892314B002094

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增殉栾
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1 Leptin NSC B (leptin) % % % (1) (2) vs %, p<0.05 (3) ±2.49% vs. 0.75±2.87% TLR0.01±0.14 vs. 0.02±0.18 p<0.05 (4) Trunk % TLR

2 Abstract Cardiovascular disease is the leading cause of death in developed countries. It is noted that there were much more women than before died of cardiovascular disorders in Taiwan. The mortality and incidence of CHD in the young female are less than the male, but are similar in both sexes after menopause. Dyslipidemia could be one of the important factors. Android distribution and increase in body fat composition among post-menopausal women may be also associated with the risk of cardiovascular diseases. Leptin is produced in adipose tissue and act as a signal from fat tissue to the hypothalamus to regulate the amount of body fat stores by controlling energy balance and appetite. The changes of trunk-total body fat ratio and trunk-leg fat ratio were significantly higher in post- than pre-menopausal women, which denoted a centralization of body fat distribution after menopause. Baseline serum leptin levels were correlated with total body fat proportion and trunkleg fat ratio in pre-menopausal women only. Our study strongly suggests that menopause is independently related to a centralization of body fat distribution. Leptin may play an important role in body composition regulation in premenopausal rather than post-menopausal women. KeywordsBody composition, DEXA, Leptin

4 leptin () 4060 (30) 3

5 ( ) ( ) 200 FSH E2 () (anterior superior iliac crest) 3. (leptin) 4. DEXA () DEXA(NORLAND, XR-26, MARK-2) 4.gama ( leptin )

6 () 1. X leptin leptin ± ± ± ±

7 Trunk% TLR Trunk% TLR Tanaka H, Date C, Chen H et al. A brief review of epidemiological studies on ischemic heart disease in Japan. J Epidemiol 1996; 6: S Thom TJ, Epstein FH, Feldman JJ et al. Trends in total mortality and mortality from heart disease in 26 countries from 1950 to Int J Epidemiol 1985; 14: Annual computerized file of vital statistics, Department of Health, Executive Yuan, ROC. Taipei, :, Wenger NK, Speroff L, Packard B. Cardiovascular health and disease in woman. N Engl J Med 1993; 329: Gordon T, Kannel WB, Hjortland MC, McNamara PM. Menopause and coronary heart disease. Ann Intern Med 1978; 89: Mattews KA, Meilahan E, Kuller LH, Kelsey SF, Caggiula AW, Wing RR. Menopause and risk factors for coronary heart disease. N Engl J Med 1989; 321: Jensen J, Nilas L, Christiansen C. Influence of menopause on serum lipids and lipoproteins. Maturitas 1990; 12: Kuller M, Gutai JP, Metlahn E, Matthews KA, Plantinga P. Relationship of

8 endogenous sex steroid hormones to lipids and apoproteins in postmenopausal woman. Arteriosclerosis 1990; 10: Pasquali R, Casimirri F, Pascal G et al. Influence of menopause on blood cholesterol levels in women: the role of body composition, fat distribution and hormone milieu. J Int Med 1997; 241: Lapidus L, Bengtsson C, Larsson S, et al. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow-up of participants in the population study of women in Gothenburg, Sweden. Br Med J 1984; 289: Donahue RP, Abbott RD, Bloom DM, Yano K. Central obesity and coronary heart disease. Lancet 1987: Hartz A, Grubb B, Wild R, et al. The association of waist hip ratio and angiographically determined coronary artery disease. Int J Obes 1990; 14: Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observation. Metabolism 1970; 19: Novack LP. Aging, total body potassium, fat-free mass and cell mass in males and females between ages 18 and 85 years. J Gerontol 1972; 27: Compston JE, Bhambham M, Laskey MA, Murphy S, Khaw KT. Body composition and bone mass in post-menopausal women. Clin Endo 1992; 37: Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy X-ray absorptiometry for total body and regional bone mineral and soft tissue composition. Am J Clin Nutr 1990;51: Nilas L, Christiansen C. Rates of bone loss in normal women: evidence of accelerated trabecular bone loss after the menopause. Eur J Clin Invest 1988; 18:

