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폐경 후 여성에서 혈청 렙틴 농도와 대사증후군과의 관계

The relationship between serum leptin level and metabolic syndrome in postmenopausal women

김미란|유영옥|김은중|조현희|권동진|김장흡|이석우
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2010.03|Obstetrics & Gynecology Science|제53권 제03호|pp. 254-263

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참고문헌

키워드

대사증후군PostmenopauseMetabolic syndrome렙틴Leptin폐경 후
주제분류산부인과학

초록

목적: 폐경이 되면 체지방 및 복부비만의 증가 및 대사증후군의 유병률이 증가하며 심혈관계 질환의 빈도가 증가하는 것으로 보고되고 있다. 렙틴은 지방 세포에서 분비되는 호르몬으로 에너지 대사 조절, 여성 생식 기관 조절 등에 관여한다. 폐경 전후 여성에서 혈청 렙틴과 대사증후군과의 연관성에 대하여 연구를 시행하였다. 연구 방법: 2006년 1월부터 2007년 12월까지 가톨릭대학교 의과대학 성빈센트병원 산부인과를 방문한 폐경 전 여성 56명, 폐경 후 여성 112명을 대상으로 하였으며 각각의 그룹에서 혈청 렙틴, 복부비만도, 대사증후군 위험인자들을 비교하였고 혈청 난포자극호르몬, 에스트라디올 등의 여성 호르몬과 복부비만도, 대사증후군과 렙틴과의 관계를 상관분석, 회귀분석 및 ANCOVA를 이용하여 분석하였다. 결과: 전체 여성 중 대사증후군을 진단받은 여성은 각각 폐경 전에서 37.5%, 폐경 후에서 45.5%이었고, 폐경 후 여성에서 폐경 전보다 혈청 렙틴 농도와 체지방비율이 더 높았다. 체질량 지수를 보정하였을 때 비비만군에서 난포자극호르몬이 높을수록 혈청 렙틴의 농도가 증가하였으며, 폐경 후 여성에서 복부비만도를 나타내는 허리 엉덩이둘레비율 및 내장지방면적과 렙틴은 양의 상관관계를 보였다. 렙틴과 대사증후군 및 위험인자와의 비교에서는 복부비만만이 유의한 양의 상관관계를 보였으며, 체질량지수를 보정하였을 경우 대사증후군 자체와는 연관성이 없었다. 결론: 폐경 후 여성에서 난포 자극 호르몬의 증가 및 복부비만은 혈청 렙틴 농도를 증가시킨다. 렙틴과 대사증후군의 기타 다른 위험인자들, 심혈관 질환의 위험성과의 관련성 규명에 대한 더 깊은 연구가 필요하다.

Abstract

Objective: Menopause status may lead to increases of body fat, abdominal obesity, and the incidence of metabolic syndrome (MS). Leptin is an adipokine that is secreted by adipocytes and plays an important role in regulating energy homeostasis and the reproductive system. This study examined the relationship among obesity, MS, and serum leptin levels in pre- and postmenopausal women. Methods: We divided 168 women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into premenopausal vs. postmenopausal, obese vs. non-obese groups based on their body mass index (BMI) and the presence of MS. We measured serum follicle-stimulating hormone (FSH) level, serum estradiol level, BMI, the waist-hip ratio (WHR) and visceral fat area (VFA), serum fasting glucose, lipid profile, blood pressure, and serum leptin level. Results: Of 56 premenopausal and 112 postmenopausal women, there were 21 (37.5%) premenopausal and 51 (45.5%) postmenopausal women with MS. In the non-obese premenopausal and postmenopausal women, there were positive correlations between FSH, markers of abdominal obesity such as WHR and VFA, and serum leptin after adjusting for BMI in postmenopausal women. In the MS group, only WHR was correlated with the serum leptin level after adjusting for BMI in all groups. Conclusion: Increased serum FSH level and abdominal obesity lead to an increased serum leptin level in postmenopausal women. Further studies are needed to clarify the relationship between leptin and the metabolic syndrome, risk of cardiovascular disease in postmenopausal women.

참고문헌 (45)

