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1.
Obstet Gynecol ; 137(3): 423-429, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33543899

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), uses two primary receptors, type II transmembrane serine protease and angiotensin-converting enzyme-2, for priming and cellular invasion, respectively. Both proteins have been demonstrated to be present in different concentrations in females and males, which may explain a mechanism for the reported higher case-fatality rate in males. Despite the known sex difference in COVID-19 disease mortality, preliminary data suggest there are certain female populations, including pregnant and menopausal women and possibly polycystic ovarian syndrome patients who are more susceptible to COVID-19-related morbidity. This commentary analyzes the interplay between sex differences, hormones, and the immune function in each of these populations with respect to the risk and severity of COVID-19 and proposes biological rationales to explain these differences.


Assuntos
/epidemiologia , Predisposição Genética para Doença , /genética , Cromossomos Humanos X , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Menopausa/fisiologia , Morbidade , Síndrome do Ovário Policístico/epidemiologia , Gravidez , Serina Endopeptidases/genética , Fatores Sexuais
2.
Nat Rev Endocrinol ; 17(1): 47-66, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33173188

RESUMO

Obesity is associated with many adverse health effects, such as an increased cardiometabolic risk. Despite higher adiposity for a given BMI, premenopausal women are at lower risk of cardiometabolic disease than men of the same age. This cardiometabolic advantage in women seems to disappear after the menopause or when type 2 diabetes mellitus develops. Sexual dimorphism in substrate supply and utilization, deposition of excess lipids and mobilization of stored lipids in various key metabolic organs (such as adipose tissue, skeletal muscle and the liver) are associated with differences in tissue-specific insulin sensitivity and cardiometabolic risk profiles between men and women. Moreover, lifestyle-related factors and epigenetic and genetic mechanisms seem to affect metabolic complications and disease risk in a sex-specific manner. This Review provides insight into sexual dimorphism in adipose tissue distribution, adipose tissue, skeletal muscle and liver substrate metabolism and tissue-specific insulin sensitivity in humans, as well as the underlying mechanisms, and addresses the effect of these sex differences on cardiometabolic health. Additionally, this Review highlights the implications of sexual dimorphism in the pathophysiology of obesity-related cardiometabolic risk for the development of sex-specific prevention and treatment strategies.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Obesidade/fisiopatologia , Caracteres Sexuais , Tecido Adiposo/fisiopatologia , Animais , Feminino , Humanos , Resistência à Insulina/fisiologia , Fígado/metabolismo , Fígado/fisiopatologia , Masculino , Menopausa/fisiologia , Músculo Esquelético/fisiopatologia , Obesidade/complicações , Fatores de Risco
3.
Maturitas ; 143: 209-215, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308631

RESUMO

OBJECTIVE: To examine the association of adverse childhood experiences (ACEs) with overall menopausal symptom burden in midlife women. STUDY DESIGN: This was a cross-sectional study of women between the ages of 40 and 65 years who were seen for specialty consultation in the Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN between May 1, 2015 and December 31, 2016. MAIN OUTCOME MEASURES: Participants completed the ACE questionnaire to assess childhood abuse and neglect, the Menopause Rating Scale (MRS) to assess menopausal symptom burden, the Patient Health Questionnaire (PHQ-9) to assess depression, the Generalized Anxiety Disorder questionnaire (GAD-7) to assess anxiety, and provided information on current abuse (physical, sexual and verbal/emotional). RESULTS: Women meeting inclusion criteria (N = 1670) had a median age of 53.7 years (interquartile range: 49.1, 58.0). Of these women, 977 (58.5 %) reported any ACE and 288 (17.2 %) reported ≥4 ACEs. As menopausal symptoms increased in severity from the first to fourth quartile, the odds ratio of ACE 1-3 (vs. 0) increased from 1 to 2.50 (trend p < 0.01), and the odds ratio of ACE ≥ 4 (vs. 0) increased from 1 to 9.61 (trend p < 0.01), a pattern that was consistent across all menopausal symptom domains. The association between severe menopausal symptoms and higher childhood adversity (ACE score 1-3 or ≥4 vs. ACE = 0) remained significant after adjusting for age, partner status, education, employment, depression, anxiety, and hormone therapy use (OR 1.84 and 4.51, p < 0.01). CONCLUSION: In this large cross-sectional study, there was a significant association between childhood adversity and self-reported menopausal symptoms that persisted even after adjustment for multiple confounders. These associations highlight the importance of screening women with bothersome menopausal symptoms for childhood adversity, and of offering appropriate management and counseling for the adverse experiences, when indicated.


