Elevated leptin levels in healthy climacteric women from Northeastern Brazil: an effect of age or adiposity?

OBJECTIVE: Climacterium is associated with elevated leptin levels and increased risk of cardiovascular disorders. Conflicting data diverge on whether high leptin levels in climacterium reflect increasing adipose mass or, at least partially, age-related hormonal changes. This study addresses this issue in women from a Brazilian state with a low human development index. SUBJECTS AND METHODS: A case-control study was conducted, enrolling 136 women from the state of Maranhão, 52 (38.2%) climacteric and 84 (61.8%) non-climacteric. Biometric, biochemical, hormonal and immunological parameters were analyzed. RESULTS: Climacteric women showed a moderately increased waist/hip ratio (0.894 versus 0.834, p < 0.05), sustained body mass index (27.46 versus 28.68, p > 0.05) increased leptin levels (9.59 versus 7.13, p < 0.05) and no evidence of metabolic syndrome. No other parameters were altered. The climacteric cohort didn't show significant body fat gains but displayed a typical age-related redistribution of adipose tissue. Even so, leptin levels were significantly elevated compared with non-climacteric women. CONCLUSIONS: Altogether, these data support the hypothesis that leptin is elevated, at least partially, as a function of age and climacterium and is not necessarily correlated with metabolic dysfunction and systemic inflammation. Further studies are needed to evaluate the impact of higher leptin levels on postmenopausal women. Arch Endocrinol Metab. 2020;64(3):276-81.

Elevated leptin levels in healthy climacteric women from Northeastern Brazil: an effect of age or adiposity?

ABSTRACT Objective Climacterium is associated with elevated leptin levels and increased risk of cardiovascular disorders. Conflicting data diverge on whether high leptin levels in climacterium reflect increasing adipose mass or, at least partially, age-related hormonal changes. This study addresses this issue in women from a Brazilian state with a low human development index. Subjects and methods A case-control study was conducted, enrolling 136 women from the state of Maranhão, 52 (38.2%) climacteric and 84 (61.8%) non-climacteric. Biometric, biochemical, hormonal and immunological parameters were analyzed. Results Climacteric women showed a moderately increased waist/hip ratio (0.894 versus 0.834, p < 0.05), sustained body mass index (27.46 versus 28.68, p > 0.05) increased leptin levels (9.59 versus 7.13, p < 0.05) and no evidence of metabolic syndrome. No other parameters were altered. The climacteric cohort didn't show significant body fat gains but displayed a typical age-related redistribution of adipose tissue. Even so, leptin levels were significantly elevated compared with non-climacteric women. Conclusions Altogether, these data support the hypothesis that leptin is elevated, at least partially, as a function of age and climacterium and is not necessarily correlated with metabolic dysfunction and systemic inflammation. Further studies are needed to evaluate the impact of higher leptin levels on postmenopausal women. Arch Endocrinol Metab. 2020;64(3):276-81

Efeito da terapia de reposição hormonal sobre o estado férrico / Effect of hormone replacement therapy in iron status

Introdução: Na literatura, numerosas publicações relatam a determinação do estado férrico em crianças, adolescentes e mulheres em fase reprodutiva, no entanto são raras as pesquisas quanto às alterações do ferro em estoque e eritrograma pós-terapia de reposição hormonal (TRH) em pré-menopausadas e menopausadas. O aumento dos estoques de ferro em mulheres pré-menopausadas e menopausadas pode conduzir à elevação do estresse oxidativo e, conseqüentemente, ao risco de desenvolvimento de câncer e doenças cardiovasculares. Objetivo: Avaliar o efeito da TRH sobre o eritrograma e o estado férrico em mulheres na pré-menopausa e na menopausa. Métodos: Foram determinados os eritrogramas e as dosagens de ferro, capacidade total de ligação do ferro a transferrina (CTLF) e ferritina séricas em 30 mulheres no climatério antes e após seis meses de TRH com medroxiprogesterona e estradiol. Os eritrogramas, as dosagens de ferro e CTLF foram determinados por meio da utilização de métodos clássicos, e a ferritina, por quimiluminescência. Resultados: Após o uso da TRH, constataram-se significante redução do número de eritrócitos, elevação dos índices hematimétricos e tendência à diminuição nos níveis de ferro sérico e CTLF. Nenhuma alteração significante nos níveis de ferritina e no índice de saturação de transferrina foi detectada após a TRH. Discussão e conclusão: No presente estudo não foram encontradas alterações nos paramêtros hematimétricos e no estado férrico que impeçam a utilização da TRH no climatério e na menopausa. Os resultados sugerem que a TRH exerceu efeito benéfico sobre o estado férrico nas mulheres no climatério deste estudo, mantendo os estoques de ferro normais e promovendo a elevação dos índices hematimétricos.

