停經前後體脂肪組成與血清瘦素值之研究

Body Fat Composition and Serum Leptin Levels before and after Menopause

身體脂肪組織的含量及分佈，與心臟血管疾病、糖尿病及其他有關代謝之疾病有極大的相關性，尤其男性比女性化之脂肪分佈，更容易罹患心臟血管疾病。研究指出，女性停經後心臟血管疾病的發生率迅速上升，此可能與其身體組成的改變有關。瘦素主要由脂肪細胞所分泌，在控制體重及熱量平衡上的角色極為重要，停經是否影響瘦素的濃度，值得進一步的探討。本研究自民國87年3月至9月間，選取在台北某健診中心接受健康檢查之40至60歲、共300位停經前後的健康女性為研究樣本。結果發現：（1）停經後婦女之年齡、身體質量指數、腰圍、腰臀比及體脂肪等明顯高於未停經婦女，而體重及臀圍兩組則無統計顯著差異；（2）停經後婦女之尿酸、總膽固醇、低密度脂蛋白膽固醇及三酸甘油酯值皆明顯高於未停經婦女，而飯前血糖、高密度脂蛋白膽固醇及瘦素值兩組則無統計顯著差異；（3）瘦素值依序分別與脂肪重量（r=0.65）、身體脂肪含量比例（r=0.62）及身體質量指數（r=0.61）成明顯正相關；（4）以瘦素值為依變數，年齡、停經狀態、身體質量指數、身體脂肪含量比例與身體脂肪重量為自變數做多變項直線迴歸分析，發現只有身體脂肪重量會獨立影響瘦素值（p<0.01），而年齡、停經狀態、身體脂肪含量比例及身體質量指數皆不影響瘦素值。本研究指出停經後婦女身體脂肪含量增加及分佈的中央化，並伴隨血脂異常，故其心血管及代謝疾病的危險性增加，因此婦女停經後更應注意其飲食及生活型態，並保持適當的運動習慣。

People with android distribution of body fat are more susceptible to cardiovascular and metabolic diseases than those with a gynecoid distribution. The increased risk of cardiovascular diseases in postmenopausal women may be related to increased deposits and centralization of body fat. Leptin, the product of the ob gene, is a hormone secreted by fat cells. The role of fat mass regulation by leptin is well-established. This study investigated the relationship between serum leptin levels and menopausal status. Three hundred healthy women, aged 40 to 60, were recruited from a health clinic in Taipei from March to September 1998. We found that age, body mass index, waist circumference, waist-hip ratio and body fat deposits were higher in postmenopausal than in pre-menopausal women. Serum uric acid, total cholesterol, low-density lipoprotein cholesterol and triglycerides levels were also higher in postmenopausal than in premenopausal women. However, the body weight, hip circumference, glucose, high-density lipoprotein cholesterol and leptin levels were not statistically different in these women. Serum leptin levels were correlated with body fat weight (r=0.65), body fat proportion (r=0.62) and body mass index (r=0.61). Multiple linear regression analysis body fat weight independently predicted serum leptin levels, while age, menopausal status, body mass index and body fat proportion did not. Dyslipidaemia, greater deposit and centralization of body fat occur in postmenopausal women and are accompanied by an increased risk of cardiovascular diseases. Healthy life styles, dietary patterns and regular exercise are very important in women who enter into the postmenopausal period in order to control these increased risks.