Modificación de la composición corporal con la terapia hormonal parenteral y oral en la menopausia / Changes in body composition with the use of parenteral and oral hormone therapy in the menopause

Resumen Antecedentes: La menopausia se relaciona con cambios en la composición corporal que el uso de terapia hormonal (TH) puede revertir. Objetivo: Determinar el efecto de la TH parenteral y oral sobre la composición corporal en la menopausia. Material y métodos: Se realizó un estudio retrolectivo que incluyó a 86 mujeres de 45 a 55 años, con FSH > 20 Ul/ml, antecedente de histerectomía y sintomatología vasomotora, a las cuales se les administró TH por vía oral (44 pacientes) o parenteral (42 pacientes) durante seis meses. Se les realizó impedancia bioeléctrica antes y después del tratamiento. Resultados: La TH por vía oral se asoció con una disminución de diferentes parámetros de la composición corporal entre los que destaca la disminución de la grasa visceral (p < 0.05). La TH parenteral no mostró modificación en la composición corporal. Conclusión: La TH por vía oral modifica de manera positiva la composición corporal, lo cual puede contribuir a regular el estado metabólico.

Abstract Background: Menopause is associated with changes in body composition that the use of hormone therapy (HT) can reverse. Objective: To determine the effect of parenteral and oral HT on body composition in menopause. Material and methods: A retrolective study was carried out in 86 women aged 45 to 55 years old, with FSH > 20 Ul/ml, a history of hysterectomy and vasomotor symptoms. The participants received oral HT (44 patients) or parenteral (42 patients) for six months. Bioelectrical impedance was performed before and after treatment. Results: Oral HT was associated with a decrease in different parameters of body composition, among which the decrease in visceral fat stands out (p < 0.05). Parenteral HT did not show changes in body composition. Conclusion: Oral HT positively modifies body composition, which can help regulate the metabolic state.

Relationship between bone remodeling and metabolism in the elderly / Relación entre la actividad ósea y el metabolismo en el adulto mayor

Background: Recent studies have shown that osteocalcin (OC) is related to not only bone metabolism but also energy metabolism. The aim of the present study was to investigate whether OC was associated with metabolic factors and bone mineral density (BMD) in elderly men. Methods: A cross-sectional study was done including 122 healthy men aged 60 years or older. Serum glucose, lipids, insulin, adiponectin and OC were measured and BMD was estimated using dual energy X-ray absorptiometry. Results: 42.8% of men had metabolic syndrome (MetS). OC levels were not significantly different between men with and without MetS. OC concentrations were inversely associated with body mass index (BMI) (r = −0.226, p = 0.04), waist circumference (r = −0.261, p = 0.02), glucose (r = −0.245, p = 0.03), insulin (r = −0.235, p = 0.03), and HOMA-IR (r = −0.211, p = 0.04). In addition, OC levels were higher in patients with diminished BMD compared with those with normal BMD. Conclusions: OC levels correlate negatively with BMI, waist circumference, glucose, insulin and HOMA-IR in elderly men, which suggests a connection between bone and energy metabolism.

Introducción: diversos estudios sugieren que la osteocalcina (OC) contribuye no solo a la regulación del metabolismo óseo, sino también al metabolismo energético. El objetivo del trabajo fue evaluar la relación entre la concentración sérica de OC y los parámetros metabólicos y la densidad mineral ósea (DMO) en adultos mayores. Métodos: estudio transversal descriptivo en 122 hombres sanos mayores de 60 años. Se les determinó glucosa, lípidos, insulina, adiponectina y OC. La DMO se analizó por absorciometría de doble fotón. Resultados: el 42.8% de la muestra presentó síndrome metabólico (SM). Los niveles de OC no difirieron entre el grupo de pacientes con y sin SM. Se observó una correlación negativa entre la concentración de OC y el índice de masa corporal (IMC) (r = −0.226, p = 0.04), circunferencia de cintura (r = −0.261, p = 0.02), glucosa (r = −0.245, p = 0.03), insulina (r = −0.235, p = 0.03) y HOMA-IR (r = −0.211, p = 0.04). Los pacientes con DMO disminuida mostraron una concentración significativamente mayor de OC en comparación con aquellos con DMO normal. Conclusiones: la OC se asoció inversamente con el IMC, la obesidad abdominal, la glucosa, la insulina y la resistencia a la insulina en hombres mayores de 60 años. Lo anterior confirma la conexión que existe entre el tejido óseo y el metabolismo.

Menopausal women have hypofibrinolysis even in subclinical stage of atherosclerosis.

BACKGROUND: PAI-1 is the main inhibitor of fibrinolysis. Increase in PAI-1 levels has been associated with the risk of coronary disease; however, there are few studies on the relationship between subclinical atherosclerosis and PAI-1 levels. OBJECTIVE: The aim of this study was to analyze the relationship between PAI-1 level and carotid intima-media thickness in premenopausal and postmenopausal women without apparent cardiovascular disease. MATERIAL AND METHODS: A cross-sectional study was conducted in 142 women aged 45 to 60 years with no history of cardiovascular disease. Anthropometric and laboratory measurements were performed, including PAI-1 levels. All participants underwent a B-Mode ultrasound to measure intima-media thickness. Subclinical atherosclerosis was considered when intima-media thickness was ≥ 0.7 mm and/or an atheromatous plaque was observed. RESULTS: Postmenopausal women had greater intima-media thickness than premenopausal women (0.688 ± 0.129 vs. 0.621 ± 0.113 mm; p < 0.05). Compared to women with normal intima-media thickness, women with subclinical atherosclerosis had higher PAI-1 levels (23.2 ± 13.7 vs. 30.4 ± 20.7 ng/ml; p < 0.05). In all participants, intima-media thickness correlated with PAI-1 (r = 0.302; p = 0.01) and with age (r = 0.358; p = 0001). CONCLUSIONS: An increase in intima-media thickness was observed in postmenopausal women compared with premenopausal women. Asymptomatic women with increased intima-media thickness had higher PAI-1 levels. These findings suggest that fibrinolytic activity is low in the subclinical stage of atherosclerosis.

