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Yang J, Yu J, Wang Y, Liao M, Ji Y, Li X, Wang X, Chen J, Qi B, Yang F. Development of hypertension models for lung cancer screening cohorts using clinical and thoracic aorta imaging factors. Sci Rep 2024; 14:6862. [PMID: 38514739 PMCID: PMC10957886 DOI: 10.1038/s41598-024-57396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
This study aims to develop and validate nomogram models utilizing clinical and thoracic aorta imaging factors to assess the risk of hypertension for lung cancer screening cohorts. We included 804 patients and collected baseline clinical data, biochemical indicators, coexisting conditions, and thoracic aorta factors. Patients were randomly divided into a training set (70%) and a validation set (30%). In the training set, variance, t-test/Mann-Whitney U-test and standard least absolute shrinkage and selection operator were used to select thoracic aorta imaging features for constructing the AIScore. Multivariate logistic backward stepwise regression was utilized to analyze the influencing factors of hypertension. Five prediction models (named AIMeasure model, BasicClinical model, TotalClinical model, AIBasicClinical model, AITotalClinical model) were constructed for practical clinical use, tailored to different data scenarios. Additionally, the performance of the models was evaluated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA). The areas under the ROC curve for the five models were 0.73, 0.77, 0.83, 0.78, 0.84 in the training set, and 0.77, 0.78, 0.81, 0.78, 0.82 in the validation set, respectively. Furthermore, the calibration curves and DCAs of both sets performed well on accuracy and clinical practicality. The nomogram models for hypertension risk prediction demonstrate good predictive capability and clinical utility. These models can serve as effective tools for assessing hypertension risk, enabling timely non-pharmacological interventions to preempt or delay the future onset of hypertension.
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Affiliation(s)
- Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Yu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaoling Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Man Liao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Ji
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Li
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Xuechun Wang
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Jun Chen
- Precision Healthcare Institute, GE Healthcare, Shanghai, China
| | - Benling Qi
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Colacurci N, Filardi PP, Chiantera A, Colao A, Pasqualetti P, Lenzi A. Sharing the multidisciplinary clinical approach to peri- and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice. Int J Gynaecol Obstet 2024. [PMID: 38404042 DOI: 10.1002/ijgo.15448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The critical phase of perimenopausal period is marked by a reduction in estrogen levels, leading to various clinical issues (vasomotor and neurodegenerative symptoms, increased osteoporosis risk and cardiovascular risk). These complex clinical scenarios pose challenges to clinicians in providing the right support for diagnosis and treatment. A group of Italian cardiologists, endocrinologists, and gynecologists conducted a survey among expert colleagues to assess consensus on controversial issues and best practices for screening and treating peri- and postmenopausal women. METHODS The Delphi methodology was used to analyze responses from a qualitative expert panel comprising 25 cardiologists, 25 endocrinologists, and 25 gynecologists, selected nationwide. Two consecutive questionnaires were proposed between February and May 2023. Agreement among experts was assessed following the Delphi method as developed by the RAND Corporation. RESULTS The results of this Delphi Consensus have been shared by the leading scientific societies: Italian Society of Cardiology, Italian Society of Endocrinology, Italian Society of Gynecology and Obstetrics, and Italian Hospital Obstetricians Gynecologists Association. CONCLUSIONS The experts highlighted comorbidities and hormone deprivation as crucial clinical problems to be evaluated in perimenopausal women, requiring investigation from cardiovascular and endocrinologic perspectives to assess cardiovascular risk, involving the use of BMI, standard blood samples, endocrine-metabolic tests, and lifestyle assessment, particularly in women with higher cardiovascular and metabolic risks candidates for hormone replacement therapy (HRT). The experts also agreed on the benefits of HRT in improving lipid metabolism and reducing insulin resistance, thereby mitigating the metabolic risks associated with menopause. However, this therapy should be tailored considering individual women's comorbidities and thrombotic risk.
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Affiliation(s)
- Nicola Colacurci
- Department of Obstetrics and Gynecology, Italian Society of Gynecology and Obstetrics, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, Italian Society of Cardiology, Federico II University of Naples, Naples, Italy
| | - Antonio Chiantera
- Italian Hospital Obstetricians Gynecologists Association, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology, Diabetology and Andrology Unit, Italian Society of Endocrinology, Federico II University of Naples, Naples, Italy
| | - Patrizio Pasqualetti
- Department of Public Health and Infectious Disease, Sapienza Rome University, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza Rome University, Rome, Italy
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The Metabolomic Rationale for Treating Perimenopausal Syndrome as Kidney Deficiency. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8568353. [PMID: 33376499 PMCID: PMC7746443 DOI: 10.1155/2020/8568353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/20/2020] [Accepted: 11/16/2020] [Indexed: 01/21/2023]
Abstract
Background Traditional Chinese medicine (TCM) typically attributes the etiopathogenesis of perimenopausal syndrome (PMS) to kidney deficiency in the TCM stratification system for diagnosis. However, the molecular basis of this classical attribution remains to be investigated. Aim of the Study. By unraveling the responses to TCM treatment for kidney deficiency, the metabolomic link between PMS and kidney deficiency can be evaluated for in-depth understanding of the mechanism of TCM treatment and development of better treatment protocols. Materials and Methods With naturally aged rats as a model for PMS, the metabolomic response to TCM treatment for kidney deficiency was investigated by 1H NMR. Results 1H NMR metabolomic evidence of plasma samples demonstrates that treatments with two classical TCM prescriptions for kidney deficiency, decoctions of Yougui and Zuogui, result in modulating the metabolic state of the disease model towards that of rats of younger age. Conclusion The data support the notion that kidney deficiency is responsible, in part at least, for PMS, and the relevant prescriptions are helpful in dampening the changes in the body's metabolic states to alleviate symptoms of the disorder.
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Dağıstan Akgöz A, Ozer Z, Gözüm S. The effect of lifestyle physical activity in reducing cardiovascular disease risk factors (blood pressure and cholesterol) in women: A systematic review. Health Care Women Int 2020; 42:4-27. [PMID: 33175658 DOI: 10.1080/07399332.2020.1828422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cardiovascular diseases (CVD) are the most important cause of death in older women. Although there is strong evidence in the literature that moderate lifestyle physical activity (PA) is effective in modifiable CVD risk factors, there is limited evidence demonstrating which activities are effective in women. This systematic review was conducted to evaluate the effect of lifestyle PA interventions on CVD risk factors in women. Various databases were searched for English articles from 2000 to 2019. Eight articles met the selection criteria. It is recommended to use different combinations of interventions including moderate PA, to reduce CVD risk factors in women.
