Soluble Intercellular Adhesion Molecule-1 (sICAM-1) as a Biomarker of Vascular Cognitive Impairment in Older Adults.

BACKGROUND: Endothelial dysfunction and subsequent inflammation contribute to the development of vascular cognitive impairment (VCI). Soluble intercellular adhesion molecule-1 (sICAM-1) is upregulated in endothelial dysfunction and promotes an inflammatory response; however, the relationship between sICAM-1 and VCI remains equivocal. OBJECTIVE: To determine whether sICAM-1 contributes to the prediction of VCI. METHODS: Community-dwelling older adults (n = 172) from the "Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults" (COSFOMA) study were identified as VCI or controls using standard neuropsychological evaluations and neuroimaging. sICAM-1 was quantified using ELISA, and multivariate logistic regression determined the association between sICAM-1 and VCI. RESULTS: A total of 31 VCI cases were identified. sICAM-1 was higher in VCI (VCI: 450.7 [241.6] ng/mL vs. controls: 296.9 [140.9] ng/mL). sICAM-1 concentrations above the 90th percentile (464.1 ng/mL) were associated with VCI group membership in all models (OR: 6.9, 95% CI: 1.1-42.2). The final saturated model explained 64% of the variance in VCI group membership. CONCLUSION: High concentrations of sICAM-1 are independently associated with VCI group membership. Efforts to further characterize the relationship between indices of endothelial dysfunction and pathological changes to the aging brain should be further pursued.

Menopausal women have hypofibrinolysis even in subclinical stage of atherosclerosis.

BACKGROUND: PAI-1 is the main inhibitor of fibrinolysis. Increase in PAI-1 levels has been associated with the risk of coronary disease; however, there are few studies on the relationship between subclinical atherosclerosis and PAI-1 levels. OBJECTIVE: The aim of this study was to analyze the relationship between PAI-1 level and carotid intima-media thickness in premenopausal and postmenopausal women without apparent cardiovascular disease. MATERIAL AND METHODS: A cross-sectional study was conducted in 142 women aged 45 to 60 years with no history of cardiovascular disease. Anthropometric and laboratory measurements were performed, including PAI-1 levels. All participants underwent a B-Mode ultrasound to measure intima-media thickness. Subclinical atherosclerosis was considered when intima-media thickness was ≥ 0.7 mm and/or an atheromatous plaque was observed. RESULTS: Postmenopausal women had greater intima-media thickness than premenopausal women (0.688 ± 0.129 vs. 0.621 ± 0.113 mm; p < 0.05). Compared to women with normal intima-media thickness, women with subclinical atherosclerosis had higher PAI-1 levels (23.2 ± 13.7 vs. 30.4 ± 20.7 ng/ml; p < 0.05). In all participants, intima-media thickness correlated with PAI-1 (r = 0.302; p = 0.01) and with age (r = 0.358; p = 0001). CONCLUSIONS: An increase in intima-media thickness was observed in postmenopausal women compared with premenopausal women. Asymptomatic women with increased intima-media thickness had higher PAI-1 levels. These findings suggest that fibrinolytic activity is low in the subclinical stage of atherosclerosis.

Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study.

Anemia represents a global health problem that negatively impacts quality of life in elderly population; however, its impact on the geriatric syndrome of frailty is unclear. We examined the prevalence of anemia among elderly and sought a relationship between hemoglobin and the phenotype of frailty. Baseline hemoglobin quintiles and anemia were assessed in relation to frailty status in a prospective study with 1,933 older community-dwelling adults enrolled in the Study on Aging and Dementia in Mexico (SADEM). Logistic regression was used to model the relationship between frailty and Hb, adjusting for risk factors of frailty, sociodemographic data, cognitive decline, chronic diseases, and some risky habits. Prevalence of frailty was 8.3 %. Frailty risk was highest at the lowest hemoglobin quintile (<14.3 g/dL for men; <13.3 g/dL for women), and 160 (8.3 %) were anemic (<13 g/dL for men; <12 g/dL for women). The relationship between frailty and Hb levels, adjusted for age and sex, observed in the first and fifth quintiles, compared with the fourth quintile, were 1.53 (95 % confidence interval (CI), 1.46-1.60) and 1.05 (95 % CI, 1.01-1.15). After multivariate adjustment, the odds ratios (ORs) were 1.23 (95 % CI, 1.17-1.13) and 1.06 (95 % CI, 1.01-1.11). The association was not diminished by risk factors for frailty (body mass index (BMI), comorbidity, cognitive decline, smoking, alcohol consumption, etc.). In community-dwelling older adults, low hemoglobin concentrations and anemia were independently associated with increased frailty risk. This suggests that mild anemia and low Hb levels are independent, modifiable risk factors for frailty.