9 Pun KK, Wong FHW, Loh T. Rapid postmenopausal loss of total body and regional bone mass in normal Southern Chinese females in Hong Kong. Osteo Int 1991; 1: Lindsay R, Cosman F, Herrington BS, Himmelstein S. Bone mass and body composition in normal woman. J Bone Miner Res 1992; 7: Ley CJ, Lee B, Stevenson JC. Sex- and menopause-associated changes in body fat distribution. Am J Clin Nutr 1992; 55: Wang Q, Hassager C, Ravn P, Wang S, Christiansen C. Total and regional bodycomposition changes in early post menopausal women: age-related or menopause-related? Am J Clin Nutr 1994; 60: Svendsen OL, Hassager C, Christiansen C. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absortiometry. Metabolism 1995; 44: Huang KC, Lee LT, Chen CY, Chung MI, Lin RS. Body composition in women before and after menopause. Chin J of Fam Med 1997; 7: (in Chinese) 25. Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Potional cloning of the mouse obese gene and its human homologues. Nature 1994; 372: Johan A, Bart S. Leptin(review). Lancet 1998; 351: Montague CT, Farooqi IS, Whitehead JP et al. Congenital leptin deficiency is associated with severe early-onset obesity in human. Nature 1997; 387: Considine RV, Sinha MK, Heiman ML et al. Serum immunoreactive-leptin concentrations in normal- weight and obese humans. N Engl J Med 1996; 334: Kielar D, Clark JSC, Ciechanowics A, Kurzawski G, Sulikowski T, Naruszewics

10 M. Leptin receptor isoforms expressed in human adipose tissue. Metabolism 1998; 47: N=133 N=80 N= N=133 N=80 N= N=133 N=80 N=53

11 N=133 N=80 N= N=133 N=80 N= N=133

12 N=80 N=53 ** 48.5 ± ± 4.8 cm ± ± 4.4 kg 57.3 ± ± 8.1 BMIkg/m ± ± 3.3 cm 71.6 ± ± 8.3 cm 93.1 ± ± ± ± 0.06 mmhg* 118 ± ± 17 mmhg 79 ± ± 10 * P< 0.05 ** p< N=133 N=80 N=53 kg ± ± 6.65 Fat % ± ± 6.42 kg ± ± 4.47 Trunk % 51.6 ± ± 5.3 kg* 6.12 ± ± 2.29 Abdomen % 26.8 ± ± 3.2 kg 1.85 ± ± 0.60 kg 8.18 ± ± 2.05 TRL* 1.44 ± ± 0.36 * P< 0.05 Fat % Trunk % Abdomen % TRL / 8 N=133

13 N=80 N=53 g/dl 94.8 ± ± 6.9 mg/dl ± ± 42.4 mg/dl 63.7 ± ± 16.1 mg/dl ± ± 36.5 mg/dl* 88.7 ± ± 70.7 µg/ml 8.4 ± ± 4.8 ng/ml 9.9 ± ± 4.8 * P< N=133 N=80 N= ± ± ± ± 2.20 Fat % -0.8 ± ± 3.2 Trunk ± ± 1.48 Trunk %* 0.43 ± ± 2.87 Leg ± ± 0.96 TLR* 0.01 ± ± 0.18 * P< 0.05 Fat % Trunk % Abdomen % TRL / 10

14 N=133 N=80 N= Fat % Trunk Trunk % 0.34** 0.19 Leg * TLR 0.28-* 0.15 * P< 0.05 ** p<0.01 Fat % Trunk % Abdomen % TRL /

別則為 9.8% 12.1% 27.6% 及 32%, 過重的情況隨著年齡增加而上升停經後婦女多屬中央型肥胖, 研究指出婦女在更年期後代謝症候群的盛行率會急速上升 (Rosano, Vitale,

別則為 9.8% 12.1% 27.6% 及 32%, 過重的情況隨著年齡增加而上升停經後婦女多屬中央型肥胖, 研究指出婦女在更年期後代謝症候群的盛行率會急速上升 (Rosano, Vitale, 更年期婦女肥胖防治蘇美禎曹麗英 * 壹前言婦女邁入中年之後, 發現此期身體惡疾不多, 但小病不斷, 對身體的變化充滿不確定感, 隨著皮下脂肪堆積內臟脂肪逐漸增加, 體態隨之改變 ; 體脂肪比腰臀比及身體質量指數皆比未停經婦女