Assuntos
Experiências Adversas da Infância , Envelhecimento , Menopausa , Adulto , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Ansiedade/epidemiologia , Criança , Maus-Tratos Infantis , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Menopausa/fisiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Sexualidade
4.
Maturitas ; 143: 36-40, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308634

RESUMO

This review considers the persistent vasomotor symptoms (VMS) of menopause-hot flashes-from the perspective of older women. Although these symptoms are most prevalent in younger women during the menopause transition and recent postmenopausal years, emerging data, corroborated by clinical experience, support the observation that for some women, VMS can remain bothersome into advanced age. Most clinical guidance focuses on treating VMS in younger women because of the concerns of increasing cardiovascular disease (CVD) risks and possibly dementia when menopausal hormone therapies (MHT) are initiated at more advanced ages. Furthermore, recent studies into the physiology of VMS suggest a potential link with endothelial dysfunction and evidence of increased subclinical CVD and CVD events. Clinical trials have reported that older women with VMS have markedly increased CVD risk in response to oral MHT initiation compared with asymptomatic women. Nonhormonal treatment options are available for those who elect not to use, or are advised not to use, menopausal hormone therapies. As the global population ages, more research is needed to clarify the physiology of VMS in older women, suggest optimal approaches to enhance awareness of potential health risks of VMS, and recommend strategic management of VMS in older women, with the goal of promoting health and maintaining quality of life.


Assuntos
Menopausa/fisiologia , Sistema Vasomotor , Envelhecimento/fisiologia , Feminino , Humanos
5.
Maturitas ; 141: 1-8, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33036697

RESUMO

OBJECTIVE: Our study aims to investigate the differences in insomnia between Chinese and Western women during menopause to fill the gaps in the research on menopause in Chinese women, and to examine the premenopausal factors predictive of moderate to severe insomnia during menopause. STUDY DESIGN: This is a longitudinal cohort study conducted in an urban Chinese community with a total of 458 participants. MAIN OUTCOME MEASURES: Presence of insomnia symptoms (trouble falling asleep, waking up early); vasomotor symptoms; anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and menopausal stages. RESULTS: Multivariable analysis showed that compared with that in premenopause, the prevalence of trouble falling asleep was significantly higher in menopausal transition (P = 0.029) and postmenopause (P < 0.001), and the prevalence of early-morning awakenings also significantly increased in menopausal transition (P = 0.003) and postmenopause (P = 0.011). In multivariable analysis anxiety (P = 0.022) and depression (P = 0.005) were independently and significantly positively associated with trouble falling asleep. Anxiety (P < 0.001), depression (P = 0.018), and levels of follicle stimulating hormone (P-0.031) were independently and significantly positively associated with trouble falling asleep. Women who experienced insomnia in premenopause had a significantly higher risk of moderate to severe insomnia in menopausal transition (P = 0.003) and postmenopause (P = 0.047) than those who did not. CONCLUSION: This study showed that the prevalence of sleep disturbance significantly increased during and after menopause. Women with anxiety and depression had a higher risk of insomnia. Difficulty in sleep initiation in the premenopausal period was a strong predictor of moderate to severe insomnia at menopausal transition and postmenopause.


Assuntos
Ansiedade/fisiopatologia , Depressão/fisiopatologia , Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sono , Adulto , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos de Coortes , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Estudos Longitudinais , Menopausa/fisiologia , Pessoa de Meia-Idade , Perimenopausa , Pós-Menopausa , Pré-Menopausa , Prevalência , Fatores de Risco , Transtornos do Sono-Vigília
6.
Medicine (Baltimore) ; 99(36): e22048, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899065

RESUMO

Owing to hormonal changes, women experience various psychophysiological alterations over a wide age range, which may result in decreased quality of life as well as in increased risks of diseases, such as cardiovascular diseases. Although studies have been performed to research complementary methods, such as meditation, the research field still requires an adequate amount of studies for public health guidelines. This pilot cross-sectional study aims to investigate a potential association of meditation with menopausal symptoms and blood chemistry for healthy women. In this study, data of 65 healthy women (age range 25-67) including 33 meditation practitioners and 32 meditation-naïve controls were analyzed to compare the Menopausal Rating Scale scores and blood chemistry with 7 more dropouts in the blood chemistry. For blood chemistry, nine components including glucose (GLU) and high-density lipoprotein cholesterol (HDL) were measured. Two-way analysis of variance was performed by dividing the total participants into 2 groups: premenopausal and postmenopausal participants. Compared to the control group, the meditation group showed a trend of reductions in the Menopausal Rating Scale total score (P = .054) and its 2 subcomponents: depressive mood (P = .064) and irritability (P = .061). In HDL level, there was a significant interaction between group and menopausal state (P = .039) with following post hoc results: among the premenopausal participants, a significant increase in the meditation group compared to the control group (P = .005); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .030). In GLU level, there was a mild interaction between group and menopausal state (P = .070) with following post hoc results: among the postmenopausal participants, a trend of increase in the control group compared to the meditation group (P = .081); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .040). Our research suggests a potential association of practicing meditation with alleviations in menopausal symptoms and changes in blood chemistry, warranting further studies with a longitudinal study design and larger populations to understand the underlying causal relationships.


