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Li J, Liu F, Liu Z, Li M, Wang Y, Shang Y, Li Y. Prevalence and associated factors of depression in postmenopausal women: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:431. [PMID: 38858633 DOI: 10.1186/s12888-024-05875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Depression is a prevalent mental health problem in postmenopausal women. Given its significant impact on the quality of life and overall well-being of postmenopausal women, there is need for a comprehensive review and meta-analysis of the existing research globally. This systematic review and meta-analysis evaluated the global prevalence of depression and potential associated factors in postmenopausal women. METHODS The Cochrane Library, PubMed, EMBASE, Web of Science, MEDLINE, and PsycINFO databases were systematically searched from inception to March 22, 2023. The meta-analysis used the random-effects model to calculate the prevalence of depression rates and associated factors. In addition, subgroup analysis and sensitivity analysis were performed. Publication bias was assessed using funnel plots, Egger's test, and nonparametric trim-and-fill tests. RESULTS The meta-analysis included 50 studies that involved 385,092 postmenopausal women. The prevalence of depression in postmenopausal women was 28.00% (95% CI, 25.80-30.10). Among the factors relevant to depression among postmenopausal women, marital status (OR: 2.03, 95%CI: 1.33-3.11), history of mental illness (OR: 2.31, 95%CI: 1.50-3.57), chronic disease (OR: 3.13, 95%CI: 2.20-4.44), menstrual cycle (OR: 1.42, 95%CI: 1.17-1.72), abortion numbers (OR: 1.59, 95%CI: 1.40-1.80), menopausal symptoms (OR: 2.10, 95%CI: 1.52-2.90), and hormone replacement therapy (OR: 1.76, 95%CI: 1.31-2.35) were risk factors, while physical activity (OR: 0.56, 95%CI: 0.53-0.59), number of breastfed infants (OR: 0.43, 95%CI: 0.19-0.97), menopause age (OR: 0.44, 95%CI: 0.37-0.51) were preventive factors. CONCLUSIONS This study demonstrated that the prevalence of postmenopausal depression is high, and some risk factors and protective factors associated with it have been identified. It is necessary to improve screening and management and optimize prevention and intervention strategies to reduce the harmful effects of postmenopausal depression.
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Affiliation(s)
- Jiaxin Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Fangli Liu
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China.
- Institution of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China.
- Xinyang Vocational and Technical College, Xinyang, Henan, P. R. China.
| | - Ziwei Liu
- The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Mengjie Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yingying Wang
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yameng Shang
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yuege Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
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Андреева ЕН, Артымук НВ, Веснина АФ, Зазерская ИЕ, Карахалис ЛЮ, Каткова НЮ, Пигарова ЕА, Сахаутдинова ИВ, Спиридонова НВ, Тапильская НИ, Хамошина МБ, Шереметьева ЕВ, Юренева СВ, Ярмолинская МИ. [Resolution of the national interdisciplinary council of experts "High-dose vitamin D (Devilam) in the practice of an obstetrician-gynecologist"]. PROBLEMY ENDOKRINOLOGII 2024; 70:103-116. [PMID: 38796767 PMCID: PMC11145572 DOI: 10.14341/probl13465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024]
Abstract
On March 28, 2024, the Council of Experts "High-dose vitamin D (Devilam) in the practice of obstetrician-gynecologist, gynecologist and endocrinologist" was held in Moscow with the participation of leading experts gynecologists, endocrinologists and obstetricians-gynecologists, during which new possibilities for the use of high-dose vitamin D in patients of various ages who need correction of existing vitamin D deficiency or insufficiency.