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Affiliation(s)
| | - Zeynep Ozer
- Department of Internal Medicine Nursing, Akdeniz Universitesi, Antalya, Turkey
| | - Sebahat Gözüm
- Department of Public Health Nursing, Akdeniz Universitesi, Antalya, Turkey
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Okoth K, Chandan JS, Marshall T, Thangaratinam S, Thomas GN, Nirantharakumar K, Adderley NJ. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ 2020; 371:m3502. [PMID: 33028606 PMCID: PMC7537472 DOI: 10.1136/bmj.m3502] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To consolidate evidence from systematic reviews and meta-analyses investigating the association between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. DESIGN Umbrella review. DATA SOURCES Medline, Embase, and Cochrane databases for systematic reviews and meta-analyses from inception until 31 August 2019. REVIEW METHODS Two independent reviewers undertook screening, data extraction, and quality appraisal. The population was women of reproductive age. Exposures were fertility related factors and adverse pregnancy outcomes. Outcome was cardiovascular diseases in women, including ischaemic heart disease, heart failure, peripheral arterial disease, and stroke. RESULTS 32 reviews were included, evaluating multiple risk factors over an average follow-up period of 7-10 years. All except three reviews were of moderate quality. A narrative evidence synthesis with forest plots and tabular presentations was performed. Associations for composite cardiovascular disease were: twofold for pre-eclampsia, stillbirth, and preterm birth; 1.5-1.9-fold for gestational hypertension, placental abruption, gestational diabetes, and premature ovarian insufficiency; and less than 1.5-fold for early menarche, polycystic ovary syndrome, ever parity, and early menopause. A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease. The associations for ischaemic heart disease were twofold or greater for pre-eclampsia, recurrent pre-eclampsia, gestational diabetes, and preterm birth; 1.5-1.9-fold for current use of combined oral contraceptives (oestrogen and progesterone), recurrent miscarriage, premature ovarian insufficiency, and early menopause; and less than 1.5-fold for miscarriage, polycystic ovary syndrome, and menopausal symptoms. For stroke outcomes, the associations were twofold or more for current use of any oral contraceptive (combined oral contraceptives or progesterone only pill), pre-eclampsia, and recurrent pre-eclampsia; 1.5-1.9-fold for current use of combined oral contraceptives, gestational diabetes, and preterm birth; and less than 1.5-fold for polycystic ovary syndrome. The association for heart failure was fourfold for pre-eclampsia. No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment. CONCLUSIONS From menarche to menopause, reproductive factors were associated with cardiovascular disease in women. In this review, presenting absolute numbers on the scale of the problem was not feasible; however, if these associations are causal, they could account for a large proportion of unexplained risk of cardiovascular disease in women, and the risk might be modifiable. Identifying reproductive risk factors at an early stage in the life of women might facilitate the initiation of strategies to modify potential risks. Policy makers should consider incorporating reproductive risk factors as part of the assessment of cardiovascular risk in clinical guidelines. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019120076.
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Affiliation(s)
- Kelvin Okoth
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Shakila Thangaratinam
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Nicola J Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Ryu KJ, Park H, Park JS, Lee YW, Kim SY, Kim H, Jeong Y, Kim YJ, Yi KW, Shin JH, Hur JY, Kim T. Vasomotor Symptoms: More Than Temporary Menopausal Symptoms. J Menopausal Med 2020; 26:147-153. [PMID: 33423402 PMCID: PMC7797223 DOI: 10.6118/jmm.20030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 01/10/2023] Open
Abstract
Vasomotor symptoms (VMS), such as hot flashes and night sweating, are classic menopausal symptoms experienced by a majority of perimenopausal and postmenopausal women. VMS have received a great deal of attention due to their relationship with cardiometabolic risk. Further, accumulating evidence indicates that VMS are associated with an increased risk of several chronic diseases, including metabolic syndrome, type 2 diabetes mellitus, nonalcoholic fatty liver diseases, and osteoporosis in perimenopausal and postmenopausal women. These findings suggest VMS as biomarkers of impaired cardiometabolic conditions rather than just temporary symptoms in menopausal women, warranting further studies to confirm the casual relationship of VMS with these diseases and the exact underlying mechanism in this context.
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Affiliation(s)
- Ki Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
| | | | - Yeon Woo Lee
- Korea University College of Medicine, Seoul, Korea
| | | | - Hayun Kim
- Korea University College of Medicine, Seoul, Korea
| | - Youngmi Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Kyong Wook Yi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jung Ho Shin
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jun Young Hur
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
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Maniçoba ACBN, Galvão-Moreira LV, D'Albuquerque IMSC, Brito HO, do Nascimento JR, do Nascimento FRF, do C L Barbosa M, da Costa RMG, do D S B Nascimento M, Dos S Faria M, Brito LMO. Plasma Cytokine Levels in Overweight Versus Obese Disease-Free Perimenopausal Women. Endocr Metab Immune Disord Drug Targets 2019; 20:917-923. [PMID: 31858915 DOI: 10.2174/1871530320666191220110503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the plasma cytokine levels during T cell-mediated inflammatory responses and compare the metabolic markers between overweight and obese perimenopausal women without systemic diseases. METHODS Sixty perimenopausal women were divided into two groups (overweight and obese). Participants in both groups had their waist-to-height ratio (WHtR) measured and blood samples collected for the evaluation of estradiol, fasting glucose, leptin, high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, IL-10, IL-17A levels, and lipid profile. RESULTS In univariate analysis, women with obesity showed increased WHtR, fasting glucose, leptin, and IL-6 (p < 0.05) levels; however, significant differences were not observed in IL-10 or IL-17A (p > 0.05) levels. In the receiver operating characteristic curve, the highest areas under the curve were shown for leptin (0.856) and IL-6 (0.706). IL-6 levels correlated with both hs-CRP (r = 0.302, p = 0.020) and leptin (r = 0.294, p = 0.022). However, in multivariate analysis, IL-6 was not associated with a greater likelihood of obesity (OR = 1.61; 95% CI: 0.82-3.15; p = 0.16), when potential confounders were considered. CONCLUSION IL-6 levels varied between overweight and obese perimenopausal women, and this association was weaker when adjusted for other clinical variables.
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Affiliation(s)
- Anna C B N Maniçoba
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
| | | | | | - Haissa O Brito
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
| | - Johnny R do Nascimento
- Postgraduate Program in Health Sciences, Federal University of Maranhão, São Luís, Brazil
| | | | | | - Rui M G da Costa
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
| | | | - Manuel Dos S Faria
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil,Department of Medicine I, Federal University of Maranhão, São Luís, Brazil
| | - Luciane M O Brito
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
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Li RL, Shen XL, Xu F, Shui XJ, Chen YM, Wang WH, Zheng JY. Evaluation of ovarian function using three dimensional ultrasound in perimenopausal women. Gynecol Endocrinol 2019; 35:1059-1062. [PMID: 31185760 DOI: 10.1080/09513590.2019.1625879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
To evaluate the feasibility and clinical value of three-dimensional ultrasound in evaluating ovarian function in perimenopausal women. In this prospective cohort study, 102 patients with clinically suspected perimenopause and 90 patients with menopause were enrolled. These patients were classified into three groups according to the level of follicle stimulating hormone (FSH) and estradiol (E2): menopause group, perimenopause group, and normal group. Perimenopause group: There were significant differences in volume, vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) in the ovaries after treatment. Cycle 1 > cycle 0 (p < .05) and cycle 3 <cycle 0 (p < .05) in FSH. Menopause group: There were significant differences in volume, VI, FI, and VFI of the ovaries after treatment: Cycle 3 >cycle 0 (p < .05), and in FSH: cycle 3 < cycle 0 (p < .05). Three-dimensional ultrasound in ovarian quantitative measurement can objectively reflect the change in the ovarian function, predicting the effect of drug treatment, and provided an objective information for early intervention to menopausal.