  1. Flegal KM, "Prevalence and trends in obesity among US adults, 1999-2000", JAMA, 288, pp.1723~1727 (2002)
  2. Calle EE, "Overweight. obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults", N Engl J Med, 348, pp.1625~1638 (2003)
  3. Bray GA, "Medical consequences of obesity", J Clin Endocrinol Metab, 89, pp.2583~2589 (2004)
  4. Kuczmarski RJ, "Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991", JAMA, 20, pp.205~211 (1994)
  5. Poehlman ET, "Changes in energy balance and body composition at menopause: a controlled longitudinal study", Ann Intern Med, 123, pp.673~675 (1995)
  6. Pasquali R, "Body weight, fat distribution and the menopausal status in women. The VMH Collaborative Group", Int J Obes Related Metab Disord, 18, pp.614~621 (1994)
  7. Björkelund C, "Reproductive history in relation to relative weight and fat distribution", Int J Obes Related Metab Disord, 20, pp.213~219 (1996)
  8. Carr MC, "The emergence of the metabolic syndrome with menopause", J Clin Endocrinol Metab, 88, pp.2404~2411 (2003)
  9. Lindheim SR, "Comparison of estimates of insulin sensitivity in pre- and postmenopausal women using the insulin tolerance test and the frequently sampled intravenous glucose tolerance test", J Soc Gynecol Investig, 1, pp.150~154 (1994)
  10. Ford ES, "Prevalence of the metabolic syndrome among U.S. adults: findings from the third National Health and Nutrition Examination Survey", JAMA, 287, pp.356~359 (2002)
  11. Malik S, "Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults", Circulation, 110, pp.1245~1250 (2004)
  12. Després JP, "Abdominal obesity as important component of insulin resistance syndrome", Nutrition, 9, pp.452~459 (1993)
  13. Kannel WB, "Regional obesity and risk of cardiovascular disease; the Framingham Study", J Clin Epidemiol, 44, pp.183~190 (1991)
  14. Prins JB, "Adipose tissue as an endocrine organ", Best Pract Res Clin Endocrinol Metab, 16, pp.639~651 (2002)
  15. Caro JF, "Leptin: the tale of an obesity gene", Diabetes, 45, pp.1455~1462 (1996)
  16. Nagatani S, "Evidence for GnRH regulation by leptin: leptin administration prevents reduced LH secretion during fasting", Neuroendocrinology, 67, pp.370~376 (1998)
  17. Duggal PS, "The in vivo and in vitro effects of exogenous leptin on ovulation in the rat", Endocrinology, 141, pp.1971~1976 (2000)
  18. Agarwal SK, "Leptin antagonizes the insulin-like growth factor-I augmentation of steroidogenesis in granulose and theca cells of the human ovary", J Clin Endocrinol Metab, 84, pp.1072~1076 (1999)
  19. Soules MR, "Executive summary: Stages of Reproductive Aging Workshop (STRAW)", Fertil Steril, 76, pp.874~848 (2001)
  20. Examination Committee of Criteria for ‘Obesity Disease; in Japan; Japan Society for the Study of Obesity, "New criteria for ‘obesity disease’ in Japan", Circ J, 66, pp.987~992 (2002)
  21. Alberti KG, "Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation", Diabet Med, 15, pp.539~553 (1998)
  22. National Cholesterol Education Program (NCEP), "Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)", Circulation, 106, pp.3143~3421 (2002)
  23. 보건복지부, "국민영양조사", ~ (2005)
  24. Gambacciani M, "Prospective evaluation of body weight and body fat distribution in early postmenopausal women with and without hormonal replacement therapy", Maturitas, 39, pp.125~132 (2001)
  25. Lovejoy JC, "Increased visceral fat and decreased energy expenditure during the menopausal transition", Int J Obes (Lond), 32, pp.949~958 (2008)
  26. Park YW, "The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994", Arch Intern Med, 163, pp.427~436 (2003)
  27. Zhang Y, "Positional cloning of the mouse obese gene and its human homologue", Nature, 372, pp.425~432 (1994)
  28. Hileman SM, "Leptin, nutrition, and reproduction: Timing is everything", J Clin Endocrinol Metab, 85, pp.804~807 (2000)
  29. Friedman JM, "Leptin and the regulation of body weight in mammals", Nature, 395, pp.763~770 (1998)
  30. Buettner C, "Letpin controls adipose tissue lipogenesis via central, STAT3-independent mechanisms", Nat Med, 14, pp.667~675 (2008)
  31. Greco AV, "Insulin resistance in morbid obesity: reversal with intramyocellular fat depletion", Diabetes, 51, pp.144~151 (2002)
  32. Buettner C, "Critical role of STAT3 in leptin’s metabolic actions", Cell Metabol, 4, pp.49~60 (2006)
  33. Wallace AM, "Plasma leptin and the risk of cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS)", Circulation, 104, pp.3052~3056 (2001)
  34. Moschos S, "Leptin and reproduction: a review", Fertil Steril, 77, pp.433~444 (2002)
  35. Shimizu H, "Estrogen increases in vivo leptin production in rats and human subjects", J Endocrinol, 154, pp.285~292 (1997)
  36. Chu MC, "Insulin resistance in postmenopausal women with metabolic syndrome and the measurements of adiponectin, leptin, resistin, ghrelin", Am J Obstet Gynecol, 194, pp.100~104 (2006)
  37. Sowers MR, "Change in adipocytokines and ghrelin with menopause", Maturitas, 59, pp.149~157 (2008)
  38. Lapidus L, "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", Br Med J (Clin Res Ed), 289, pp.1257~1261 (1984)
  39. Mahabir S, "Body mass index, percent body fat and regional body fat distribution in relation to leptin concentrations in healthy, non-smoking postmenopausal women in a feeding study", Nutr J, 6, pp.3~ (2007)
  40. Ritland LM, "Centrally located body fat is related to appetitive hormones in healthy postmenopausal women", Eur J Endocriol, 158, pp.889~897 (2008)
  41. Huang KC, "Plasma leptin is associated with insulin resistance independent of age, body mass index, fat mass, lipid and pubertal development in nondiabetic adolescents", Int J Obes Relat Metab Disord, 28, pp.470~475 (2004)
  42. Franks PW, "Leptin predicts a worsening of the feature of the metabolic syndrome independently of obesity", Obes Res, 13, pp.1476~1484 (2005)
  43. Wellen KE, "Obesity-induced inflammatory changes in adipose tissue", J Clin Invest, 112, pp.1785~1788 (2003)
  44. Patel SB, "Leptin: linking obesity, the metabolic syndrome, and cardiovascular disease", Curr Hypertens Rep, 10, pp.131~137 (2008)
  45. Ryo M, "A new simple method for the measurement of visceral fat accumulation by bioelectrical impedance", Diabetes Care, 28, pp.451~453 (2005)

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