Assuntos
Análise Química do Sangue/métodos , Meditação/métodos , Menopausa/sangue , Menopausa/psicologia , Adulto , Glicemia , Estudos de Casos e Controles , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Pós-Menopausa/psicologia , Pré-Menopausa/sangue , Pré-Menopausa/psicologia , Qualidade de Vida
7.
Hautarzt ; 71(10): 786-790, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32852599

RESUMO

Topical hormonal treatment allows anti-aging of the skin when used during and after the menopause without an increase in the blood level of hormones. Natural hormones are only prescribed by medical doctors. In controlled clinical studies versus placebo and application for months, an increase in skin quality parameters, reduction of dryness, increase of glycosaminoglycanes, increase in elastic fibers und increase of collagen precursers and collagen fibers on the mRNA and protein level could be shown, the latter proven by biopsies. Skin with dramatic sun-damage does not respond to this treatment option. Patients with melasma or seborrhoe should not be treated with hormonal topical preparations. Compared to the natural hormones, phytotherapeutics do not bind to hormone receptors in relevant levels. Growth hormones should not be used in anti-aging treatment due to a potential carcinogenic effect.


Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Menopausa/fisiologia , Envelhecimento da Pele/efeitos dos fármacos , Pele/efeitos dos fármacos , Administração Tópica , Envelhecimento , Feminino , Humanos , Pele/anatomia & histologia , Pele/metabolismo
8.
Medicine (Baltimore) ; 99(28): e20847, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664078

RESUMO

High-grade ductal carcinoma in situ (DCIS) requires resection due to the high risk of developing invasive breast cancer. The predictive powers of noninvasive predictors for high-grade DCIS remain contradictory. This study aimed to explore the predictive value of calcification for high-grade DCIS in Chinese patients.This was a retrospective study of Chinese DCIS patients recruited from the Women's Hospital, School of Medicine, Zhejiang University between January and December 2018. The patients were divided into calcification and non-calcification groups based on the mammography results. The correlation of calcification with the pathologic stage of DCIS was evaluated using the multivariable analysis. The predictive value of calcification for DCIS grading was examined using the receiver operating characteristics (ROC) curve.The pathologic grade of DCIS was not associated with calcification morphology (P = .902), calcification distribution (P = .252), or breast density (P = .188). The multivariable analysis showed that the presence of calcification was independently associated with high pathologic grade of DCIS (OR = 3.206, 95% CI = 1.315-7.817, P = .010), whereas the age, hypertension, menopause, and mammography BI-RADS were not (all P > .05) associated with the grade of DCIS. The ROC analysis of the predictive value of calcification for DCIS grading showed that the area under the curve was 0.626 (P = .019), with a sensitivity of 73.1%, specificity of 52.2%, positive predictive value of 72.2%, and negative predictive value of 53.3%.The presence of calcification is independently associated with high pathologic grade of DCIS and could predict high-grade DCIS in Chinese patients.


Assuntos
Neoplasias da Mama/patologia , Calcinose/patologia , Carcinoma Intraductal não Infiltrante/patologia , Gradação de Tumores/métodos , Adulto , Fatores Etários , Grupo com Ancestrais do Continente Asiático/etnologia , Neoplasias da Mama/diagnóstico por imagem , Calcinose/classificação , Carcinoma Intraductal não Infiltrante/etnologia , Feminino , Humanos , Hipertensão/epidemiologia , Mamografia/métodos , Menopausa/fisiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
9.
PLoS One ; 15(6): e0235478, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603379

RESUMO

OBJECTIVE: Most women live to experience menopause and will spend 4-8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers. METHODS: Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17ß-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC). RESULTS: The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90-0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83-0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women. CONCLUSIONS: The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials.