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Affiliation(s)
- Ren-Liang Li
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Xiao-Lu Shen
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Fang Xu
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Xu-Juan Shui
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Yu-Mei Chen
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Wen-Huan Wang
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
| | - Jia-Yong Zheng
- Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, PR China
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Yoon H, Lee JH, Gi MY, Cha JA, Moon AE, Seong JM. Relationship Between Metabolic Syndrome and Beta-Cell Function in Nondiabetic Korean Premenopausal and Postmenopausal Women: 2015 Korean National Health and Nutrition Examination Survey. Metab Syndr Relat Disord 2019; 18:39-46. [PMID: 31589549 DOI: 10.1089/met.2019.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: This study was conducted to assess the relationship between metabolic syndrome (MetS) and beta-cell function in nondiabetic Korean women. Methods: This study included 2,507 women (premenopausal women, 1,359; postmenopausal women, 1,148) who were aged ≥20 and used 2015 Korean National Health and Nutrition Examination Survey (KNHANES) data. Results: Key study results were as follows: first, in both premenopausal and postmenopausal women, after adjusting for related variables [except body mass index (BMI)], MetS (P < 0.001) and metabolic syndrome score (MSS; P < 0.001) were positively associated with the homeostasis model assessment of beta-cell function (HOMA-B) levels. Second, in premenopausal women, when further adjusted for BMI, MetS (P = 0.002) and MSS (P < 0.001) were also positively associated with HOMA-B levels. However, in postmenopausal women, when further adjusting for BMI, the associations of MetS (P = 0.322) or MSS (P = 0.855) and HOMA-B levels were no longer significant. Conclusions: Metabolic syndrome was positively associated with beta-cell function in nondiabetic Korean premenopausal women, but not in Korean postmenopausal women.
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Affiliation(s)
- Hyun Yoon
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan-si, South Korea
| | - Jun Ho Lee
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan-si, South Korea
| | - Mi Young Gi
- Department of Nursing, Christian College of Nursing, Gwangju, South Korea
| | - Ju Ae Cha
- Department of Nursing, Chunnam Techno University, Gokseong-gun, South Korea
| | - Ae Eun Moon
- Department of Dental Hygiene, Honam University, Gwangju, South Korea
| | - Jeong Min Seong
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok-si, South Korea
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Zhu Q, Yao Y, Ning CX, Chen XP, Luan FX, Liu L, Liu Q, Wang N, Zhang F, Zhao YL. Oestradiol: any role in cardiovascular risk factors in female centenarians of Hainan? BMC Cardiovasc Disord 2019; 19:115. [PMID: 31096919 PMCID: PMC6521527 DOI: 10.1186/s12872-019-1103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/07/2019] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies reported that low level of oestradiol (E2) was associated with higher risk of cardiovascular disease (CVD). However, little study examined the relationship between E2 and CVD in longevous women, which were deficient in serum E2 for the post-menopausal status. Therefore, this study aims to explore the association between E2 and CVD risk factors in a group of female centenarians of Hainan, China. Methods A total of 413 female centenarians (aged from 100 to 115) from China Hainan Centenarian Cohort Study (CHCCS) were enrolled in this study. Home interviews were conducted to collected data on demographic characteristics, health-related lifestyles, and anthropometrics. The level of serum E2 was assessed in the Clinical Laboratory of Hainan branch of PLA General Hospital. The variables of CVD risk factors, including blood pressures, lipids and blood glucose, were measured through standard procedures. Results Significant negative correlations between levels of serum E2 and TC, HDL-C, and LDL-C were observed in this study. Compared with the highest group of E2, the odds ratio and 95% confidence intervals of high LDL-C in groups 3, 2 and 1 were OR1.94 (CI0.82–4.62), OR3.61 (CI1.27–10.25) and OR9.29 (CI2.08–41.53), respectively. Similarly, the prevalence of hypertension was decreased with the increase of serum E2. The odds ratio and 95% confidence intervals of stage-2 hypertension in groups 3, 2 and 1 versus highest E2 group were OR1.34 (CI0.49–3.72), OR1.36 (CI0.47–3.99) and OR1.38 (CI0.45–4.20), respectively. Conclusions This study examined the relationship between E2 and CVD risk factors in a group of community-based female centenarians. A negative correlations between serum E2 levels and CVD risk factors, i.e. high level of LDL-C, TC, and hypertension were observed in this population. Besides, the level of serum E2 is also negatively correlated with HDL-C. Further studies on the correlation between serum E2 and CVD risk factors, especially dyslipidemia, in longevous and post-menopausal women are warranted.
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Affiliation(s)
- Qiao Zhu
- Hainan branch of PLA General Hospital, Sanya, 572000, China.
| | - Yao Yao
- Hainan branch of PLA General Hospital, Sanya, 572000, China.,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Chao-Xue Ning
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Xiao-Ping Chen
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Fu-Xin Luan
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Liang Liu
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Qiong Liu
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Na Wang
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Fu Zhang
- Hainan branch of PLA General Hospital, Sanya, 572000, China
| | - Ya-Li Zhao
- Hainan branch of PLA General Hospital, Sanya, 572000, China.
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Grygiel-Górniak B, Mosor M, Marcinkowska J, Przysławski J, Nowak J. Uric acid and obesity-related phenotypes in postmenopausal women. Mol Cell Biochem 2018; 443:111-119. [PMID: 29075989 PMCID: PMC5943388 DOI: 10.1007/s11010-017-3215-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/20/2017] [Indexed: 12/22/2022]
Abstract
The aim of this study was to find the genetic, metabolic, and nutritional risk factors, which can be associated with uric acid (UA) level. The risk factors related to uricemia were assessed among 271 postmenopausal women without cardiometabolic disorders and hypolipidemic/hypoglycemic treatment selected from a cohort of 1423 obese postmenopausal women. The bioimpedance analysis and biochemical and genetic analyses were performed in two groups characterized by serum UA ≥ 4 mg/dL (238 μmol/L) and < 4 mg/dL. The TaqMan-based real-time PCR method was applied to assess the role of Pro12Ala of peroxisome proliferation-activated receptor (PPAR)gamma-2 and Trp64Arg of beta-3-adrenergic receptor (ADRB) polymorphisms. Women with UA level ≥ 4 mg/dL were characterized by larger body mass, triceps skinfold, waist circumference, body fat amount, and serum insulin, glucose, and triglyceride levels. There was no difference in dietary habits between the analyzed groups. Body mass, waist circumference, body fat amount, diastolic blood pressure, and serum insulin, glucose, high-density lipoprotein, and triglyceride levels, Homeostasis Model Assessment-Insulin Resistance, and energy from the dietary fat influence the UA level ≥ 4 mg/dL; however, the serum UA was not determined by Pro12Ala and Trp64Arg polymorphism analyses. The model of linear regression revealed that the group characterized by body mass index ≥ 25 kg/m2 and glucose ≥ 100 mg/dL has 4 times increased risk of UA level (p = 0.0009); after adding triglycerides ≥ 150 mg/dL, the risk of UA increased 7 times (p = 0.0216). Increasing the level of UA ≥ 4 mg/dL is associated with overweight, hyperglycemia, and hypertriglyceridemia in women without a history of cardiometabolic disorders. A better management of metabolic factors could help prevent further increase in UA levels.
