ABSTRACT
This narrative review highlights the degree to which new antiobesity medications based on gut-derived nutrient-stimulated hormones (incretins) cause loss of lean mass, and the importance of resistance exercise to preserve muscle. Glucagon-like peptide 1 receptor agonists (GLP-1RA) induce substantial weight loss in randomized trials, effects that may be enhanced in combination with glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Liraglutide and semaglutide (GLP-1RA), tirzepatide (GLP-1 and GIP receptor dual agonist), and retatrutide (GLP-1, GIP, and glucagon receptor triple agonist) are peptides with incretin agonist activity that induce â¼15-24% weight loss in adults with overweight and obesity, alongside beneficial impacts on blood pressure, cholesterol, blood glucose, and insulin. However, these agents also cause rapid and significant loss of lean mass (â¼10% or â¼6 kg), comparable to a decade or more of aging. Maintaining muscle mass and function as humans age is crucial to avoiding sarcopenia and frailty, which are strongly linked to morbidity and mortality. Studies indicate that supervised resistance exercise training interventions with a duration >10 weeks can elicit large increases in lean mass (â¼3 kg) and strength (â¼25%) in men and women. After a low-calorie diet, combining aerobic exercise with liraglutide improved weight loss maintenance compared with either alone. Retaining lean mass during incretin therapy could blunt body weight (and fat) regain on cessation of weight loss pharmacotherapy. We propose that tailored resistance exercise training be recommended as an adjunct to incretin therapy to optimize changes in body composition by preserving lean mass while achieving fat loss.
ABSTRACT
INTRODUCTION: Physical exercise has been used to improve the physiological, metabolic and psychological factors of women. OBJECTIVE: the aim of this study was to compare the 12-week Mat Pilates training-induced effect on climacteric symptoms in hypertensive and normotensive, non-obese postmenopausal women. METHODS: Forty-seven irregularly active, non-obese postmenopausal women participated in the study: 24 normotensive (58 ± 4 years) and 23 hypertensive (58 ± 4 years). They underwent 36 sessions of Mat Pilates in nonconsecutive days during 12 weeks. Climacteric symptoms were assessed by the Cervantes Scale (CER), Menopause Rating Scale (MRS) and Blatt-Kupperman Menopause Index (B-K). The unpaired t-test compared the clinical characteristics between the groups. For the analysis of the questionnaires, the Spearman correlation and Mann-Whitney U test were used to compare the means between the groups for non-parametric data. The generalized estimates equation (GEE) was used to compare the groups and time to score the three general and domain questionnaires. The significance level adopted was É = 0.05. RESULTS: No difference in the Mat Pilates training-induced changes were found between normotensive and hypertensive women, but there was a significant reduction in the scores of the B-K and MRS and in the percentage of disappearance of symptoms by the B-K after training in both groups. Regarding the CER, there was a reduction in symptoms in the total value and the psychological, menopause and health domains. CONCLUSION: The presence of hypertension did not change the 12-week Mat Pilates training-induced benefits on the climacteric symptoms of non-obese postmenopausal women.
Subject(s)
Exercise Movement Techniques , Hypertension , Blood Pressure/physiology , Exercise/physiology , Female , Humans , Hypertension/therapy , PostmenopauseABSTRACT
OBJECTIVE: To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women. METHODS: The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0. RESULTS: The multiple linear regression showed a positive association (p < 0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p < 0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13 ± 7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms. CONCLUSION: There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.
OBJETIVO: Verificar se há correlação entre o índice de massa corporal e os sintomas do climatério em mulheres na pós-menopausa. MéTODOS: Participaram do estudo 109 mulheres na pós-menopausa, com idade média de 57 ± 8 anos, índice de massa corporal (IMC) médio de 30 ± 6 kg/m2 e 8 ± 8 anos após a menopausa. Para a avaliação dos sintomas climatéricos, foram utilizados os questionários específicos para essa população: Índice de Kupperman-Blatt (IKB), Menopause Rating Scale (MRS), e Escala de Cervantes (EC). A análise dos dados foi realizada por meio do teste do chi-quadrado, análise de variância (analysis of variance, ANOVA, em inglês) com o teste post hoc de Bonferroni e regressão linear múltipla. O nível de significância adotado foi p < 0,05. Todas as análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, Estados Unidos), versão 26.0. RESULTADOS: A regressão linear múltipla mostrou associação positiva (p < 0,01) entre os valores do IMC e os sintomas do climatério quando ajustados pela idade e pelo tempo após a menopausa nos 3 questionários utilizados (IKB: B = 0,432; CE: B = 304; e MRS: B = 302). Quanto às pontuações dos sintomas, as mulheres com obesidade apresentaram médias maiores (p < 0,05) quando comparadas às mulheres eutróficas (IKB = 28 ± 10 e 20 ± 10; e MRS = 20 ± 10 e 13 ± 7). Na análise pelo chi-quadrado 28% das mulheres obesas apresentaram sintomas graves, e 46%, moderados, ao passo que apenas 1% e 46% das eutrópicas apresentavam esses mesmos sintomas. CONCLUSãO: Há uma associação entre IMC e sintomas climatéricos, e mulheres com sobrepeso ou obesidade apresentam sintomas mais intensos e moderados do que mulheres eutróficas.
