Low bone mineral density in pre-menopausal women one year after gastric bypass / Baixa densidade mineral óssea em mulheres pré-menopausadas um ano após bypass gástrico

Introduction: Nutritional deficiencies, hormonal changes and severe weight loss after Roux-en-Y Gastric Bypass (RYGB) can promote changes in bone metabolism which may lead to a reduction in bone mineral density (BMD). Objective: to investigate the prevalence of osteopenia/osteoporosis and factors associated with BMD in pre-menopausal women who underwent RYGB. Methodology: a cross-sectional study conducted with secondary data of patients followed-up in a specialized center for obesity treatment. Variables studied: biochemical and anthropometric data, body composition by multifrequency bioimpedance and BMD of the lumbar spine (LS), total femur (TF) and femur neck (FN) by dual-energy X-ray absorptiometry. For statistical analysis, the SPSS® software and a 5% significance level were utilized. Results: seventy-two (72) pre-menopausal women were evaluated. Mean age, BMI and mean post-surgery time was 38.7±6.5 years, 25.8±2.5 kg/m² and 13.1±1.7 months, respectively. The prevalence of osteopenia in at least one of the densitometry sites was 13.9%, with LS being the most frequent site. A lower LS BMD was associated with greater weight loss, higher percentage of body fat before surgery and lower post-surgery serum vitamin D levels. There was a positive correlation between skeletal muscle mass index adjusted for height in the pre-surgery period and LS BMD (r=0.361; p=0.010) and TF (r=0.404; p=0.004). Conclusion: a relevant prevalence of osteopenia was detected in pre-menopausal women after RYGB, mainly in the LS.

Introdução: o Bypass Gástrico em Y de Roux (BPGYR) pode promover mudanças no metabolismo ósseo decorrentes de deficiências nutricionais, alterações hormonais e perda severa de peso, podendo acarretar redução da Densidade Mineral Óssea (DMO). Objetivo: investigar a prevalência de osteopenia/osteoporose e fatores associados à DMO em mulheres pré-menopausadas submetidas à BPGYR. Metodologia: estudo transversal com dados secundários de pacientes acompanhadas em um serviço especializado no tratamento da obesidade. Variáveis estudadas: dados bioquímicos e antropométricos, composição corporal por bioimpedância multifrequencial e DMO de coluna lombar (CL), fêmur total (FT) e colo do fêmur (CF) por Absorciometria por Dupla Emissão de Raios X. Para análise estatística foi utilizado o programa SPSS®, com o nível de significância de 5%. Resultados: foram avaliadas 72 mulheres pré-menopausadas, com média de idade e de IMC de 38,7±6,5 anos e 25,8±2,5 kg/m², respectivamente, e tempo médio de pós-operatório de 13,1±1,7 meses. A prevalência de osteopenia em pelo menos um dos sítios densitométricos foi de 13,9%, sendo a CL o sítio mais frequente. Uma menor DMO na CL se associou a maior perda de peso, maior percentual de massa gorda antes da cirurgia e níveis séricos menores de vitamina D pós-operatória. Observou-se correlação positiva entre o índice de massa muscular esquelética ajustada pela altura no pré-operatório e a DMO da CL (r=0,361; p=0,010) e do FT (r=0,404; p= 0,004). Conclusão: detectou-se prevalência relevante de osteopenia em mulheres pré-menopausadas após BPGYR, principalmente na CL.

Research Progress on Animal Models of Menopausal Syndrome： A Review / 中国实验方剂学杂志

In order to explore the pathological mechanism of perimenopausal syndrome and seek prevention and treatment measures， it is necessary to establish animal models that similar to human perimenopausal syndrome， so as to provide reference for drug research， new drug development and clinical application. In this paper， the keywords of "perimenopausal period" "perimenopausal syndrome" "menopause" "menopausal syndrome""menopausal period" "menopausal syndrome" and "animal" were searched in China National Knowledge Infrastructure （CNKI）， Chongqing Weipu， China Biomedical Literature Database （CBM） and Pubmed. In addition， the selection of domestic peripheral menopausal syndrome model animals in recent years and the advantages and disadvantages of corresponding models were summarized. A total of 673 studies were identified， of which 61 were included in the analysis. The most common animal model of perimenopausal syndrome is castration model， while the immunodeficiency model is less used. With the aging of the population and the rapid increase of psychosocial stress， the incidence of perimenopausal syndrome is high. Therefore， it is particularly important to explore the mechanism of perimenopausal syndrome. According to the experimental purpose， experimental period， experimental technology and other factors， the selection of appropriate model animals and modeling methods is the key of the success of the experiment of perimenopausal syndrome.