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Affiliation(s)
- B Grygiel-Górniak
- Department of Rheumatology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
| | - M Mosor
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - J Marcinkowska
- Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - J Przysławski
- Department of Bromatology and Human Nutrition, Poznan University of Medical Sciences, Poznan, Poland
| | - J Nowak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
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12
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Soutelo J, Samaniego YA, Fornari MC, Reyes Toso C, Ponzo OJ. Cardiometabolic Changes in Different Gonadal Female States Caused by Mild Hyperuricemia and Exposure to a High-Fructose Diet. Int J Endocrinol 2018; 2018:6021259. [PMID: 30245716 PMCID: PMC6136543 DOI: 10.1155/2018/6021259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The objective of this study is to observe if mild hyperuricemia and a high-fructose diet influence the cardiovascular and metabolic systems in hypogonadic female Wistar rats compared to normogonadic female rats. METHODS Fifty-six (56) adult female Wistar rats were used in the present work. Animals were divided into two groups: normogonadic (NGN) and hypogonadic (HGN). These groups were also divided into four subgroups in accordance with the treatment: control with only water (C), fructose (F), oxonic acid (OA), and fructose + oxonic acid (FOA). Lipid profile, glycemia, uric acid, and creatinine determinations were assessed. Cardiovascular changes were evaluated by measuring blood pressure, myocyte volume, fibrosis, and intima-media aortic thickness. RESULTS HGN rats had higher levels of total cholesterol (TC) (p < 0.01) and noHDLc (p < 0.01), in addition to higher levels of uric acid (p < 0.05). The OA group significantly increased myocyte volume (p < 0.0001) and the percentage of fibrosis as well as the group receiving FOA (p < 0.001) in both gonadal conditions, being greater in the HGN group. Hypogonadic animals presented a worse lipid profile. CONCLUSION Mild hyperuricemia produces hypertension together with changes in the cardiac hypertrophy, fibrosis, and increased thickness of the intima media in hypogonadic rats fed high-fructose diet.
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Affiliation(s)
- J. Soutelo
- Department of Physiology, Medicine School, University of Buenos Aires (UBA), Buenos Aires, Argentina
- Endocrinology Service Medical Complex, Argentine Federal Police (PFA), Churruca-Visca Hospital, Buenos Aires, Argentina
| | - Y. A. Samaniego
- Department of Physiology, Medicine School, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - M. C. Fornari
- Laboratory Fornari-Bioalpha, Buenos Aires, Argentina
| | - C. Reyes Toso
- Department of Physiology, Medicine School, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - O. J. Ponzo
- Department of Physiology, Medicine School, University of Buenos Aires (UBA), Buenos Aires, Argentina
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Hsu CC, Kuo HC, Huang KE. The Effects of Phytosterols Extracted from Diascorea alata on the Antioxidant Activity, Plasma Lipids, and Hematological Profiles in Taiwanese Menopausal Women. Nutrients 2017; 9:nu9121320. [PMID: 29206136 PMCID: PMC5748770 DOI: 10.3390/nu9121320] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022] Open
Abstract
The efficacy of phytosterols extracted from Diascorea alata on antioxidant activities, plasma lipids and hematological profiles was assessed in postmenopausal women. Gas chromatography and mass spectrophotometry was employed to determine the steroid content of Taiwanese yam (Diascorea alata cv. Tainung No. 2). A two-center, randomized, double-blind, placebo-controlled clinical investigation on 50 postmenopausal women randomly assigned to two groups treated for 12 months with placebo or two sachets daily of Diascorea extracts containing 12 mg/dose was carried out. The main outcome measures were the plasma antioxidant activities, hematological profiles, and the concentrations of plasma lipids, including cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, very low density lipoprotein,, and apolipoprotein A1 and B. A one-way analysis of covariance (ANCOVA) test was performed to investigate the significance. Beta-sitosterol, stigmasterol, 22-23-dihydro-, and γ-sitosterol were major phytosterols determined from Diascorea extracts. At six months in those receiving Diascorea, there were significantly decreased leukocyte counts (p < 0.01) and improvement on antioxidant activity of malondialdehyde (p < 0.001). After 12 months’ treatment, elevations of hematocrit and mean corpuscular volume (p < 0.01) were noted in those receiving Diascorea. Moreover, the low dose Diascorea consumption in menopausal women for one year generally did not present positive effects on lipid profiles.
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Affiliation(s)
- Chao-Chin Hsu
- Graduate Institute of Medical Science, Chang Jung Christian University, Tainan 71101, Taiwan.
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 110, Taiwan.
| | - Hsin-Chih Kuo
- Department of Health Management, I-Shou University, Kaohsiung 84001, Taiwan.
| | - Ko-En Huang
- Department of Obstetrics and Gynecology, Chang Gung University School of Medicine and Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
- San an Obstetrics and Gynecology Hospital, 177 Meisu East 2nd Road, Kaohsiung 804, Taiwan.
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Sun Y, Ruan X, Mueck AO. Dependency of cardiovascular risk on reproductive stages and on age among middle-aged Chinese women. Climacteric 2017; 20:484-490. [PMID: 28771097 DOI: 10.1080/13697137.2017.1357691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the 10-year cardiovascular risk in middle-aged Chinese women living in the same community and the impact of reproductive aging and age. METHODS This was a cross-sectional study in the Yuetan Community of Beijing. Data on lifestyle habits, prevalence and treatment of chronic diseases with significance for cardiovascular disease (CVD) development were collected by interview. CVD risk factors were assessed by physical examination and laboratory tests. The 10-year cardiovascular risk was calculated using the Framingham 10-year risk score. STRAW +10 criteria were used for the stages of reproductive aging. RESULTS A total of 536 women, aged 40-60 years, were enrolled. The incidences of hypertension, dyslipidemia, abdominal obesity, glucose intolerance and diabetes were 32.6%, 45.7%, 65.5%, 37.9% and 10.1%, respectively. After adjustment, the incidence of hypertension and diabetes increased with age and with reproductive aging. Dyslipidemia and glucose intolerance were only associated with age. Abdominal obesity was related neither to age nor to reproductive aging. The 10-year cardiovascular risk ranged from 1% to 24.8%; 11.6% of women had a moderate or high Framingham 10-year risk score. CONCLUSIONS CVD risk factors were frequent and more than 10% of the women were at moderate or high risk of developing cardiovascular disease within the next 10 years. To our knowledge, this was demonstrated for the first time in middle-aged Chinese women. Thus, women should maintain a healthy lifestyle and physicians should monitor them to prevent CVD.
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Affiliation(s)
- Y Sun
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.,b Yuetan Community Health Service Centre , Fuxing Hospital, Capital Medical University , Beijing , China
| | - X Ruan
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.,c Department of Women's Health , University Clinical Centre Tuebingen , Tuebingen , Germany
| | - A O Mueck
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.,c Department of Women's Health , University Clinical Centre Tuebingen , Tuebingen , Germany
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15
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Im EO, Ko Y, Chee E, Chee W, Mao JJ. Midlife women's cardiovascular symptoms: A cluster analysis. Health Care Women Int 2017; 38:1275-1288. [PMID: 28532290 DOI: 10.1080/07399332.2017.1332626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Menopausal transition, in which biological and psychosocial changes are caused due to estrogen fluctuations, has been reported to increase cardiovascular risk among midlife women. The purposes of this study were to identify the clusters of midlife women by cardiovascular symptoms and to examine racial/ethnic differences in the clusters. This was a secondary analysis, in which hierarchical cluster and multinomial logistic analyses were conducted with the data (N = 966) collected in two previous studies. Three clusters were adopted: Cluster 1 (high vasomotor and low cardiorespiratory), Cluster 2 (low vasomotor and high cardiorespiratory and high discomfort/pain), and Cluster 3 (high discomfort/pain and high indigestion).