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Affiliation(s)
- Е. Н. Андреева
- Национальный медицинский исследовательский центр эндокринологии; Российский университет медицины
| | | | - А. Ф. Веснина
- Национальный медицинский исследовательский центр эндокринологии
| | - И. Е. Зазерская
- Национальный медицинский исследовательский центр им. В. А. Алмазова
| | | | - Н. Ю. Каткова
- Приволжский исследовательский медицинский университет
| | - Е. А. Пигарова
- Национальный медицинский исследовательский центр эндокринологии
| | | | | | - Н. И. Тапильская
- Научно-исследовательский институт акушерства, гинекологии и репродуктологии имени Д.О. Отта
| | | | | | - С. В. Юренева
- Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени В.И. Кулакова
| | - М. И. Ярмолинская
- Научно-исследовательский институт акушерства, гинекологии и репродуктологии имени Д.О. Отта
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Ibrahim AI, Sodipo OO, Oduniyi OA. Risk factors for osteoporosis among postmenopausal women in a Nigerian teaching hospital. J Family Med Prim Care 2023; 12:1145-1149. [PMID: 37636158 PMCID: PMC10451596 DOI: 10.4103/jfmpc.jfmpc_2193_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/10/2022] [Accepted: 01/31/2023] [Indexed: 08/29/2023] Open
Abstract
Background Osteoporosis is a progressive bone disease characterized by a reduction in bone mass and density, leading to bone fragility and an increased risk of sustaining fractures. Several studies have shown that the risk for osteoporosis increases with age and after menopause. Methods A cross-sectional study was undertaken of 422 postmenopausal women at the Family Medicine Clinic of the Lagos State University Teaching Hospital (LASUTH). Variables such as socio-demographic characteristics, anthropometric indices, and lifestyle habits of participants were assessed. In addition, bone mineral density was measured using a validated portable dual-energy X-ray absorptiometry scanner. The results of the bone mineral density were analyzed based on T-scores. Results The mean age of the study subjects was 59.8± ±6.4 years, while the mean age at menopause was 50.15 ± 4.1 years. The majority of the subjects were obese (41.5%), while the prevalence of osteoporosis and osteopenia was 15.1% and 30.6%, respectively. The use of oral steroids was associated with osteoporosis (P < 0.05). Conclusion We recommend regular bone mineral density screening of postmenopausal women at the primary care level for early diagnosis and treatment of osteoporosis to prevent fragility fractures.
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Affiliation(s)
- Adekunle Ismail Ibrahim
- Department of Family Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | | | - Oludaisi A. Oduniyi
- Department of Family Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective. Nutrients 2022; 14:nu14051107. [PMID: 35268082 PMCID: PMC8912662 DOI: 10.3390/nu14051107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/03/2023] Open
Abstract
Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.
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Zhang WY, Guo YJ, Wang KY, Chen LM, Jiang P. Neuroprotective effects of vitamin D and 17ß-estradiol against ovariectomy-induced neuroinflammation and depressive-like state: Role of the AMPK/NF-κB pathway. Int Immunopharmacol 2020; 86:106734. [PMID: 32604067 DOI: 10.1016/j.intimp.2020.106734] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/08/2020] [Accepted: 06/21/2020] [Indexed: 12/24/2022]
Abstract
Estrogen replacement therapy (ERT) has been proven to relieve menopausal-related mental disorders including depression in postmenopausal women. However, the unsafety of ERT hinders its clinical use. In this study, we would evaluate whether vitamin D (VD), a hormone with optimal safety profile, could relieve the depressive-like symptom in ovariectomized (OVX) rats. Furthermore, we would determine whether vitamin D and 17β-estradiol (E2) exert neurological function through their immunomodulatory effect in OVX rats. Middle-aged female SD rats were randomly divided into four groups, namely, control (SHAM), OVX, OVX + VD, and OVX + E2. Vitamin D (calcitriol, 100 ng/kg) and 17β-estradiol (30 μg/kg) had been daily gavaged in the OVX + VD and OVX + E2 group, respectively. After 10-week administration, vitamin D and 17β-estradiol both showed anti-depressive-like activity in the OVX rats. Using the method of immunofluorescent staining and western blot, vitamin D and 17β-estradiol were demonstrated to upregulate each other's receptors, including VDR, ERα, and ERβ in the hippocampus of OVX rats. Additionally, the upregulation of VDR, calbindin-D28k, and calbindin-D9k suggested that the vitamin D signaling system was amplified by vitamin D and 17β-estradiol. Vitamin D and 17β-estradiol showed neuroprotective effects by decreasing OVX-induced apoptosis and neuronal damage, regulating the AMPK/NF-κB signaling pathway, and reducing the proinflammatory cytokines (IL-1β, IL-6, and TNFα), as well as iNOS and COX-2 in the hippocampus of OVX rats. Collectively, the present study demonstrated that vitamin D and 17β-estradiol could upregulate each other's receptors and regulate the AMPK/NF-κB pathway to relieve the OVX-induced depressive-like state. The results could stimulate translational research towards the vitamin D potential for prevention or treatment of menopause-related depression.