Changes in normal lipid profile of menopausal women with combined hormone replacement therapy. Comparative clinical trial of two hormonal combinations (conjugated estrogens/medroxyprogesterone acetate versus estradiol valerate/cyproterone acetate).

OBJECTIVES: To compare the effect on plasma lipids of conjugated estrogens/medroxyprogesterone acetate (CE/MPA) and estradiol valerate/cyproterone acetate (EV/CPA) in healthy peri and postmenopausal women during 1 year. METHODS: Multicentric, controlled, single blinded Phase III clinical trial. Women were randomized to two treatment groups: Group A (n = 49 women): CE 0.625 mg/day for 21 days and MPA 5 mg from day 12 to 21. Group B (n = 55 women): EV 2 mg/day for 21 days and CPA 1 mg from day 12 to 21. Total cholesterol (TC), high density cholesterol (HDL-C), low density cholesterol (LDL-C), triglycerides, aminotransferases and alkaline phosphatase were measured before starting therapy, and after 3, 6, 9 and 12 months of hormone replacement therapy (HRT). TC/HDL-C and LDL-C/HDL-C ratios were determined. RESULTS: There were no changes in TC levels. HDL-C increased and LDL-C decreased significantly, with no differences between groups but within each group. Triglycerides increased significantly but remained within normal values, with no differences between groups. TC/HDL-C ratio showed a slight and steady decrease in both groups. LDL-C/HDL-C ratio decreased in both treatment groups. CONCLUSION: Both cyclic sequential preparations used in HRT showed a favorable effect on plasma lipids in healthy peri and postmenopausal women, with an increase in HDL-C and a decrease in LDL-C levels, as well as in the LDL-C/HDL-C and TC/HDL-C ratios. Our study confirms the positive effect of estrogens on lipids, which does not seem to be adversely affected by the addition of progestogens derived from pregnanes.

Evaluación médica de la paciente climatérica / Medical evaluation of climateric patient

Se decidió elaborar un plan para evaluación de las mujeres mayores de 35 años con síntomas de climaterio, consistente en la aplicación de una encuesta, un examen ginecológico completo que incluyó citología vaginal, ecosonograma pélvico con transductor vaginal y mamografía, y determinaciones de calcio, fósforo, fosfatasa alcalina, colesterol triglicéridos, radiografías de columna vertebral y densitometría monofotónica de radio. Se encontró lo siguiente: la media fue de 50 años (DE 7.6 años y mediana 49 años), 34/65 mujeres habían sido sometidas a histerctomía y colo 34/64 habían recibido inmunización antitetánica. Había una enfermedad crónica en 36/59, consumo de alcohol en 5/66 y de tabaco en 9/66; mientras que 32/68 aceptaron no hacer ejercicio regularmente. Se encontró hipercolesterolemia en 19/66 e hipertrigliceridemia en 8/6a. Hubo osteopenia en 33/60. Hubo hallazgos "menores" a niveles de ECG, mamagrafía y ecosonografía pélvica. Estos resultados muestran la necesidad de estructurar un plan de manejo pera este segmento de la población, especialmente en esta área donde la Encuesta Nacional de Salud 1988, señala como pa principal causa de mortalidad en mujeres mayores de 50 años a la lesión coronaria

Clonidina no tratamento de pacientes climatericas / Clonidine in the treatment of climateric patients

Noventa e quatro pacientes climatericas sintomaticas e hipertensas foram tratadas com 0,4mg de clonidina (agonista alfa adrenergetico) durante 6 meses. Os resultados revelaram diminuicao do indice menopausal de Kupperman ao fim do sexto mes de tratamento, principalmente as custas dos sintomas vasomotores e parestesia...