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Affiliation(s)
- Eun-Ok Im
- a School of Nursing , Duke University , Durham , North Carolina , USA
| | - Young Ko
- b School of Nursing , Gachon University , Incheon , South Korea
| | - Eunice Chee
- a School of Nursing , Duke University , Durham , North Carolina , USA
| | - Wonshik Chee
- a School of Nursing , Duke University , Durham , North Carolina , USA
| | - Jun James Mao
- c Memorial Sloan-Kettering Cancer Center , The Bendheim Center for Integrative Medicine , New York , New York , USA
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16
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The development of the metabolic syndrome and insulin resistance after adjuvant treatment for breast cancer. Cancer Nurs 2016; 37:355-62. [PMID: 24088604 DOI: 10.1097/ncc.0b013e3182a40e6d] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adjuvant breast cancer treatment is associated with a number of adverse physical changes, including weight gain, and therefore may represent a critical period for the development of metabolic disturbance. OBJECTIVE The aim of this study was to evaluate changes in the presentation of the metabolic syndrome (MetSyn) and insulin resistance from breast cancer surgery to postcompletion of adjuvant treatment. METHODS Sixty-one participants who had completed metabolic screening, including fasting blood samples and anthropometric measurements, on the morning of breast cancer surgery were recruited. Measures were repeated after completion of adjuvant treatment. Change in the proportion of participants presenting with the MetSyn was evaluated using the related-samples McNemar test, and changes in measures of glucose metabolism (fasting insulin, insulin resistance [homeostatic model assessment index], and glycosylated hemoglobin [HbA1c]) were analyzed using paired t tests. The Kruskal-Wallis test was used to compare differences in changes in metabolic parameters across clinical and lifestyle characteristics. RESULTS There was a significant (P < .001) increase in fasting insulin (mean [SE] change, 2.73 [0.57] mU/L), homeostatic model assessment index (0.58 [0.14]), and HbA1c level (4.49 [5.63] mmol/mol) from baseline to follow-up along with an increase in the proportion diagnosed with the MetSyn (P = .03). Those with the MetSyn at diagnosis experienced a greater increase in insulin resistance. Premenopausal women experienced greatest increases in HbA1c level. CONCLUSIONS Results demonstrate the development of significant metabolic dysfunction, characterized by glucose dysmetabolism and MetSyn, after adjuvant treatment for breast cancer. IMPLICATIONS FOR PRACTICE Interventions to improve the metabolic profile of breast cancer survivors are warranted.
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Hinton AO, He Y, Xia Y, Xu P, Yang Y, Saito K, Wang C, Yan X, Shu G, Henderson A, Clegg DJ, Khan SA, Reynolds C, Wu Q, Tong Q, Xu Y. Estrogen Receptor-α in the Medial Amygdala Prevents Stress-Induced Elevations in Blood Pressure in Females. Hypertension 2016; 67:1321-30. [PMID: 27091896 DOI: 10.1161/hypertensionaha.116.07175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/16/2016] [Indexed: 11/16/2022]
Abstract
Psychological stress contributes to the development of hypertension in humans. The ovarian hormone, estrogen, has been shown to prevent stress-induced pressor responses in females by unknown mechanisms. Here, we showed that the antihypertensive effects of estrogen during stress were blunted in female mice lacking estrogen receptor-α in the brain medial amygdala. Deletion of estrogen receptor-α in medial amygdala neurons also resulted in increased excitability of these neurons, associated with elevated ionotropic glutamate receptor expression. We further demonstrated that selective activation of medial amygdala neurons mimicked effects of stress to increase blood pressure in mice. Together, our results support a model where estrogen acts on estrogen receptor-α expressed by medial amygdala neurons to prevent stress-induced activation of these neurons, and therefore prevents pressor responses to stress.
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Affiliation(s)
- Antentor Othrell Hinton
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yanlin He
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yan Xia
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Pingwen Xu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yongjie Yang
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Kenji Saito
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Chunmei Wang
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Xiaofeng Yan
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Gang Shu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Alexander Henderson
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Deborah J Clegg
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Sohaib A Khan
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Corey Reynolds
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Qi Wu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Qingchun Tong
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yong Xu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.).
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Stefanska A, Bergmann K, Sypniewska G. Metabolic Syndrome and Menopause: Pathophysiology, Clinical and Diagnostic Significance. Adv Clin Chem 2015; 72:1-75. [PMID: 26471080 DOI: 10.1016/bs.acc.2015.07.001] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Menopause is a risk factor for cardiometabolic diseases, including metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases. MetS is a constellation of interdependent factors such as insulin resistance, abdominal obesity, dyslipidemia, and hypertension. The prevalence of MetS in postmenopause is due to loss of the protective role of estrogens and increased circulating androgens resulting in changes to body fat distribution and development of abdominal obesity. Excessive visceral adipose tissue plays an important role due to synthesis and secretion of bioactive substances such as adipocytokines, proinflammatory cytokines, reactive oxygen species, prothrombotic, and vasoconstrictor factors. MetS may also impact risk assessment of breast cancer, osteoporosis and chronic kidney disease, and quality of life during the menopausal transition. Increased MetS has stimulated the exploration of new laboratory tests for early detection and therapies.
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Affiliation(s)
- Anna Stefanska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Katarzyna Bergmann
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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Effects of lifestyle intervention improve cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. Menopause 2015; 21:1263-8. [PMID: 24781851 DOI: 10.1097/gme.0000000000000248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to test the efficacy of a 12-month lifestyle intervention in improving cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. METHODS One hundred healthy menopausal transition and early postmenopausal women aged 40 to 60 years were randomly assigned to receive either lifestyle change intervention (n = 53) or usual care (n = 47). Menopause status was defined by the menstrual change criteria of the Stages of Reproductive Aging Workshop + 10 based on prospective menstrual calendars. Women in the intervention group were provided with a colorful booklet that included dietary and physical activity recommendations, were individually interviewed, and completed biophysical cardiovascular risk assessments at the Women's Health Center (Beijing, China). Women were encouraged to follow a healthy eating pattern and to increase their aerobic activity (moderate level, 3 d/wk, 40 min/d). Women in the control group continued their usual eating patterns and activities. Weight, body mass index (BMI), waist circumference-to-hip circumference ratio (WHR), waist circumference (WC), body composition, blood pressure (BP), blood glucose, and serum lipids were assessed at baseline, 3 months, 6 months, and 12 months in both groups. RESULTS Women in the intervention group were observed to have significant decreases in weight, BMI, WC, WHR, systolic BP, total cholesterol, and low-density lipoprotein cholesterol compared with women in the control group. At 3 months, there were significant decreases in weight (-0.28 vs 0.68 kg, P = 0.002), BMI (-0.06 vs 0.44 kg/m2, P = 0.003), WC (-0.28 vs 1.43 cm, P = 0.001), and WHR (-0.01 vs 0.01, P = 0.045) in the intervention group compared with the control group. At 6 months, there were significant decreases in WC (-0.73 vs 1.02 cm, P = 0.012), WHR (-0.02 vs -0.003, P = 0.020), and systolic BP (-7.52 vs -0.63 mm Hg, P = 0.012) favoring the intervention group over the control group. At 12 months, there were significant decreases in total cholesterol (-0.07 vs 0.03 mmol/L, P = 0.045) and low-density lipoprotein cholesterol (-0.13 vs 0.01 mmol/L, P = 0.022) in the intervention group versus the control group. CONCLUSIONS Lifestyle intervention may be an effective means for reducing cardiovascular disease risk factors in menopausal transition and early postmenopausal women in China.