Pattern of Adiponectin, Osteocalcin, Irisin, FGF-21, and MCP-1 According to the Body Size Phenotype: Could They Be Markers of Metabolic Health in Mexican-Mestizo Middle-Aged Women?

Variations in levels of some adipokines, myokines, osteokines, hepatokines and inflammatory cytokines contribute to abnormal glucose and lipid metabolism. The aim of this study was to determine the pattern of adiponectin, osteocalcin (OCN), irisin, FGF-21, and MCP-1 according to the body size phenotype of middle-aged women, and their associations with BMI, visceral adipose tissue (VAT), and HOMA-IR. A cross-sectional study in 265 women aged from 40 to 65 years was performed. The biochemical characteristics were evaluated in metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy obese, and metabolically unhealthy obese women. There was an association of OCN with BMI (r = -0.107; p = 0.047); adiponectin with BMI (r = -0.217; p = 0.001), insulin (r = -0.415; p = 0.0001), HOMA-IR (r = -0.429; p = 0.0001), and VAT (r = -0.134; p = 0.025); irisin with BMI (r = 0.604; p = 0.001), insulin (r = 0.446; p = 0.0001), HOMA-IR (r = 0.452; p = 0.0001), and VAT (r = 0.645; p = 0.0001); FGF-21 with insulin (r = -0.337; p= 0.030) and HOMA-IR (r = -0.341; p = 0.03); and MCP-1 with BMI (r = 0.481; p = 0.0001), VAT (r = 0.497; p = 0.001), insulin (r = 0.298; p= 0.001), and HOMA-IR (r = 0.255; p = 0.004). A multivariate analysis showed that an elevation of OCN (OR 1.4 (95%CI 1.06-1.81)) and a reduction of adiponectin (OR 0.9 (0.84-0.96)) were associated factors for a metabolic unhealthy phenotype in normal weight participants. Likewise, higher irisin (OR 1.007 (1.003-1.011)) and MCP-1 (1.044 (1.008-1.083)) were risk factors for a metabolic unhealthy phenotype in woman with obesity. OCN, adiponectin, irisin, FGF-21, and MCP-1 are associated with some metabolic parameters such as BMI, HOMA-IR, and VAT, and could be possible biomarkers of an unhealthy metabolic phenotype in middle-aged women.

Alpha estrogen receptor polymorphisms and their association with breast density. / Polimorfismos del receptor de estrógenos alfa y su asociación con la densidad mamaria.

BACKGROUND: In the development of breast cancer (BC), estrogen exposure and the increase in breast density (BD) are two determinant factors for BC risk. OBJECTIVE: To identify the relationship between the XbaI and PvuII polymorphisms in the estrogen receptor (ER-alpha) with BD. MATERIAL AND METHODS: Cross-sectional study which included 225 women, aged 40-65 years, without evident cancer data, who underwent routine mammography for early BC diagnosis in a radiology department. Two groups were formed: women with increased and with normal BD. Participants were genotyped for the XbaI and PvuII polymorphisms. RESULTS: 19.1% had normal weight, 37.7% overweight, and 43.2% were obese women. In relation to high-risk patterns, 105 women had increased BD and 120 had normal BD (53.3%). The frequency of women with increased BD was also lower in postmenopausal women. Regarding the type of BD, there was no statistically significant difference between frequencies of PvuII and XbaI genotypes. Logistic regression showed that only age and body mass index (BMI) were associated with BD. CONCLUSION: PvuII and XbaI ER-alpha genotypes were similar among women with dense and non-dense breasts; differently, other factors were associated with BD (age, BMI and menopausal status). Therefore, emphasis should be placed on clinical practice in the relationship between BMI and BD.