La grasa epicárdica se relaciona con la visceral, el síndrome metabólico y la resistencia a la insulina en mujeres menopáusicas / Epicardial Adipose Tissue Is Associated With Visceral Fat, Metabolic Syndrome, and Insulin Resistance in Menopausal Women

Introducción y objetivos El tejido adiposo epicárdico se ha asociado con diversos índices de adiposidad y resistencia a insulina. La medición de este tejido por ecocardiografía se considera una herramienta útil y accesible para valorar factores de riesgo cardiometabólico; no obstante, aún no existen suficientes estudios en mujeres posmenopáusicas, que es una etapa en la que se presenta un incremento del riesgo cardiovascular. El objetivo del estudio es analizar la relación entre las mediciones del tejido adiposo epicárdico y tejido adiposo visceral, perímetro de cintura, índice de masa corporal y resistencia a insulina en mujeres posmenopáusicas.MétodosEstudio transversal comparativo en 34 mujeres posmenopáusicas con y sin síndrome metabólico a las que se realizó ecocardiograma transtorácico y análisis de composición corporal.ResultadosSe encontró asociación positiva de las medidas de grasa epicárdica con el tejido adiposo visceral, el índice de masa corporal y el perímetro de cintura; en el surco aortoventricular derecho, las correlaciones fueron r = 0,505 (p < 0,003), r = 0,545 (p < 0,001) y r = 0,515 (p < 0,003) respectivamente. También se observó que las mujeres posmenopáusicas con síndrome metabólico presentaban aumento del tejido adiposo epicárdico en comparación con las que no tienen el síndrome (544,2 ± 122,9 frente a 363,6 ± 162,3 mm2; p = 0,03).ConclusionesEl tejido adiposo epicárdico medido por ecocardiografía se asocia con el tejido adiposo abdominal y corporal en las mujeres posmenopáusicas. Las posmenopáusicas con síndrome metabólico presentan mayor cantidad de grasa epicárdica. La medición del tejido adiposo epicárdico por ecocardiografía puede ser un método de utilidad para evaluar el riesgo cardiovascular en la posmenopausia (AU)

Introduction and objectives Epicardial adipose tissue has been associated with several obesity-related parameters and with insulin resistance. Echocardiographic assessment of this tissue is an easy and reliable marker of cardiometabolic risk. However, there are insufficient studies on the relationship between epicardial fat and insulin resistance during the postmenopausal period, when cardiovascular risk increases in women. The objective of this study was to examine the association between epicardial adipose tissue and visceral adipose tissue, waist circumference, body mass index, and insulin resistance in postmenopausal women.MethodsA cross sectional study was conducted in 34 postmenopausal women with and without metabolic syndrome. All participants underwent a transthoracic echocardiogram and body composition analysis.ResultsA positive correlation was observed between epicardial fat and visceral adipose tissue, body mass index, and waist circumference. The values of these correlations of epicardial fat thickness overlying the aorta-right ventricle were r = 0.505 (P < .003), r = 0.545 (P < .001), and r = 0.515 (P < .003), respectively. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome than in those without this syndrome (mean [standard deviation], 544.2 [122.9] vs 363.6 [162.3] mm2; P = .03).ConclusionsEpicardial fat thickness measured by echocardiography was associated with visceral adipose tissue and other obesity parameters. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome. Therefore, echocardiographic assessment of epicardial fat may be a simple and reliable marker of cardiovascular risk in postmenopausal women (AU)

Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women.

INTRODUCTION AND OBJECTIVES: Epicardial adipose tissue has been associated with several obesity-related parameters and with insulin resistance. Echocardiographic assessment of this tissue is an easy and reliable marker of cardiometabolic risk. However, there are insufficient studies on the relationship between epicardial fat and insulin resistance during the postmenopausal period, when cardiovascular risk increases in women. The objective of this study was to examine the association between epicardial adipose tissue and visceral adipose tissue, waist circumference, body mass index, and insulin resistance in postmenopausal women. METHODS: A cross sectional study was conducted in 34 postmenopausal women with and without metabolic syndrome. All participants underwent a transthoracic echocardiogram and body composition analysis. RESULTS: A positive correlation was observed between epicardial fat and visceral adipose tissue, body mass index, and waist circumference. The values of these correlations of epicardial fat thickness overlying the aorta-right ventricle were r = 0.505 (P < .003), r = 0.545 (P < .001), and r = 0.515 (P < .003), respectively. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome than in those without this syndrome (mean [standard deviation], 544.2 [122.9] vs 363.6 [162.3] mm(2); P = .03). CONCLUSIONS: Epicardial fat thickness measured by echocardiography was associated with visceral adipose tissue and other obesity parameters. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome. Therefore, echocardiographic assessment of epicardial fat may be a simple and reliable marker of cardiovascular risk in postmenopausal women.