Minireview: A Need for an Adequate Diet Program for Postmenopausal Women with Obesity in the Republic of Korea

Women undergo various physical changes because of hormonal changes occurring after menopause. Some representative changes caused by the reduction in estrogen levels in these women are dyslipidemia, abnormal lipoprotein levels, obesity, weight gain, and changes in body fat distribution. A characteristic of women approaching menopause is the shift of fat from their hips and thighs to their abdomen. Notably, fat accumulation is common in internal organs, resulting in male-pattern obesity among women approaching menopause; therefore, these women require more exercise therapy than premenopausal women to prevent and treat obesity. To the best of our knowledge, no effective exercise therapy guidelines have been established for postmenopausal women; therefore, I aimed to suggest more effective diet and exercise therapies for postmenopausal women with obesity. For this purpose, I organized the diet and exercise protocol by collaborating with an obstetrician and a researcher specializing in sports medicine; further, this protocol was actually applied to all participants. The results indicated that the protocol is effective in reducing weight; however, joint pain was commonly noted in participants who dropped out of the program. Based on the evaluation of joint pain, this study found that it is necessary to perform exercise therapy by avoiding weight-bearing activities and reinforcing personalized joint strengthening exercises because reduced estrogen level is an important factor exacerbating arthritis in postmenopausal women.

Is There a Difference in Serum Vitamin D Levels and Bone Mineral Density According to Body Mass Index in Young Adult Women?

BACKGROUND: In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women. METHODS: A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index. RESULTS: Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake. CONCLUSIONS: Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.

Relationship between Bone Density, Eating Habit, and Nutritional Intake in College Students

BACKGROUND: The importance of bone health is emphasized throughout the life cycle. Young adults have problems with bone health due to irregular lifestyle and unbalanced diet, but studies related to them are insufficient. The purpose of this study was to measure the bone mineral density (BMD) of college students and to analyze the differences in BMD according to lifestyle. METHODS: BMD was measured by bone ultrasound in 161 male and female college students. The questionnaire was surveyed about lifestyle, eating habits, and nutrient intake status. RESULTS: Osteopenia was 8.8% in male and 10.8% in female. The body fat percentage of female was significantly higher than male. Male college students, smoking, fast food consumption, and overeating rate were significantly higher than female. Nutrient intake was not significantly different between male and female students. But energy and vitamin A and C levels were inadequate, and protein and sodium intake was excessive compared with the recommended nutrient intake for Koreans. BMD was significantly lowest in male who often intake fast food than male who did not intake at all or intake sometimes. Female who often intake fast food had significantly lower BMD than female who did not eat at all. CONCLUSIONS: College students have different BMDs according to lifestyle. There was a difference in BMD according to smoking and fast food consumption.

Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials

OBJECTIVES: Atrophic vaginitis (AV), which is common in postmenopausal women, is characterized by vaginal dryness, dyspareunia, and discomfort. There are a variety of therapeutic agents for the treatment of AV, besides hormone replacement therapy. We performed this systematic review to compare the effectiveness of various therapies for symptom improvement in AV patients. METHODS: We searched the Cochrane Library, EMBASE, MEDLINE, and other literature (Google Scholar, Web of Science, and hand search) for studies published between January 2010 and March 2015. AV was evaluated by the following outcomes: vaginal pH, dyspareunia, vaginal dryness, or cytological change (endometrial thickness, percentages of superficial cells and parabasal cells). They measured treatment efficacy with various outcomes pertaining to AV symptoms. RESULTS: Meta-analysis suggested that ospemifene was effective against dyspareunia, vaginal dryness, endometrial thickness, and percentage changes in superficial and parabasal cells. Vaginal pH was most affected by soy isoflavone vaginal gel. Ospemifene was effective for AV symptoms. CONCLUSIONS: This systematic review compared the effects of several therapeutic agents on symptoms of AV through a network meta-analysis. This study provides objective evidence for clinical treatment and efficacy management in AV.