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de Villiers TJ, Pines A, Panay N, Gambacciani M, Archer DF, Baber RJ, Davis SR, Gompel AA, Henderson VW, Langer R, Lobo RA, Plu-Bureau G, Sturdee DW. Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric 2014; 16:316-37. [PMID: 23672656 DOI: 10.3109/13697137.2013.795683] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- T J de Villiers
- MediClinic Panorama and Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa
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Exogenous estrogen does not attenuate the association between rofecoxib and myocardial infarction in perimenopausal women. J Cardiovasc Pharmacol 2012; 57:194-200. [PMID: 21052013 DOI: 10.1097/fjc.0b013e31820350d3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Rofecoxib has been proposed to increase the risk of myocardial infarction (MI) through suppression of cyclooxygenase 2–mediated prostacyclin. Estrogen may have protective effects through augmenting cyclooxygenase 2 expression and subsequently increasing prostacyclin. Estrogen may attenuate the association between rofecoxib and MI. We used 1999–2002 Medicaid claims data to measure the MI hazard ratio (HR) attributed to rofecoxib exposure in estrogen-exposed and unexposed 45- to 65-year-old women.We identified 184,169 female rofecoxib users who contributed 309,504 person-years and experienced 1217 first MIs. Estrogen exposure seemed protective [MI-HR 0.72; 95% confidence interval (CI), 0.62–0.84] in this cohort. Rofecoxib was associated with an elevated MI-HR in both estrogen-exposed (2.01; 95% CI, 1.60–2.54) and estrogen-unexposed women (1.69; 95% CI, 1.43–1.99). The rofecoxib–estrogen interaction ratio was not significantly different from 1 (1.19; 95% CI, 0.91–1.57). Although estrogen use was associated with a lower risk of MI, it did not seem to attenuate the association between rofecoxib and MI.
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Should risk of bone fragility restrict weight control for other health reasons in postmenopausal women? – A ten year prospective study. Maturitas 2012; 71:162-8. [DOI: 10.1016/j.maturitas.2011.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/20/2011] [Accepted: 11/27/2011] [Indexed: 12/27/2022]
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Tandon VR, Mahajan A, Sharma S, Sharma A. Prevalence of cardiovascular risk factors in postmenopausal women: A rural study. J Midlife Health 2011; 1:26-9. [PMID: 21799635 PMCID: PMC3139259 DOI: 10.4103/0976-7800.66993] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim: The present observational, cross-sectional prospective study was conducted during the period of 1 year in one of the rural health centers to study prevalence of conventional cardiovascular disease risk factors (CVRFs) in postmenopausal women. Materials and Methods: Five hundred consecutive postmenopausal women were screened for detailed information regarding common menopausal symptoms, the presence or absence of conventional CVRFs. Physical activity was measured, and dietary lifestyle was also assessed. Use of hormone replacement therapy (HRT) and other drugs were also noted. Knowledge regarding their menopause was also evaluated. Results: Mean age at menopause was 49.35 years, Mean number of menopausal symptoms was 6.70 ± 5.76, and mean duration since menopause was (MDSM = 4.70 years)). Fatigue, lack of energy (70%), cold hand and feet, rheumatology-related symptoms (60%) cold sweats, weight gain, irritability, and nervousness (50%), palpitation of heart, excitable/anxiety (30%) each were common complaints. Hypertension was diagnosed or a person was a known hypertensive (56%). Diabetes was diagnosed or a person was known diabetic in 21%, and BMI was found to be 25 kg/m2 in 78%. Truncal obesity with waist-hip ratio >0.8 in 68% females, whereas abdominal obesity with waist size >88 cm was in 60% women. Dyslipidemia was seen in 39%. It was defined by the presence of high TC (=200 mg/dL) in 30%, high LDL-c (=130 mg/dL) in 27%, low HDLc (<40 mg/dL) in 21% or high TG (=150 mg/dL) in 31%. Metabolic syndrome was present in 13% of cases. CRP was found positive in 12 out of 39 total evaluated women, and serum uric acid was found >6.5 mg/dL in 4%. Smoking (0.5%), alcohol (0%,), tobacco chewing (4%), and family history of premature heart disease (9%) were recorded. Lifestyle was active in 35%, hectic in 10%, and sedentary in 55% of postmenopausal women (PMWs). Only 5% of women were receiving HRT, 0.5% isoflavone-containing phytoestrogens, 0.4% tibolone, 24% anti-HT, 9% anti-diabetic, 8% lipid-lowering drugs, and only three patients were on anti-obesity along with dietary and lifestyle management. Out of 68 patients, who were advised for electrocardiography (ECG), 23 were found positive for ischemic changes on ECG and out of 12 women advised for treadmill test (TMT), only four were found positive for ischemic heart disease (IHD). Risk factor count of more than four was found in 11%. Over all 96% of women were affected by menopause or related problems. Only 9% were aware about their menopause, 3% for importance of lifestyle modification, weight and dietary management programs to ameliorate menopause or menopause-compounded CVRFs. Conclusion: This study showed alarmingly high prevalence of most of the conventional CVRFs, especially diabetes, hypertension, dyslipidemia, obesity, and other risk factors in postmenopausal women from rural areas.