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Affiliation(s)
- Wen-Yuan Zhang
- Department of Pharmacy, Zhongshan Affiliated Hospital of Zhongshan University, Zhongshan, China
| | - Yu-Jin Guo
- Institute of Clinical Pharmacy and Pharmacology, Jining First People's Hospital, Jining Medical University, Jining, China
| | - Ke-Yi Wang
- Department of MRI, Zhongshan Affiliated Hospital of Zhongshan University, Zhongshan, China
| | - Lin-Mu Chen
- Department of Pharmacy, Zhongshan Affiliated Hospital of Zhongshan University, Zhongshan, China
| | - Pei Jiang
- Institute of Clinical Pharmacy and Pharmacology, Jining First People's Hospital, Jining Medical University, Jining, China.
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Öztürk N, Ozturk-Isik E, Ülgen Y. Screening Post-menopausal Women for Bone Mineral Level by Bioelectrical Impedance Spectroscopy of Dominant Arm. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2018; 9:39-47. [PMID: 33584919 PMCID: PMC7852016 DOI: 10.2478/joeb-2018-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Indexed: 06/01/2023]
Abstract
Dominant arm bioimpedance spectroscopy (BIS) and lumbar and hip dual energy X-ray absorptiometry (DXA) measurements were conducted simultaneously on 48 post-menopausal women, aged between 43 and 86 years, with no hip or arm fracture history at Department of Radiology of Istanbul University Cerrahpasa Hospital. According to lumbar DXA results, 21 women were classified as normal, 22 as osteopenia and 5 as osteoporosis; whereas hip DXA results classified 30 women as normal, 15 as osteopenia and 3 as osteoporosis. Only 26 participants had identical lumbar and hip bone mineral density (BMD) diagnostic results. Dominant arm characteristic frequencies of normal subjects were statistically significantly different from osteoporotic subjects based on both lumbar (p < 0.005) and hip classification groups (p < 0.001). Hip and lumbar spine DXA BMD values were significantly correlated (r = 0.55, p < 0.005). The dominant arm BIS characteristic frequency, considered as the single predictor in earlier diagnosis of osteoporosis, was found negatively correlated with DXA measurements for both hip and lumbar spine regions. The Spearman rank correlation coefficient of BIS values with the hip DXA values (r = -0.53, p < 0.001) was higher than that of lumbar spine (r = -0.37, p < 0.001). In receiver operating characteristic (ROC) curve analysis, the best discrimination of dominant arm characteristic frequency was made between normal and osteoporotic subjects based on the hip subgroups (p < 0.001). Both lumbar bone mineral content (BMC) (r = -0.47, p < 0.001) and hip BMC (r = -0.4340, p < 0.005) were statistically significantly correlated with dominant arm characteristic frequency.