Cell Therapy Products in Alzheimer Disease

We are rapidly becoming an aging society, with the ongoing increase in challenges of the elderly. The age-related cognitive decline in accordance with aging society is of major importance in public health. Recent studies have proved the impacts of sex-steroid hormone on the brain; compliant with aging, menopause and decrease in estrogen have an effect on the occurrence and prevention of Alzheimer's disease. A new hypothesis states that Alzheimer's disease is a postmenopausal dementia, and is a negative form of estrogen deficiency. In this review article, we reckoned the cause of postmenopausal Alzheimer's disease. We further investigated new cell therapies for postmenopausal Alzheimer's disease, which are under development in some pharmaceutical companies. One remedy is cell therapy that inhibits the amyloid beta formation, and the other is the umbilical cord blood derived mesenchymal stem cell therapy.

Relationship between Serum 25-hydroxy-vitamin D Concentration and Risk of Metabolic Syndrome in Patients with Fatty Liver

BACKGROUND: The vitamin D deficiency rate in Koreans is still high and dietary intake is insufficient. The purpose of this study was to provide basic data for the management of metabolic syndrome (MetS) by analyzing the effect of vitamin D levels on the MetS in patients with fatty liver. METHODS: We analyzed the MetS ratio and serum 25-hydroxy-vitamin D (25[OH]D) concentration in 151 adults diagnosed with fatty liver by using obesity index and blood profiles. We collected data on demographic factors, nutrient intake, and lifestyle habits. RESULTS: The mean 25(OH)D concentration of all subjects was 14 ng/mL and the insufficiency and deficiency rates were 40.4% and 29.8%. The proportion of MetS was 38.4% and the mean 25(OH)D level of MetS group was 12.1 ng/mL. Low-density lipoprotein cholesterol, triglyceride, and blood glucose were higher in the MetS group than in the normal group, and the waist circumference of the male was significantly higher than that of the normal group. The results showed that the lower the vitamin D concentration, the higher the risk of MetS (odds ratio, 1.47, 95% confidence interval, 0.98–2.81; P=0.043). CONCLUSIONS: These results suggest that serum 25(OH)D levels may be a risk factor for MetS in patients with fatty liver.

Serum Vitamin D Level Related to Coffee Consumption in Korean Young Adults Using the 5th Korea National Health and Nutrition Examination Survey

BACKGROUND: Even young adults are highly interested in their osteological health, yet their calcium intake does not match the level of such interest. Increase in bone loss is known to be associated with higher intake of caffeine and coffee consumption among the young Korean is rising steadily. This study was conducted to reveal the relationship between coffee consumption and serum vitamin D level in Korean young adults. METHODS: This study analyzed potential difference in lifestyle and concentration of vitamin D in blood in relation to coffee intake frequency of 2,523 subjects on the basis of data from the 5th Korea National Health and Nutrition Examination Survey. RESULTS: According to the analysis, groups of males, with high income, frequent social activity followed by alcohol consumption and smoking, and high rate of dining out showed a high frequency of coffee consumption. Vitamin D concentration among the groups was 16.2±5.3 mL and 80.3% of them were considered to be vitamin D-deficient. All the groups appeared to have deficiencies compared to males who did not consume caffeine at all. CONCLUSIONS: The practice of having an adequate amount of coffee is needed, and more efforts should be done to improve vitamin D intake among young adults.

The Clinical Effects of Dendropanax Morbifera on Postmenopausal Symptoms: Review Article

Postmenopausal women aged 50s generally experience gradual changes in body such as decline in antioxidant and estrogen levels as the body ages. To overcome these aging-associated changes, the needs for health functional foods are increasing. Dendropanax morbifera (DM) have antioxidant effects, anti-inflammatory against cancer cells, antidiabetic, and antiatherogenic effect which are associated with postmenopausal symptoms. We analyzed clinical effects of DM on aging-related symptoms by reporting their antioxidant, anticancer and inflammatory activity, etc. and their bioactivity. Data sources EMBASE, SCOPUS, PubMed, Web of Science, and Google Scholar databases were searched up to August 2016 for studies investigating medicinal plants in prevention and treatment of diabetes. The search terms were “Dendropanax morbifera”. The reference lists of articles were also reviewed for additional relevant studies. Extracts of DM have various efficacy such as antioxidant, anti-cancer, anti-inflammatory activity and anti-thrombotic effect.