Subject(s)
Menopause , Postmenopause , Aged , Body Mass Index , Female , Humans , Middle Aged , Obesity/complications , Surveys and QuestionnairesABSTRACT
Abstract Objective To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women. Methods The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0. Results The multiple linear regression showed a positive association (p<0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p<0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13±7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms. Conclusion There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.
Resumo Objetivo Verificar se há correlação entre o índice de massa corporal e os sintomas do climatério em mulheres na pós-menopausa. Métodos Participaram do estudo 109 mulheres na pós-menopausa, com idade média de 57± 8 anos, índice de massa corporal (IMC) médio de 30± 6kg/m2 e 8± 8 anos após a menopausa. Para a avaliação dos sintomas climatéricos, foram utilizados os questionários específicos para essa população: Índice de Kupperman-Blatt (IKB), Menopause Rating Scale (MRS), e Escala de Cervantes (EC). A análise dos dados foi realizada por meio do teste do chi-quadrado, análise de variância (analysis of variance, ANOVA, em inglês) com o teste post hoc de Bonferroni e regressão linear múltipla. O nível de significância adotado foi p<0,05. Todas as análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, Estados Unidos), versão 26.0. Resultados A regressão linear múltipla mostrou associação positiva (p < 0,01) entre os valores do IMC e os sintomas do climatério quando ajustados pela idade e pelo tempo após a menopausa nos 3 questionários utilizados (IKB: B = 0,432; CE: B = 304; e MRS: B = 302). Quanto às pontuações dos sintomas, as mulheres com obesidade apresentaram médias maiores (p < 0,05) quando comparadas às mulheres eutróficas (IKB = 28 ± 10 e 20 ± 10; e MRS = 20± 10 e 13 ±7). Na análise pelo chi-quadrado 28% das mulheres obesas apresentaram sintomas graves, e 46%, moderados, ao passo que apenas 1% e 46% das eutrópicas apresentavam esses mesmos sintomas. Conclusão Há uma associação entre IMC e sintomas climatéricos, e mulheres com sobrepeso ou obesidade apresentam sintomas mais intensos e moderados do que mulheres eutróficas.
Subject(s)
Humans , Female , Climacteric , Menopause , ObesityABSTRACT
The aim of this study was to investigate the association between the symptoms and quality of life (QOL) in climacteric with the level and intensity of physical activity (PA), body mass index (BMI), use of menopausal hormone therapy (MHT) and education level. The study was carried out with 641 climacteric women, 56 ± 6 years of age, who completed four questionnaires: Kupperman-Blatt Index (KBI) and Menopause Rating Scale (MRS) to assess climacteric symptoms, the Cervantes Scale (CS) for assess QOL, the International Physical Activity Questionnaire short version (IPAQ) to assess PA and questions about weight, height, use of MHT and level of education. Spearman's correlation was performed in SPSS 26 software and binary logistic regression in Stata 14.0 software, adopting a p < 0.05. Having a university education (KBI = 44%), practicing more than 150 minutes of total PA/week (KBI = 48%) and more than 10 minutes of vigorous PA/week (KBI = 36%) were protective factors for vasomotor symptoms, weakness, headache, paresthesia, vertigo, arthralgia or myalgia, palpitations, tingling and symptoms related to moderate/high mood. Having a normal BMI (CS =4 3%), university level of education (CS = 46%) and practicing more than 150 minutes of total PA/week (CS = 61%) are protective factors for better QOL. For psychological, somatic and urogen-ital symptoms, assessed by MRS, there was no association with exposure factors. Thus, reaching the PA recommendations, having a university education level and having a normal BMI are protective factors for moderate and severe climacteric symptoms and QOL
O objetivo desta pesquisa foi investigar a associação entre os sintomas e qualidade de vida (QDV ) no cli-matério com o nível e intensidade da atividade física (AF), índice de massa corporal (IMC), utilização de terapia hormonal da menopausa (THM) e nível de escolaridade.O estudo foi realizado com 641 mulheres climatéricas, com 56 ± 6 anos de idade, que preencheram o Índice de Kupperman-Blatt (IKB) e Menopause Rating Scale (MRS) para avaliar os sintomas do climatério, a Escala de Cervantes (EC) para avaliar a QDV, o Questionário Internacional de Atividade Física versão curta (IPAQ) para avaliar AF e perguntas sobre peso, estatura, uso de THM e nível de escolaridade. Foi realizado a correlação de Spearman no software SPSS 26 e a regressão logística binária no software Stata 14.0, adotando-se um p < 0,05. Ter nível de escola-ridade universitário (IKB = 44%), praticar mais de 150 minutos de AF total/semana (IKB = 48%) e mais de 10 minutos de AF vigorosa/semana (IKB = 36%), são fatores de proteção para sintomas vasomotores, fraque-za, cefaleia, parestesia, vertigem, artralgia ou mialgia, palpitações, formigamentos e sintomas relacionados ao humor moderado/acentuado. Ter IMC normal (EC = 43%), nível de escolaridade universitário (EC = 46%) e praticar mais de 150 minutos de AF total/semana (EC = 61%), são fatores protetores de proteção para melhor QDV. Para sintomas psicológicos, somáticos e urogenital, avaliados pelo MRS, não houve associação com os fatores de exposição.Assim, atingir as recomendações de AF, ter nível de escolaridade universitário e o IMC normal são fatores de proteção para sintomas climatéricos moderados e acentuados e QDV