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Affiliation(s)
- Vishal R Tandon
- Postgraduate Department of Pharamcology and Therapeutic, Government Medical College, Jammu 180 001, Jammu and Kashmir, India
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Sturdee DW, Pines A, Archer DF, Baber RJ, Barlow D, Birkhäuser MH, Brincat M, Cardozo L, de Villiers TJ, Gambacciani M, Gompel AA, Henderson VW, Kluft C, Lobo RA, MacLennan AH, Marsden J, Nappi RE, Panay N, Pickar JH, Robinson D, Simon J, Sitruk-Ware RL, Stevenson JC. Updated IMS recommendations on postmenopausal hormone therapy and preventive strategies for midlife health. Climacteric 2011; 14:302-20. [PMID: 21563996 DOI: 10.3109/13697137.2011.570590] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- D W Sturdee
- International Menopause Society, Wray, Lancaster, UK
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Lambrinoudaki I, Armeni E, Georgiopoulos G, Kazani M, Kouskouni E, Creatsa M, Alexandrou A, Fotiou S, Papamichael C, Stamatelopoulos K. Subclinical atherosclerosis in menopausal women with low to medium calculated cardiovascular risk. Int J Cardiol 2011; 164:70-6. [PMID: 21737156 DOI: 10.1016/j.ijcard.2011.06.063] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/08/2011] [Accepted: 06/10/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The menopausal status is closely related with cardiovascular disease (CVD). Nevertheless, it is still not included in risk stratification by total cardiovascular risk estimation systems. The present study aimed to evaluate the extent of subclinical vascular disorders in young healthy postmenopausal women. METHODS This cross-sectional study consecutively recruited 120 healthy postmenopausal women without clinically overt CVD or diabetes, aged 41-60 years and classified as not high-risk by the Heartscore (<5%). In addition to risk factors used for Heartscore calculations, years since menopause and associated risk factors (triglycerides (range 37-278 mg/dl), waist circumference (62-114 cm), fasting blood glucose (69-114 mg/dl) and HOMA-IR (0.44-5)) were also assessed. Carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness in the abnormal range as well as atheromatous plaques both in carotid and femoral arteries were used to define the presence of subclinical atherosclerosis. RESULTS Subclinical atherosclerosis and the presence of at least one plaque were identified in 55% and 28% of women, respectively. Subjects with subclinical atherosclerosis had higher age, years since menopause, HOMA-IR and blood pressure. By multivariate analysis years since menopause and systolic blood pressure independently determined subclinical atherosclerosis while 79% of intermediate-risk women (Heartscore 2-4.9%) being in menopause for at least 4 years would be reclassified to a higher risk for the presence of atherosclerosis. CONCLUSION Subclinical atherosclerosis was highly prevalent in postmenopausal women with low to medium Heartscore. Thus our data suggest that menopausal status and associated risk factors should be additionally weighted in risk calculations, regarding primary prevention strategies in this population.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, 76 Vas. Sofias Ave., University of Athens, Aretaieio Hospital, Athens, Greece
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Konrad T, Bär F, Schneider F, Franke S, Böhles H, Vetter G, Balkau B. Factors influencing endothelial function in healthy pre- and post-menopausal women of the EU-RISC study. Diab Vasc Dis Res 2011; 8:229-36. [PMID: 21746771 DOI: 10.1177/1479164111416139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We studied the impact of lifestyle, body composition, different insulin sensitivity indices and the first insulin response in healthy pre- and post-menopausal women with a low cardiovascular risk profile (the EU-RISC study, 'Relationship between Insulin Sensitivity and Cardiovascular Disease' (n = 51, 47 ± 4 years, body mass index 23.6 ± 3.7 kg/m(2), waist girth 79.2 ± 10.3 cm) on endothelial function (flow mediated arterial dilatation (FMD)), an early marker for atherosclerosis. RESULTS Waist circumference (p = 0.06), tobacco consumption (p = 0.02) and leucocyte count (p = 0.09) were inversely related with FMD in both pre- and post-menopausal women. Neither insulin sensitivity nor first insulin response indices were correlated with FMD. In pre-menopausal women (n = 24), waist (p < 0.02), waist-to-hip ratio (p < 0.02), HDL cholesterol (p < 0.01) and smoking habits (p < 0.03) were significantly correlated with endothelial function. In postmenopausal women (n = 27) age (r = -0.17, p = 0.04) was related with FMD. CONCLUSION Smoking and waist circumference, a simple marker of visceral adiposity, were related with endothelial function in healthy pre- and post-menopausal women.
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Affiliation(s)
- Thomas Konrad
- Institute for Metabolic Research, University Frankfurt am Main, Germany.
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Tolstov SN, Mychka VB. Metabolic (cytoprotective) therapy of menopausal disturbances. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2011. [DOI: 10.15829/1728-8800-2011-3-72-75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The paper presents modern views on cardiovascular aspects of menopause and metabolic therapy of menopausal disturbances with meldonium (Mildronate®). The role of estrogen deficiency in climacteric disturbance development, key pathogenetic mechanisms of menopausal metabolic syndrome (MS), and relevant features of arterial hypertension and endothelial dysfunction development are discussed. The data on Mildronate® clinical use for cardiovascular prevention are summarized. The wide prevalence and multiple clinical manifestations of menopausal disturbances point to the need for their complex therapy. Mildronate® therapy is a new approach for systemic correction of metabolic disturbances in women with climacteric symptoms and menopausal MS.
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Affiliation(s)
| | - V. B. Mychka
- A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
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Soutelo J, Saban M, Quevedo V, Gandur E, Paris A, Alba P, Gonzalez J, Barbero M, Frizt C, Faraj G. Metabolic syndrome in Argentine women: ATPIII, IDF, IDF/AHA/NHLBI; what criterion should be used? Gynecol Endocrinol 2011; 27:448-51. [PMID: 20670098 DOI: 10.3109/09513590.2010.501883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The menopause and the metabolic syndrome (MS) are related with the increase of the risk of cardiovascular diseases. OBJECTIVES To evaluate the existence of metabolic risk factors and the prevalence of MS in pre- and post-menopausal women. SUBJECTS 253 women: 120 pre-menopausal and 133 post-menopausal. Anthropometric, arterial pressure and waist circumference measurements were carried out. Glycaemia, lipids, creatinine, hepatogram, uric acid and thyroid-stimulating hormone were dosed. RESULTS Statistical higher registries of arterial pressure, levels of glycaemia, total cholesterol, low-density lipoprotein, triglycerides and TG/high-density lipoprotein relation were observed among post-menopausal patients. As regards this group, the MS diagnosis was considerably higher, being the same by all the criteria. CONCLUSIONS We found more prevalence of cardiometabolic and MS risk factors among the group of post-menopausal patients. The responsible mechanisms would respond to the secondary hypoestrogenaemia at the cease of the ovarian function. Because of this fact, menopausal women should be considered a risk group for the development of MS.
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Affiliation(s)
- Jimena Soutelo
- Endocrinology Service Medical Complex (PFA), (Argentine Federal Police) Churruca - Visca Hospital, Buenos Aires, Argentina.
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Choquette S, Riesco É, Cormier É, Dion T, Aubertin-Leheudre M, Dionne IJ. Effects of soya isoflavones and exercise on body composition and clinical risk factors of cardiovascular diseases in overweight postmenopausal women: a 6-month double-blind controlled trial. Br J Nutr 2011; 105:1199-209. [PMID: 21205384 DOI: 10.1017/s0007114510004897] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Results from a pilot project indicate that isoflavones and exercise could have an additive effect on body composition and clinical risk factors of CVD in postmenopausal women. The objective of the present study was to assess the combined effect of exercise and isoflavones in overweight-to-obese postmenopausal women. In this double-blind randomised controlled trial, 100 overweight-to-obese (BMI 29·9 (sd 3·2) kg/m2) postmenopausal women were assigned to four groups: (1) placebo (PLA); (2) isoflavones (ISO); (3) exercise and placebo (Ex+PLA); (4) exercise and isoflavones (Ex+ISO). The supplementation contained 70 mg/d of isoflavones. Exercise consisted of three weekly sessions of resistance training and aerobics. Outcome measures included fat mass (FM), lean body mass (LBM), bone mineral density, lipid profile, fasting glucose, fasting insulin and insulin resistance (homeostasis assessment model). The main effects of exercise were observed for total FM (P = 0·02), FM% (P < 0·01), trunk FM% (P = 0·05), arm FM% (P < 0·01), leg FM% (P = 0·02), arm LBM (P < 0·01), leg LBM (P = 0·02) and C-reactive protein (P < 0·01). A main effect was detected for isoflavones in improving leg FM% (P = 0·05). No interactions were observed between isoflavones and exercise. In conclusion, it was observed that 6 months of exercise brought favourable changes in total FM, FM% and LBM in overweight postmenopausal women. No synergistic effects were observed between exercise and isoflavones. However, isoflavones could have a beneficial effect on leg FM%.