Role Identification of Passiflora Incarnata Linnaeus: A Mini Review

Some species of traditional herbal medicine has a history of use, most traditional natural herbs have been used for various diseases such as diabetes, hypertension, and obesity. Among them, Passiflora incarnata L. is a traditional natural medicine, flowers as well as berries, roots, and leaves have been used as a medicine. It has been used as a natural medicine for the treatment of insomnia and anxiety for a longtime in Europe, and it has been used primarily for sedation tea in North America. Moreover, Passiflora incarnata L. is widely used anti-asthmatic, analgesic and sedation in Brazil. In other words, Passiflora incarnata L. has been used to treat a sedative, dysmenorrhea, insomnia, cancer, etc. in many countries. Present review of the plants showed a wide range of pharmacological activity in anxiolytic relax the clinical disease, such as anti-inflammatory, anxiety and antioxidant. In addition, Passiflora incarnata L. affects menopause symptoms such as vasomotor symptoms, insomnia, and depression. This review aims to provide the latest information on specific functional components of Passiflora incarnata L. especially the results of clinical trials will provide new insights into opportunities for the future development of natural medicines and doors will be used for purposes of analysis.

Relationship between Heavy Metal Exposure and Bone Mineral Density in Korean Adult

BACKGROUND: Exposure to heavy metals from environmental and industrial sources remains a concern of serious public health risk. This study was conducted to analysis the relationship between heavy metal concentrations and bone density. METHODS: This study used data from a nation-based sample of Koreans (n=2,429) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were obtained heavy metals (lead, mercury and cadmium), socioeconomic and demographic factors and bone mineral density (BMD) measured by T-score. RESULTS: Menopausal women, current smoker or the frequent alcohol drinking, low educational level and low family income were greater in the osteopenia or osteoporosis groups than normal group, and were associated with an increased blood heavy metal concentration levels. The highest quartile group in blood lead had a 1.47 times (95% confidence interval [CI] 1.16-1.87) risk of osteopenia or osteoporosis. In case of blood cadmium, the risk for osteopenia or osteoporosis increased 2.1 times (95% CI 1.64-2.68). CONCLUSIONS: We observed a significant association between blood heavy metals (lead and cadmium) levels and low BMD. Our findings suggest that heavy metal exposure may be a risk factor for osteoporosis.

Comparison in Adherence to Osteoporosis Guidelines according to Bone Health Status in Korean Adult

BACKGROUND: Osteoporosis one of the most serious disease to decrease the quality of life and cause economic loss. Thus, prevention of osteoporosis has become an important health concern. The study examined in adherence to osteoporosis guidelines and compared the levels of adherence to osteoporosis guidelines between bone health status in Korean adult. METHODS: This study used data from a nationally represented sample of Koreans (n=3,419) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were divided into three groups by T-score: normal, osteopenia and osteoporosis. Assessment of adherence level was based on 5 components of osteoporosis guidelines, considering intake of sodium, calcium and protein, smoking and regular exercise. RESULTS: The sex, body mass index, income and educational level did not significantly differ between three groups. Deficient intake of calcium was significantly associated with a threefold greater odds in osteoporosis group (OR 3.6; 95% confidence interval [CI] 2.52-5.22). Excessive protein intake was significantly increased the risk only in osteoporosis group compared to the normal group (OR 1.71; 95% CI 1.15-2.62). Smoking increased the risk in osteoporosis group compared to the normal group (OR 2.88; 95% CI 1.75-4.76), osteoporosis group compared to the osteopenia group (OR 2.69; 95% CI 1.61-4.55). CONCLUSIONS: Nutritional factor (intake of calcium and protein) and lifestyle-related factor (smoking and exercise) must be accompanied the management for bone health. An adherence of guidelines is considered very important for the prevention of osteoporosis.

