绝经过渡期妇女性激素与胰岛素敏感性的改变

目的:观察中老年妇女性激素和胰岛素敏感性与月经状态的关系。方法:年龄40~70岁妇女166例,分为5组:月经规律组、绝经过渡期早期组、绝经过渡期晚期组、绝经早期组和绝经中晚期组。分别测定雌二醇(E2)、雌酮(E1)、促卵泡激素(FSH)、睾酮(T)、性激素结合球蛋白(SHBG)、空腹血糖(FBG)、空腹胰岛素(INS),并计算游离睾酮(FT)及胰岛素作用指数(IAI)。结果:(1)T和FT在绝经过渡期早期组较其他各组有显著升高(P<0.05),在绝经中晚期组较绝经过渡期有显著降低(P<0.05)。E1/E2从绝经过渡期早期即上升,至绝经中晚期显著升高(P<0.05)。FSH从绝经过渡期早期组即显著升高。SHBG各组之间无显著性差异;(2)各组之间FBG和IAI无显著性差异。INS在绝经过渡期早期组显著升高,与绝经后比较差异有显著性(P<0.05);(3)T与E1、FBG和INS正相关,与年龄、FSH和IAI负相关,与E2不相关。结论:妇女在绝经过渡期早期,T、FT显著升高;INS显著升高,但FBG和IAI没有明显变化。

The change of sex hormones and insulin sensitivity in menopause transition women

Objective:To study the change of sex hormones and glucose metabolism accompanied by the menstrual stages change in women more than 40 years old.Methods:One hundred and sixty-six women aged between 40 an 70 years were assigned to 5 groups,regular menstrual cycle group,early period of menopausal transition group,late period of menopausal transition group,early period of postmenopausal group and mid-late period of postmenopausal group.Estradiol (E_2),estrone (E_1),follicular stimulating hormone (FSH),testosterone (T),sex hormone-binding globulin (SHBG),fasting blood glucose(FBG),fasting insulin(INS) were examined in all patients.Free testosterone(FT) and insulin action index (IAI) were calculated.Results:(1)T and FT were obviously elevated in early period of menopausal transition group(P<0.05).E_1/E_2 levels increased from 3.2 to more than 10 after entering early period of menopausal transition group.There was no significant difference of SHBG in the 5 groups(P>0.05).(2)INS were obviously elevated in early period of menopausal transition group(P<0.05).There was no difference of FBG and ISI in the 5 groups.(3)T was positively correlated with E_1,FBG and INS,negatively with age,FSH and IAI.Conclusion:In concomitance with transferring to early period of menopausal transition,T,FT and INS were elevated significantly with no changed FBG and IAI.