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Affiliation(s)
- Stéphane Choquette
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1
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Gambacciani M, Rosano G, Cappagli B, Pepe A, Vitale C, Genazzani AR. Clinical and metabolic effects of drospirenone–estradiol in menopausal women: a prospective study. Climacteric 2011; 14:18-24. [DOI: 10.3109/13697137.2010.520099] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Duzenli MA, Ozdemir K, Sokmen A, Gezginc K, Soylu A, Celik C, Altunkeser BB, Tokac M. The effects of hormone replacement therapy on myocardial performance in early postmenopausal women. Climacteric 2010; 13:157-70. [PMID: 19672733 DOI: 10.3109/13697130902929567] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The results of the studies in which the effect of hormone replacement therapy (HRT) on cardiac function have been evaluated are rather disputable. In these studies, cardiac function was evaluated with conventional echocardiographic methods. This study was planned in order to investigate the effects of HRT on myocardial velocities and myocardial performance index (MPI) in healthy early postmenopausal women. METHOD In a prospective, controlled study, 60 healthy postmenopausal women were assigned to two groups (32 in the HRT group and 28 in the control group). After conventional echocardiographic parameters were measured, tissue Doppler echocardiography recordings were obtained from the mitral and tricuspid annulus. Systolic myocardial velocity (Sm), early and late diastolic myocardial velocities (Em and Am) and time intervals were measured and MPI was calculated. Then the symptom-limited exercise stress test using the Bruce protocol was performed. After 3 and 6 months of HRT (oral 0.625 mg conjugated estrogen + 2.5 mg medroxyprogesterone acetate/day), the same examinations were repeated. The effects of HRT on myocardial velocities, MPI and exercise time were evaluated at the 3rd and 6th months. RESULTS The parameters of the control group remained statistically unchanged during the study. HRT did not have any effect on segmental and mean left ventricular (LV) Sm or right ventricular (RV) Sm. However, LV Em/Am and RV Em/Am ratios significantly increased at the 6th month of HRT, and LV and RV MPI values were observed to decrease significantly as compared to basal values. Additionally, a significant increase was observed in exercise duration and metabolic equivalent values after 3 months of HRT, and this increase continued at the 6th month as well. The favorable changes in all parameters in the HRT group were significantly different from those of the control group. CONCLUSION Data obtained in this study suggest that HRT is not only effective for treating menopausal complaints but also increases cardiovascular performance by improving especially diastolic functions in early postmenopausal women.
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Affiliation(s)
- M A Duzenli
- Department of Cardiology, Selcuk University, Konya, Turkey
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Cicero AFG, Derosa G, D'angelo A, Bove M, Gaddi AV, Borghi C. Gender-specific haemodynamic and metabolic effects of a sequential training programme on overweight-obese hypertensives. Blood Press 2009; 18:111-6. [DOI: 10.1080/08037050902903355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stramba-Badiale M. Postmenopausal hormone therapy and the risk of cardiovascular disease. J Cardiovasc Med (Hagerstown) 2009; 10:303-9. [PMID: 19430340 DOI: 10.2459/jcm.0b013e328324991c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Sex hormones exert significant effects on the cardiovascular system. Ovarian hormone deficiency associated with menopause plays an important role in the development of cardiovascular disease in women. The reduced risk of cardiovascular diseases associated with hormone replacement therapy (HRT), reported in observational studies, has not been subsequently confirmed in randomized clinical trials. Therefore, at the present time, HRT is not recommended for postmenopausal women for the prevention of cardiovascular diseases. However, the possible role and safety of HRT in women who experience menopausal symptoms that significantly affect their quality of life is still under debate. The increased risk of cardiovascular disease in the larger randomized trial was found in the oldest women and in those who started HRT late after menopause began. Further basic and clinical studies are necessary to evaluate the mechanisms underlying the possible detrimental or protective effects of HRT and to assess benefits and risks of different dosages, route of administration, and duration of HRT. In the absence of clear evidence on the safest hormone regimen, the prescription of HRT in order to reduce menopausal symptoms should be limited to younger postmenopausal women at low risk for cardiovascular diseases, starting in the period close to the beginning of menopause. The benefit of HRT in relieving menopausal symptoms and reducing the occurrence of hip fractures should be weighted against the increased risk of cardiovascular disease and breast cancer. For this purpose, it is crucial to identify the presence of cardiovascular risk factors in perimenopausal and postmenopausal women. The cardiovascular effects of sex hormones, the increased risk of cardiovascular disease after menopause, and the effects of HRT on cardiovascular risk are critically reviewed, as well as their impact on the recommendations for clinical practice.
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Affiliation(s)
- Marco Stramba-Badiale
- Department of Rehabilitation Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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ANAYA STEPHANIEA, CHURCH TIMOTHYS, BLAIR STEVENN, MYERS JONATHANN, EARNEST CONRADP. Exercise Dose-Response of the V˙E/V˙CO2 Slope in Postmenopausal Women in the DREW Study. Med Sci Sports Exerc 2009; 41:971-6. [DOI: 10.1249/mss.0b013e3181930009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Hyperinsulinaemia, a key factor of the metabolic syndrome in postmenopausal women. Maturitas 2009; 62:362-5. [DOI: 10.1016/j.maturitas.2008.11.026] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Revised: 11/24/2008] [Accepted: 11/25/2008] [Indexed: 12/12/2022]
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Meurman JH, Tarkkila L, Tiitinen A. The menopause and oral health. Maturitas 2009; 63:56-62. [PMID: 19324502 DOI: 10.1016/j.maturitas.2009.02.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 02/15/2009] [Accepted: 02/19/2009] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To review the literature about oral symptoms and signs at the menopause with an emphasis on hormone replacement therapy (HRT). To give practical guidelines for women and their physicians in menopause-related oral health problems. METHODS The PubMed and Cochrane databases was searched until mid January 2009 with key words such as "menopause", "menopausal complaints", "postmenopausal complaints" and "oral diseases", "oral discomfort", "dental health", "dental diseases", "saliva", "burning mouth syndrome", "dry mouth", "xerostomia". Because of a scarcity of controlled studies no systematic review could be conducted. RESULTS Oral discomfort is found in many menopausal women in addition to more general climacteric complaints. The principal peri- and postmenopausal symptoms are dry mouth and burning mouth (glossodynia) which, in turn, may increase the occurrence of oral mucosal and dental diseases, such as candidiasis. The mechanisms of hormone-related oral symptoms and signs are not known although oestrogen receptors, for example, have been detected in the oral mucosa and salivary glands. In principle, the histology of oral and vaginal mucosa is very similar and thus their symptoms might share a common cause. Yet, hormone replacement therapy use does not necessarily prevent or help women with oral symptoms. CONCLUSION Properly controlled long-term randomized studies are needed to assess the effect of HRT on oral discomfort. Future gene profiling could identify women who may or may not benefit from HRT with regard to oral symptoms.
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Abstract
Menopause and the menopausal transition present unique preventive health and quality-of-life challenges for women. The number of patients in the menopausal age group is increasing and represents a significant portion of the population. Care of the menopausal patient can be challenging for the caregiver. This chapter reviews the major health care challenges as well as evaluation and treatment of common quality-of-life issues for menopausal patients.
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Affiliation(s)
- Kirsten J Lund
- University of Colorado, Department of OB-GYN, Denver, CO, USA.
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Cheifitz R. Lipids, statins and cardiovascular disease. Climacteric 2008; 11:347-8; author reply 348-50. [PMID: 18645702 DOI: 10.1080/13697130802242632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Rosano GM, Vitale C, Fini M. Lipids, statins and cardiovascular disease. Climacteric 2008. [DOI: 10.1080/13697130802242640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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