女性の生涯よりみた肥満

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Adipose tissue undergoes aging process as other tissues and both of quantity and distribution of body fat vary with an older age. Obesity in which body fat accumulates excessively is also influenced by aging. For evaluation of obesity, Kaup's index was most correlated with the thickness of fat tissues. Waist hip ratio (WHR) increased with an older age. From the view point of menarche, a role of body fat in reproductive function was evaluated. Ratio of body fat to body weight in the menarcheal age was between 22 and 24%. The ratio of non-menarcheal girls was smaller than that of the menarcheal of the same age. A proper amount of body fat seemed to be necessary for onset of ovarian function to menstruate. On obesity in reproductive age, two topics were discussed. One was the mechanism of menstrual disorders in obese women, the other complications of pregnancy. Concerning the central mechanism of menstrual disorders, hypothalamic disorders cause overfeeding to obesity and gonadal dysfunction to menstrual disorders because feeding center and control center of gonadal system are located in hypothalamus. For the peripheral mechanism, accumulation of fat soluble steroid hormones in the fat tissue disturbs cyclic state of endocrine fluctuation, and extraglandular estrogen production from androgen by aromatase in adipose tissue causes hyperestrogenism. Besides, hyperandrogenism in obese women was stressed on for a causing factor of menstrual disorders in obesity. Hyperandrogenism of obese women with menstrual disorders was associated with high level of cortisol and was corrected by weight reduction to regularize menstrual cycle. Classification of obstetric complications of obese women was proposed. Obstetric complications of obese women were classified into two categories of the mother and of the fetus. Toxemia of pregnancy of the mother and gigantism of the fetus are the main complications of obese pregnant women, and the other complications are derived from these two disorders. Management of obese pregnant women should be addressed to prevention from onset of toxemia of pregnancy and gigantism. Obesity in climacteric and postmenopausal women is inclined to complicate aging disorders and fat distribution concentrates on trunk. Most of the treated obese women regained to more than before treatment soon after cessation of treatment. At present, we must realize the limitation of therapeutic effect on obesity. However, it can be insisted that the significance of treatment of obesity is appreciable in the restoration of reproductive function.
社団法人日本産科婦人科学会の論文
1989-08-01

女性の生涯よりみた肥満

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