INTRODUCCIÓN: En el desarrollo de cáncer de mama (CaMa), la exposición estrogénica y el aumento de la densidad mamaria (DM) son dos factores determinantes de riesgo. OBJETIVO: Identificar la asociación entre los polimorfismos XbaI y PvuII del receptor de estrógenos (ER-alfa) con la DM. MATERIAL Y MÉTODOS: Estudio transversal que incluyó 225 pacientes de 40-65 años, sin datos evidentes de cáncer, que se realizaron mastografía de rutina en un departamento de radiología para diagnóstico precoz de CaMa. Se clasificaron en dos grupos: con presencia o ausencia de DM aumentada. Se les tomó muestra sanguínea para extraer DNA y determinar los polimorfismos XbaI y PvuII del gen ER-alfa. RESULTADOS: 19.1% tuvo peso normal, 37.7% sobrepeso y el 43.2% obesidad. En relación con la DM, 105 tuvieron mama densa (46.7%) y 120 mama no densa (53.3%). La frecuencia de mujeres con mama densa fue inferior en las mujeres posmenopáusicas. En cuanto al tipo de DM, no hubo diferencia significativa entre las frecuencias en los genotipos de PvuII y XbaI. La regresión logística mostró que solo la edad y el índice de masa corporal (IMC) fueron factores determinantes de la DM. CONCLUSIONES: Los genotipos PvuII y XbaI del ER-alfa fueron similares entre las mujeres con mama densa y no densa; en contraste, otros factores se relacionaron con la DM (edad, IMC y estado menopáusico). Por ende, en la práctica clínica se debe enfatizar la relación del IMC con la DM, pues esta representa un factor de riesgo de CaMa.

Modificación de la composición corporal con la terapia hormonal parenteral y oral en la menopausia / Changes in body composition with the use of parenteral and oral hormone therapy in the menopause

Resumen Antecedentes: La menopausia se relaciona con cambios en la composición corporal que el uso de terapia hormonal (TH) puede revertir. Objetivo: Determinar el efecto de la TH parenteral y oral sobre la composición corporal en la menopausia. Material y métodos: Se realizó un estudio retrolectivo que incluyó a 86 mujeres de 45 a 55 años, con FSH > 20 Ul/ml, antecedente de histerectomía y sintomatología vasomotora, a las cuales se les administró TH por vía oral (44 pacientes) o parenteral (42 pacientes) durante seis meses. Se les realizó impedancia bioeléctrica antes y después del tratamiento. Resultados: La TH por vía oral se asoció con una disminución de diferentes parámetros de la composición corporal entre los que destaca la disminución de la grasa visceral (p < 0.05). La TH parenteral no mostró modificación en la composición corporal. Conclusión: La TH por vía oral modifica de manera positiva la composición corporal, lo cual puede contribuir a regular el estado metabólico.

Abstract Background: Menopause is associated with changes in body composition that the use of hormone therapy (HT) can reverse. Objective: To determine the effect of parenteral and oral HT on body composition in menopause. Material and methods: A retrolective study was carried out in 86 women aged 45 to 55 years old, with FSH > 20 Ul/ml, a history of hysterectomy and vasomotor symptoms. The participants received oral HT (44 patients) or parenteral (42 patients) for six months. Bioelectrical impedance was performed before and after treatment. Results: Oral HT was associated with a decrease in different parameters of body composition, among which the decrease in visceral fat stands out (p < 0.05). Parenteral HT did not show changes in body composition. Conclusion: Oral HT positively modifies body composition, which can help regulate the metabolic state.

Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women.

