围绝经期及绝经后女性应用激素替代治疗后对胰岛素抵抗水平的影响

发布时间：2018-03-27 22:40

本文选题：绝经期女性　切入点：激素替代治疗　出处：《浙江大学》2014年硕士论文

【摘要】：目的：研究围绝经期及绝经后女性绝经状态与胰岛素抵抗之间的关系,以及在应用激素替代治疗(HRT)后胰岛素的改善情况。方法：所有病例均来自于浙江大学附属妇产科医院更年期门诊就诊患者,根据其月经情况将其分为围绝经早期、围绝经晚期及绝经后组,分别测定其初诊时内分泌水平、空腹血糖及胰岛素水平,并计算HOMA指数；在其HRT6个月后再次复测上述指标进行对比。结果：围绝经早期、围绝经晚期、绝经后组其E2水平显著下降(p0.05)；FSH水平显著上升(p0.05)；而胰岛素抵抗水平(HOMA-IR)随着绝经过程的进展而逐步上升(p0.05)；接受HRT后的女性其E2水平较用药前上升(p0.05),FSH水平较用药前下降(p0.05),HOMA-IR较用药前显著下降(p0.05)。结论：随着女性逐步步入绝经,其内分泌激素水平发生剧烈变化,表现为E2水平的不断降低,及FSH水平的显著升高,同时,随着绝经状态的进展,胰岛素抵抗水平(HOMA-IR)逐渐升高。围绝经期及绝经后女性在接受HRT后,E2水平轻度增高,FSH水平降低,同时其胰岛素抵抗水平得到显著改善。这提示我们,在实际临床中,围绝经期及绝经后女性内分泌水平可能与女性胰岛素抵抗存在一定关联,HRT可以一定程度上改善胰岛素抵抗相关疾病,围绝经期及绝经后妇女若无禁忌证,则可应用HRT预防胰岛素抵抗相关疾病。
[Abstract]:Aim: to study the relationship between menopausal status and insulin resistance in perimenopausal and postmenopausal women and the improvement of insulin after hormone replacement therapy (HRT). Methods: all the patients came from the menopausal clinic of the affiliated Obstetrics and Gynecology Hospital of Zhejiang University. According to their menstrual conditions, they were divided into early menopausal group, late menopausal group and postmenopausal group. Fasting blood glucose and insulin levels were calculated and the HOMA index was calculated. The indexes were measured again after their HRT6 months. In postmenopausal group, the level of E2 decreased significantly, the level of P0.05FSH increased significantly, while the level of insulin resistance (HOMA-IRR) gradually increased with the development of menopause. The level of E2 in women after HRT was higher than that before treatment, and the level of FSH was lower than that before treatment. HOMA-IR decreased significantly compared with that before treatment. Conclusion: as women step into menopause, the level of endocrine hormone changes dramatically, which is manifested by the decrease of E2 level and the significant increase of FSH level, at the same time, with the development of menopausal state, The level of insulin resistance (HOMA-IRR) increased gradually. The level of E _ 2 in postmenopausal and peri-menopausal women was slightly increased and the level of insulin resistance was significantly improved. This suggests that, in clinical practice, the level of insulin resistance is significantly improved. The endocrine level of women during and after menopause may be associated with insulin resistance in women. HRT can improve insulin resistance related diseases to some extent, if there is no contraindication between peri-menopausal and postmenopausal women, HRT can be used to prevent insulin resistance related diseases.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.75

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