2DM）患者治疗后的效果差异。方法52例短病程T2DM患者随机分为CSII（n=29）和MSII（n=23）两组,入院即开始强化降糖治疗,同时服用二甲双胍,疗程为2周,出院后随访1个月。结果CSII组血糖达标时间为（4．70±2．01）d,明显短于MSII组（6．90±1．50）d,两组之间差异有统计学意义（t=2．056,P〈0．05）。CSII组餐后2hC肽治疗前后分别为（4．24±0．25）、（6．29±0．56）ng／L,MSII组餐后2hC肽治疗前后分别为（3．20±0．11）、（7．33±0．41）ng／L,两组餐后2hC肽水平治疗后均较人院时明显增高（t值分别为2．018、2．436,P均〈0．05）,但两组之间差异无统计学意义（t=0．985,P〉0．05）。CSII组19例（65．5％）完全脱离胰岛素治疗;MSII组9例（39．1％）完全脱离胰岛素治疗,两组差异有统计学意义（x2=5．11,P〈0．05）。结论两种强化降糖方案均可使血糖在短时间内达标、胰岛功能不同程度的恢复,但CSII较MSII起效更快,更加有利于短期内脱离胰岛素的治疗。