A Study on the Clinical and Pathological Evaluation of Dysfunctional Uterine Bleeding

Background: Abnormal uterine bleeding, a commongynecological problem is caused by a range of etiologies thatmay be functional or organic. Histo-pathological analysis ofendometrial sample is considered gold standard for the studyof endometrial pathology. Thus here we made an attempt tostudy endometrial pattern in women with AUB and correlatethat with clinical parameters.Materials and Methods: This hospital based study involved 50patients with AUB and attending Varun Arjun Medical Collegeand Rohilkhand Hospital. The patients were divided asreproductive (<40), perimenopausal (41-50) and postmenopausal group (>50). The endometrial samples wereprocessed and histopathological analysis was conducted.Result: Most of study patients were under reproductive agegroup (52.8%) and multigravid (28%). Functional abnormalitieswere the common causes of AUB (72%). Menorrhagia wasmost frequent bleeding pattern observed (36%) followed bymetrorrhagia (18%). In case of reproductive age group andperimenopausal, the common histopathological abnormalitywas proliferative endometrium (18% and 12%) while for postmenopausal age group, it was 8 %. For primipara groupdisordered proliferative endometrium (8%), for multipara groupproliferative endometrium (24%) and for grand multiparagroup endometrial hyperplasia (10%) were the most frequentlyobserved abnormalities. A single case of malignancy wasobserved in post-menopausal multipara female.Conclusion: Histopathological study of endometrial biopsyhelps the clinicians in selecting the appropriate therapeuticapproach. It is simple and cheap method hence should beused as first line strategy thus reducing the need of otherexpensive and complicated approaches.

Serum anti-Mullerian hormone and homocysteine in premenopausal females with and without cardiovascular disease

Background: The objective of this study is to assess the association of anti-Mullerian hormone (AMH) and homocysteine (Hcy) levels in premenopausal females with and without cardiovascular disease.Methods: A case control study was conducted in premenopausal, menopausal and normal fertile females (n=30) with and without cardiovascular disease in a tertiary care hospital and research centre in central India. Fasting sample obtained was assessed for AMH and Hcy levels. Results were compared and data was analyzed.Results: The levels of AMH and Hcy were significantly altered in premenopausal and menopausal females as compared to normal fertile females. Moreover, there was a weak correlation when intergroup comparison was made between the parameters in females with and without cardiovascular disease.Conclusions: A prospective study with a larger sample size to assess levels of AMH need to be performed to provide insight in premenopausal females for the early detection cardiovascular disease.

Peripheral Blood Lymphocyte Subset Counts in Pre-menopausal Women with Iron-Deficiency Anaemia

Background: Iron-deficiency anaemia (IDA) is a major worldwide public health problem. Children and women of reproductive age are especially vulnerable to IDA, and it has been reported that these patients are more prone to infection. This study was done to evaluate alteration of lymphocyte subgroups in IDA. Methods: In this prospective study, we investigated lymphocyte subsets in pre-menopausal women with iron-deficiency anaemia; 50 normal subjects and 50 IDA (hypochromic microcytic) cases were enrolled. Experimental and control anticoagulated blood samples were evaluated using flow cytometry to determine the absolute and relative numbers of various lymphocyte subgroups. Finally, the results of the patient and control groups were compared. Results: Mean (SD) absolute counts of lymphocytes, CD3+ cells, CD3+/CD4+ subsets (T helper) and CD3+/CD8+ subsets (T cytotoxic) in the patient group were 2.08 (0.65) x 109/L, 1.53 (0.53) x 109/L, 0.87 (0.28) x 109/L, and 0.51 (0.24) x 109/L, respectively. The results showed significant differences between case and control groups in mean absolute counts of lymphocytes (P = 0.014), T lymphocytes (P = 0.009), helper T cells (P = 0.004), and cytotoxic T cells (P = 0.043). Conclusion: This study showed that absolute counts of peripheral blood T lymphocytes as a marker of cell-mediated immunity may be decreased in pre-menopausal women with iron-deficiency anaemia, and that these patients may be more prone to infection.

Comparison of Bone Mineral Density with Breast Cancer Patients after Chemotherapy and Normal Control in Premenopausal Women / 대한골다공증학회지

OBJECTIVES: There is a lack of data on bone loss in premenopausal patients with breast cancer after chemotherapy in Korea. In this study, we compared the bone mineral density of breast cancer patients after chemotherapy with normal control. MATERIALS AND METHODS: We used the data from the fourth Korea National Health and Nutrition Examination Survey (KNHNES) as normal control, and 119 women were enrolled who had surgery and chemotherapy due to breast cancer. They were under the age of 50 and premenopausal state according to their FSH level. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry.