Reliability of bioimpedance and indirect calorimetry to evaluate resting metabolic rate in Brazilian women with metabolic syndrome.

BACKGROUND AND AIMS: Precise evaluation of resting metabolic rate (RMR) is critical, especially for seniors in syndromes conditions. The study aimed to compare different methods and devices to evaluate the resting metabolic rate and assess them' reliability in Brazilian women with metabolic syndrome. METHODS: A single-center prospective study with forty elderly postmenopausal women was performed to verify the reliability of indirect calorimetry (IC) versus Bioimpedance (BIA) on RMR fluctuations for an interval length of six months. RESULTS: Measurements showed a high correlation between devices at baseline [BIA vs IC, intraclass correlation coefficient (ICC) = 0.906 (0.822-0.950)]. Surprisingly, a high correlation was kept between BIA and IC after six months [BIA vs. IC, ICC = 0.909 (0.829-0.952)]. The results suggest that both BIA and IC are excellent strategies to measure RMR in elderly postmenopausal women and with metabolic syndrome. CONCLUSIONS: However, the BIA method presents greater convenience, optimizes patients' time, and does not require prolonged fasting to obtain good reliable results compared to IC.

Association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes.

The aim of this study is to evaluate the association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes. A cross-sectional study was carried out with 70 (59.47 ±â€¯6.47 years; 1.56 ±â€¯0.05 m; 73.56 ±â€¯13.01 kg; 30.30 ±â€¯5.00 BMI kg/m2) postmenopausal women with type 2 diabetes (T2D). The blood samples were collected after fasting for 12 h and the main outcome parameters were serum follicle-stimulating hormone (FSH), estradiol; 25-OH vitamin D; insulin; C-Reactive Protein; cholesterol total (CT), triglycerides (TG), high density lipoprotein (HDL-cholesterol), glucose; calcium, HDL-cholesterol. The average serum 25(OH)D level in this study was 28.45 ±â€¯8.26 ng/mL. The prevalence of hypovitaminosis D was 60%. Table 1 displays mean and standard deviation values for participants' characteristics. The postmenopause status of the women studied was confirmed by FSH and estradiol measurement. All the clinical and anthropometric characteristics did not show difference (p > 0.05) between the groups (Table 2). Triglycerides level was highest (p < 0.0391) in the hypovitaminosis D group. The other serum markers did not show statistical differences (p > 0.05) between the groups. In conclusion, our results suggest that only TG level shows a negative correlation with vitamin D status in postmenopausal women with type 2 diabetes.

Can Vitamin D supplementation alone effective to increase a physical fitness levels in post-menopausal women with metabolic disorders? Brief Review.

BACKGROUND: During the climacteric period, occur an aging process of the skin, and promote several decreases in the ability of vitamin D synthesis in an organism and lower levels of Vitamin D may contribute to the appearance of conditions such as osteomalacia, osteoporosis, falls and fractures. AIM: The present brief review focuses on the influence of Vitamin D supplementation alone on physical fitness (strength, endurance, and balance) in postmenopausal with diseases or not. METHODS: Search in Medline and PubMed relevant articles with Vitamin D supplementation alone on physical fitness (strength, endurance, and balance) in postmenopausal with diseases or not, were included only 5 clinical. CONCLUSIONS: In conclusion, the effectiveness depends on the amount was prescribed for supplementation and the patient's characteristics. Doses less than 1000 IU/d did not show significant changes in physical fitness on post-menopausal women with metabolic diseases or not.

Association between muscle function and body composition, vitamin D status, and blood glucose in postmenopausal women with type 2 diabetes.

AIMS: The aim of this study was to examine the association between muscle function, and body composition, vitamin D status, and blood glucose in post-menopausal women with type 2 diabetes (T2D). METHODS: Forty post-menopausal women (62.48±7.67years; 154.6±5.11cm; 73.93±15.43kg; 31.13±5.82 BMI kg/m2) with a diagnosis of T2D participated in this cross-sectional study. The patients performed fasting blood sample exams, anthropometrics assessments, body composition, and clinical exams. Subjects performed physical tests including handgrip, timed up and go, 30-s chair stand, arm curl, and sit-to-stand. The correlation between the parameters of physical tests, age, body composition, vitamin D, and blood glucose was assessed by Pearson correlation. RESULTS: The results showed there were significant correlations between blood glucose and relative strength (R=-0.398, p=0.011), arm curl test (R=-0.367 and p=0.020), and hip flexion (R=0.427, p=0.006). CONCLUSIONS: These findings are important because they highlight the importance of resistance training in individuals with T2D and the relationship with a fat increase during a dicrease process. Furthermore, the concentration of serum glucose might be associated with decreases in muscle strength and muscle function in older adults. Thus, T2D patients should be involved with strength training to improve the strength and the muscle hypertrophy.

Terapia hormonal da menopausa: posicionamento do Departamento de Endocrinologia Feminina e Andrologia da SBEM em 2004 / Hormonal therapy of menopause: 2004 position of the Department of Female Endocrinology and Andrology of the Brazilian Society of Endocrinology and Metabolism

Após os estudos clínicos randomizados produzirem impacto e questionamentos sobre terapia hormonal da menopausa (THM) na comunidade médica, o Departamento de Endocrinologia Feminina e Andrologia da SBEM reuniu um grupo de especialistas para formular um documento informativo, crítico e de posicionamento que pudesse servir de orientação aos que praticam ou opinam sobre tratamento da menopausa. THM está indicada para alívio dos sintomas motores, conservação do trofismo vaginal, preservação de massa óssea e colágeno, melhora do bem estar e sexualidade. Os estudos sobre prevenção cardiovascular primária não são conclusivos, portanto insuficientes para indicar ou deixar de indicar THM com este objetivo. Esquemas e tipos de associação devem ser individualizados. Sempre que possível deve-se optar pelas menores doses eficazes de 17-beta estradiol, associado a progesterona natural ou seus derivados nas mulheres com útero. A duração do tratamento é vinculada a seus objetivos, devendo ser reavaliada periodicamente através de um balanço individual entre indicação e contra-indicação. Orientação quanto a um estilo de vida mais saudável, com eliminação de tabagismo, alimentação adequada em cálcio e pobre em gorduras e atividade física regular são fundamentais como cuidados associados durante a menopausa.

[Hormonal therapy of menopause: 2004 position of the Department of Female Endocrinology and Andrology of the Brazilian Society of Endocrinology and Metabolism]. / Terapia hormonal da menopausa: posicionamento do Departamento de Endocrinologia Feminina e Andrologia da SBEM em 2004.

After randomized clinical trials produced impact and questions at the medical community on menopause hormonal therapy (MHT), the Department of Female Endocrinology and Andrology of the Brazilian Society of Endocrinology convened a group of specialists to produce an informative, critical and position paper, offering guidelines for those who practice or are called to express their opinion on menopause therapy. MHT is indicated for relief of vasomotor symptoms, maintenance of vaginal tropism, bone mass and collagen preservation, sexual and general well-being. Studies on primary cardiovascular prevention are not conclusive, and thus insufficient to indicate or not MHT for this purpose. Schemes and forms of association should de individualized. Whenever possible, one should use 17-beta estradiol, associated to natural progesterone or its derivatives in women with an intact uterus, at the lowest effective doses. Duration of therapy depends on its aims, and should be periodically re-evaluated through an individual indication/contra-indication balance. Orientation toward a healthier lifestyle, with smoking cessation, adequate calcium intake and a low fat diet, together with regular physical activity is fundamental during menopause.

Expressão dos fatores de proliferação celular PCNA e Ki-67 e receptores de estrogênio e progesterona em tecido mamário normal de mulheres na pós-menopausa submetidas a dois esquemas de terapia de reposição hormonal / Expression of cell proliferation factors PCNA and Ki-67 and estrogen and progesterone receptors in normal breast tissue of post-menopause women submitted to two types of hormonal replacement therapy

Foram colhidas amostras de tecido mamário de 32 mulheres saudáveis na pós-menopausa: 19 utilizaram esquema cíclico de estrogênio e pro-gestágeno (estrogênios conjugados 0,625mg, 21 dias por mês, associa-dos ao acetato de medroxiprogesterona, 5mg, nos últimos 12 dias) e 13 tomaram apenas estrogênios (estrogênios conjugados, 0,625mg, 21 dias por mês), todas durante 6 meses consecutivos. Foram realizadas biópsias mamárias antes e ao final dos 6 meses de tratamento. A análise imunohistoquímica foi feita com anticorpos anti-PCNA do tipo PC-10, anti-Ki-67 do tipo MIB-1, anti-receptor de estrogênio do tipo 1-D5 e anti-receptor de progesterona do tipo 1-A6. Não houve diferença significativa para os fatores de mediação (receptores) no grupo que utilizou o esquema cíclico (RE: P = 0,326; RP: P = 0,228). No grupo que utilizou apenas estrogênio, obteve-se um valor de P próximo ao limite de significância estatística para o RP (P = 0,053), mas não para o RE (P = 0,203). Com relação aos fatores de proliferação celular, não foi encontrada diferença estatisticamente significativa para o PCNA em ambos os grupos (esquema cíclico: P = 0,121; estrogênio isolado; P = 0,208). Houve tendência para elevação do Ki-67 no grupo que fez uso de estrogênio apenas (P = 0,084), o que não se observou no grupo que fez uso de esquema cíclico (P = 0,776). Estes resultados sugerem que a associação de progestágeno à terapia estrogênica nesse grupo de mulheres pós-menopausa, pode ter contribuído para uma possível redução na expressão do receptor de progesterona e a proliferação celular, estimada pelo marcador Ki-67, agindo como um fator moderador de proliferação celular. Novos estu-dos são necessários para comprovar esta hipótese.