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Affiliation(s)
- Nermin Öztürk
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Yekta Ülgen
- Department of Biomedical Engineering, Bahcesehir University, Istanbul, Turkey
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Bener A, Saleh NM, Bakir A, Bhugra D. Depression, Anxiety, and Stress Symptoms in Menopausal Arab Women: Shedding More Light on a Complex Relationship. Ann Med Health Sci Res 2016; 6:224-231. [PMID: 28480097 PMCID: PMC5405634 DOI: 10.4103/amhsr.amhsr_341_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed. Aim: The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding more light on a complex relationship. Subjects and Methods: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the primary health care centers in Qatar. A representative sample of 1468 women aged 45–65 years were approached during July 2012 and May 2014 and 1101 women agreed to participate (75.0%) and responded to the study. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales 21. Data on body mass index (BMI), clinical and other parameters were used. Univariate, multivariate, and matrix correlation analysis were performed for statistical analysis. Results: A total of 1101 women agreed to participate after informed consent was obtained. The mean age and standard deviation (SD) of the menopausal age were 49.55 (3.12), the mean and SD of postmenopausal age was 58.08 (3.26) (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Furthermore, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure (BP), Vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. Furthermore, there were no differences between the groups regarding the frequency of certain levels of stress among menopause and postmenopause. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were a predictor for depression. Meanwhile, diastolic BP, occupation, and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation, and sheesha smoking habits were considered as the main risk factors associated with stress. Conclusion: A large number of factors were associated with experiencing menopausal and psycho-social problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety, and stress should be considered as important risk factors for osteoporosis.
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Affiliation(s)
- A Bener
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK
| | - N M Saleh
- Department of Obstetrics and Gynecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar
| | - A Bakir
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Haliç University, Istanbul, Turkey
| | - D Bhugra
- Department of Psychiatry, Section of Cultural Psychiatry, Institute of Psychiatry, King's College London, Maudsley Hospital, London, UK
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Kamineni V, Latha AP, Ramathulasi K. Association between serum 25-hydroxyvitamin D levels and bone mineral density in normal postmenopausal women. J Midlife Health 2016; 7:163-168. [PMID: 28096639 PMCID: PMC5192985 DOI: 10.4103/0976-7800.195694] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: This study was conducted with the objective of assessing serum 25-hydroxyvitamin D (25(OH)D) in postmenopausal women (PMW), to detect osteopenia or osteoporosis in PMW and to establish a correlation between serum 25(OH)D levels and bone mineral density (BMD). Materials and Methods: A total of 100 healthy PMW were selected, and a prospective observational study was conducted to correlate the BMD with serum 25(OH)D levels. Their laboratory investigations along with serum 25(OH)D levels were done. Their BMD was assessed with dual-energy X-ray absorptiometry at lumbar spine and neck of femur; T-scores were derived. Correlation analysis was done to investigate the relationship between serum 25(OH)D levels and BMD. Results: The proportion of osteoporosis at the hip was 31.9% in deficient group, 16.1% in insufficient, and 18.2% in sufficient group and at lumbar spine, it was 27.7%, 16.1%, and 22.7%, respectively. Forty-seven percent of PMW had deficient (<20 ng/ml) serum 25(OH)D levels and 31% had insufficiency. T-score at hip in deficient group was −2.05 ± 0.25, and in an insufficient group, it was −1.79 ± 0.13; T-score at lumbar spine was −1.92 ± 0.12 and −1.79 ± 0.12, respectively, but both were not statistically significant. Osteoporosis was seen in 24%, osteopenia in 55% at hip level and 23% and 59% respectively at lumbar spine. There was no association between serum 25(OH)D levels and BMD neither at hip nor at lumbar spine (P = 0.51 and P = 0.79 respectively). Conclusion: In this study, among our cohort of patients there was no correlation between serum 25(OH)D levels and BMD. However, Vitamin D deficiency coexists with low BMD. Vitamin D insufficiency is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.
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Affiliation(s)
- Vasundhara Kamineni
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | - Akkenapally Prasanna Latha
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | - K Ramathulasi
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
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