Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study

OBJECTIVE

To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause.

SUBJECTS

Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms.

METHODS

Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year.

RESULTS

Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73).

CONCLUSIONS

This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy

OBJECTIVE

To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy.

METHODS

Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper.

RESULTS

The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms.

CONCLUSIONS

This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.

[The role of hysteroscopy in the early diagnosis of small, focal endometrial neoplasms]

Hysteroscopy is a useful methodology for the diagnosis of uterine intracavitary disorders in women suffering from abnormal uterine bleeding. The authors report a case of small endometrial adenocarcinoma and then they discuss on validity of hysteroscopy in comparison with blind curettage of uterine cavity for the precocious diagnosis of such lesion.

[Role of microcolpohysteroscopy at an ambulatory center of level II preventive gynecologic oncology in the study of pre-neoplastic lesions of the uterine cervix]

The microcolpohysteroscopy has proved to be a very reliable methodology for the study of preneoplastic diseases of the uterine cervix especially when located in the endocervix. The authors report 100 cases with pathological Pap tests who underwent the microcolpohysteroscopy.

[Usefulness of a second-level centralized ambulatory service for the staging of diseases of the endometrium and the lower genital tract in a provincial hospital]

In 1991, at the Department of Obstetrics and Gynecology of Ivrea Hospital Hysteroscopy-Microcolposcopy-Vulvoscopy center was set up in order to improve the management of the intracavitary and lower genital tract pathologies. In such center skilled specialists having attended microcolpohysteroscopy and vulvoscopy training courses in specialised institutes are employed. They continuously keep in contact with such institutes for the updating of diagnostic and therapeutic protocols. The authors present their opinions about the usefulness of this center and the results achieved.

[Usefulness of hysteroscopy in the management of abnormal uterine bleeding and intrauterine benign disease]

The hysteroscopy is a useful methodology for the diagnosis of uterine intracavitary disorders in women suffering from abnormal uterine bleeding and infertility. The authors report 84 cases who underwent a diagnostic hysteroscopy at the Department of Obstetrics and Gynecology of Ivrea Hospital and then they will discuss the results. In particular, from their study it comes out that the methodology correlated with the histologic results has a sensibility of 100% and a specificity of 85%.