Uterine cancer and ezrin expression / 고신대학교의과대학학술지

Today, almost 20% of female cancers are gynecological in nature. In particular, uterine cervical cancer and endometrial cancer (which have been intensively studied) seriously compromise female health. One of the ezrin-radixin-moesin (ERM) proteins, ezrin, has been associated with cancer in prior studies, including the two cancers mentioned above. Ezrin expression increases, as does the expression of other factors, in uterine cervical cancer; ezrin may promote cancer development by influencing the actions of the other factors. Also, an increase in ezrin level contributes to the development of diseases such as endometrial cancer.

Alternative Therapy Trends among Korean Postmenopausal Women

No abstract available.

The Relevance of Women's Diseases, Jun Activation-domain Binding Protein 1 (JAB1) and p27(kip1)

The Jun activation-domain binding protein 1 (Jab1) recognize a potential coactivator of activator protein 1 (AP-1) such as c-fos, c-jun transcription factor and the fifth subunit of the COP9 signalosome complex. Also, Jab1 activate the c-jun gene resulted cell proliferation. Not only a powerful tumor suppressor but also regulator of apoptosis negative cdk inhibitor p27(kip1) are involved in the cell cycle. This is Jab1 and p27(kip1) interact with each other, Jab1 accelerate p27(kip1) from nuclear to cytoplasm through ubiquitin/proteasome pathway. However, information about the relationship between Jab1 and p27(kip1) is not known much. Taken together, the results of this study identify function and structure of Jab1 and p27(kip1) were described in a recent article on the basis of relevant. Besides Jab1 and p27(kip1) will organize the relationship between the disease and women.

A Study on Perception and Usage Status on Health Functional Foods in Women according to Menopause Status

OBJECTIVES: This study was performed to provide a reference base for suggesting proper guidelines for the health of the people by analyzing perception and intake pattern on health functional foods and by identifying needs in pre- and postmenopausal women. METHODS: We conducted a self-administered survey in women admitted to the Department of Obstetrics and Gynecology at a university hospital between July and August, 2014. The survey questionnaire consisted of 8 items on general characteristics, 4 items on awareness on health functional foods, and 16 items on usage status. RESULTS: Of all 133 women with ages ranging between 19 to 67 years, postmenopausal women were 57 accounting for 42.9% of all subjects. Mean age was 55.4 ± 6.2 and menopausal age was 49.6 ± 4.3 in the postmenopause group. Mean age was 38.7 ± 9.0 in the postmenopause group. With respect to components of health functional foods, 76.3% of women answered "important" in the postmenopause group, significantly higher than 49.1% in the postmenopause group (P < 0.01). In regard to price, those who answered "important" accounted for the largest percentage in the premenopausal group at 56.6%, and those who answered "moderately important" accounted for 57.9% in the postmenopausal women. A significant difference was found between the two groups (P < 0.05). CONCLUSION: Development of products reflecting consumer needs can be considered. It is important to foster an environment allowing individuals to choose right health functional foods and further studies are warranted.

The Role of Vitamin D in Menopausal Medicine / 고신대학교의과대학학술지

Menopause is the time at which menstruation stops in women. After menopause, women are more susceptible to some diseases, especially osteoporosis and cardiovascular disease. Vitamin D has a protective effect against osteoporosis by facilitating the absorption of calcium and affecting parathyroid hormone. Vitamin D also affects cardiovascular function by lowering the blood pressure, which affects the renin–angiotensin system and alters the low-density lipoprotein receptor activity. This paper discusses supplemental vitamin D in postmenopausal women with osteoporosis and cardiovascular disease.

Do endometrial movements affect the achievement of pregnancy during intrauterine insemination?