INTRODUCTION AND OBJECTIVES: Epicardial adipose tissue has been associated with several obesity-related parameters and with insulin resistance. Echocardiographic assessment of this tissue is an easy and reliable marker of cardiometabolic risk. However, there are insufficient studies on the relationship between epicardial fat and insulin resistance during the postmenopausal period, when cardiovascular risk increases in women. The objective of this study was to examine the association between epicardial adipose tissue and visceral adipose tissue, waist circumference, body mass index, and insulin resistance in postmenopausal women. METHODS: A cross sectional study was conducted in 34 postmenopausal women with and without metabolic syndrome. All participants underwent a transthoracic echocardiogram and body composition analysis. RESULTS: A positive correlation was observed between epicardial fat and visceral adipose tissue, body mass index, and waist circumference. The values of these correlations of epicardial fat thickness overlying the aorta-right ventricle were r = 0.505 (P < .003), r = 0.545 (P < .001), and r = 0.515 (P < .003), respectively. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome than in those without this syndrome (mean [standard deviation], 544.2 [122.9] vs 363.6 [162.3] mm(2); P = .03). CONCLUSIONS: Epicardial fat thickness measured by echocardiography was associated with visceral adipose tissue and other obesity parameters. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome. Therefore, echocardiographic assessment of epicardial fat may be a simple and reliable marker of cardiovascular risk in postmenopausal women.

El perímetro de cuello y su relación con los factores de riesgo cardiometabólico en las mujeres / Neck´s perimeter and its relation with the cardiometabolic risk factors in women

RESUMEN Introducción: El perímetro de cuello en la actualidad es una medida útil asociada de manera significativa a la resistencia a la insulina y al riesgo cardiometabólico. Objetivo: Determinar la relación entre el perímetro de cuello y los factores de riesgo cardiometabólico en mujeres de 45 a 60 años de edad. Métodos: Se realizó un estudio en 270 mujeres aparentemente sanas, de 45 a 60 años de edad. Se tomaron medidas antropométricas como peso corporal, índice de masa corporal, perímetro de cintura, perímetro de cuello y el tejido adiposo visceral por bioimpedancia. Se determinaron niveles séricos de glucosa, perfil lipídico (colesterol, triglicéridos, HDL-colesterol, LDL-colesterol), HbA1c, insulina y proteína C reactiva. Resultados: El índice de masa corporal de las participantes fue de 28,2 ± 4,2. Se encontró que 38,1 por ciento de las mujeres presentaban síndrome metabólico y mayor perímetro de cuello, en comparación con las participantes sin síndrome (36,8 + 2,1 vs 35,1 + 1,6 cm, respectivamente, p< 0,0001). El perímetro de cuello se asoció positivamente con índice de masa corporal (r= 0,690, p= 0,0001), tejido adiposo visceral (r= 0,548, p= 0,0001), circunferencia de Cintura (r= 0,640, p< 0,0001), glucosa (r= 0,251, p= 0,0001), triglicéridos (r= 0,143, p= 0,019), HbA1c (r= 0,160, p= 0,010) y proteína C reactiva (r= 0,342, p= 0,001). Conclusiones: Las mujeres con incremento en el perímetro de cuello presentan un perfil de riesgo cardiometabólico aumentado. La medición del perímetro de cuello representa un método útil y práctico en la predicción del riesgo cardiometabólico(AU)

ABSTRACT Introduction: Neck´s perimeter is nowadays a useful measure significantly associated to insulin resistance and to cardiometabolic risk. Objective: To determine the relation between the neck´s perimeter and the cardiometabolic risk factors in women from 45 to 60 years old. Methods: A study was performed in 270 apparently healthy women, aging 45 to 60 years old. Anthropometric measurements were taken such as weight, body mass index, waist circumference, neck´s perimeter and visceral adipose tissue by bioelectrical impedance analysis. There were identified serum levels of glucose, lipid profile (cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol), HbA1c, insulin and C-reactive protein. Results: The body mass index of the participants was 28.2 ± 4.2. It was found that 38.1 percent of the women had a metabolic syndrome and a higher perimeter of neck, in comparison with participants without the syndrome (36.8 + 2.1 vs 35.1 + 1.6 cm, respectively, p< 0.0001). The neck´s perimeter was positively associated with body mass index (r = 0.690, p= 0.0001), visceral adipose tissue (r = 0.548, p= 0.0001), waist circumference (r = 0.640, p< 0.0001), glucose (r = 0.251, p= 0.0001), triglycerides (r = 0.143, p = 0.019), HbA1c (r = 0.160, p = 0.010) and C-reactive protein (r = 0.342, p = 0.001). Conclusions: Women with an increase in the neck´s perimeter have a profile of increased cardiometabolic risk. The measurement of neck´s perimeter represents a useful and practical method for the prediction of cardiometabolic risk(AU)