This study was aimed to assess the effect of endometrial movements on pregnancy achievement in intrauterine insemination [IUI] cycles. The population of this observational study was composed of unexplained infertility couples undergoing first-time IUI with clomiphene citrate between September 2010 and October 2011. Not only endometrial movements, but also thickness, volume, pattern, and echogenic change of endometrium were analyzed prospectively in prediction of pregnancy. The total number of 241 cycles of IUI with 49 intrauterine pregnancies [20.3%] was analyzed. Pregnancy was not related to endometrial thickness and endometrial volume, but significantly related to endometrial movements associated with the number of contraction, strong movement, cervicofundal direction, and hyperechoic change [p<0.05]. Pregnant group showed higher cervicofundal movement rate [89.8 vs. 75.5%]. For IUI cycles stimulated by clomiphene citrate in unexplained infertility women, endometrial movements on the day of IUI could be a predictor of pregnancy

Neutral Sphingomyelinase and Breast Cancer Research

Our understanding of the functions of neutral sphingomyelinase (N-SMase) signaling has advanced over the past decade. In this review, we focus on the roles and regulation of N-SMase 1, N-SMase 2, N-SMase 3, an enzyme that generates the bioactive lipid ceramide through the hydrolysis of the membrane lipid sphingomyelin. A large body of work has now implicated N-SMase 2 in a diverse set of cellular functions, physiological processes, and disease pathologies. We focus on different aspects of this enzyme's regulation from transcriptional, post-translational, and biochemical. Furthermore, we expected N-SMase involvement in cellular processes including inflammatory signaling, cell growth, apoptosis, and tumor necrosis factor which in turn play important roles in pathologies such as cancer metastasis, variable disease, and other organ system disorders. Lastly, we examine avenues where targeted N-SMase inhibition may be clinically beneficial in disease scenarios.

A Pilot Study of the Impacts of Menopause on the Anogenital Distance

OBJECTIVES: It has been known that there is a difference in anogenital distance (AGD) in the animals and newborn depending on the exposure of androgenic hormones. The anatomical changes occur in the female genitalia in women after menopause. This was pilot study to find out whether the menopause affects AGD. METHODS: We evaluated a total of 50 women targeted for premenopausal and postmenopausal group in each 25 people. AGD was defined as a length between the posterior commissure of labia and anal center. AGD was measured in lithotomy position using sterile paper ruler. In order to control bias of the height and weight, which could influence the AGD, anogenital index (AGI) is defined as the weight divided by the AGD value. We used a Mann-Whitney U test to analyze the relationship between AGD and menopause for statistical analysis. RESULTS: AGD was significantly longer in premenopausal women compared to postmenopausal women (34.8 +/- 6.4 vs. 30.3 +/- 6.6, P = 0.019). AGI was significantly higher in premenopausal women than postmenopausal women (1.7 +/- 0.4 vs. 1.3 +/- 0.3, P < or = 0.000). CONCLUSION: The changes of AGD and AGI in postmenopausal women demonstrated to have potential to be used as on scale predicting the physical changes that may occur after menopause. This study could be used as the cornerstone of a large-scale studies in the future.

Application of Bioactive Natural Materials-based Products on Five Women's Diseases

Women's health has been threatened by various diseases mainly including heart disease, breast cancer, osteoporosis, depression, and autoimmune disease. But development of medication for these diseases has been restricted by high development costs and low success rates. Herein the attempt to develop valid bioactive materials from a traditional natural material has been made. Resveratrol has been reported to be effective in treatment of breast cancer and heart disease. Goji berry has received attention as a natural based therapeutic material to treat a diabetes, cardiovascular disease, and osteoporosis. Leonurus family has been reported to be effective particularly in pregnant women due to high contents of vitamin as well as stimulation of uterine contraction. Annona family has effects such as anti-anxiety, anticonvulsant and recently it is proposed to be as a therapeutic material to cure depression based on its strong antidepressant effect. Shiraia bambusicola has been utilized to cure angiogenesis-related disease from ancient China and furthermore recently it was proved to be effective in rheumatoid arthritis. Getting an understanding of utilization of these traditional natural materials not only enhances the interest in development of therapeutic materials for preventing and treating various women's diseases, but also makes it possible to develop novel therapeutic materials.