Assuntos
Envelhecimento/fisiologia , Menopausa/fisiologia , Adulto , Idoso , Estudos de Coortes , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Perimenopausa , Pós-Menopausa , Reprodução/fisiologia , Inquéritos e Questionários/estatística & dados numéricos
10.
Exp Anim ; 69(4): 395-406, 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-32493884

RESUMO

Gender and menopause influence the severity and development manner of nonalcoholic steatohepatitis (NASH). Male p62/Sqstm1 and nuclear factor E2-related factor-2 (p62 and Nrf2) double-knockout (DKO) mice exhibit severe steatohepatitis caused by hyperphagia-induced obesity, overload of lipopolysaccharide (LPS) into the liver, and potentiation of the inflammatory response in Kupffer cells. However, the pathogenetic phenotype of steatohepatitis in female DKO mice remains unknown. Phenotypic changes of steatohepatitis in DKO mice were compared in terms of gender differences. Compared with DKO male mice, DKO female mice exhibited later onset of steatohepatitis with obesity after 30 weeks of age, as well as milder severity of hepatic inflammation and fibrosis. Serum estradiol was higher in female than male mice, with levels increasing up to 30 weeks of age before decreasing until 50 weeks of age (corresponding to the post-menopausal period). Fecal and serum LPS were lower in female mice than male mice, and inflammatory signaling in the liver was attenuated in female compared with male mice. Correlating with LPS levels, the composition of intestinal microbiota in female mice was different from male mice. Gender differences were observed for the development of steatohepatitis in DKO mice. Low-grade inflammatory hit in the liver under in vivo conditions of high estradiol may be attributable to the milder pathological features of steatohepatitis in female mice.


Assuntos
Estradiol/fisiologia , Fígado Gorduroso/genética , Menopausa/fisiologia , Camundongos Knockout/genética , Fator 2 Relacionado a NF-E2/genética , Proteína Sequestossoma-1/genética , Caracteres Sexuais , Animais , Fígado Gorduroso/etiologia , Fígado Gorduroso/patologia , Feminino , Fibromialgia , Hiperfagia/complicações , Inflamação , Lipopolissacarídeos/efeitos adversos , Lipopolissacarídeos/metabolismo , Fígado/patologia , Masculino , Obesidade/complicações
11.
Nutr. hosp ; 37(3): 506-513, mayo-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193858

RESUMO

OBJETIVO: evaluar hábitos alimentarios, estilo de vida, composición corporal y prevalencia del síndrome metabólico en mujeres menopáusicas según su índice de masa corporal. MÉTODOS: estudio transversal (2011-2018) en una cohorte de mujeres menopáusicas residentes en Mallorca (n = 555) clasificadas según su índice de masa corporal (IMC): < 27,0, 27,0-29,9 y ≥ 30 kg/m2. Se evaluaron hábitos alimentarios, tóxicos y de estilo de vida, antecedentes de lactancia materna y de obesidad (en la infancia, tiempo de evolución y antecedentes familiares). Se realizó análisis de composición corporal por bioimpedancia eléctrica y se extrajo sangre en ayunas para los siguientes parámetros: glucosa, triglicéridos, colesterol total, colesterol-LDL y colesterol-HDL. RESULTADOS: la prevalencia de sobrepeso de grado II fue 26,8 % y de obesidad, del 46,5 %. La prevalencia de síndrome metabólico fue 41,4 %. Los antecedentes familiares de obesidad, obesidad en la infancia y el tiempo de evolución (≥ 15 años con obesidad) fueron mayores en mujeres obesas. La práctica de actividad física regular fue deficiente (el 63 % de las mujeres con actividad física nula y el 33 %, escasa). Las mujeres obesas presentaron una prevalencia mayor de síndrome metabólico (55,8 %) y valores mayores de IMC, circunferencia abdominal, masa grasa, grasa visceral, obesidad abdominal, tensión arterial, glucosa y triglicéridos en sangre, y valores menores de c-HDL. CONCLUSIONES: las mujeres menopáusicas estudiadas muestran hábitos dietéticos inadecuados, estilo de vida sedentario y una prevalencia elevada de obesidad y síndrome metabólico. Los factores que se asocian a dicha prevalencia son antecedentes familiares de obesidad, obesidad en la infancia, tiempo de evolución de la obesidad, sedentarismo, obesidad abdominal y localización visceral de la grasa


OBJECTIVE: to assess eating habits, lifestyle, body composition and prevalence of Metabolic Syndrome in menopausal women evaluated according to body mass index. METHODS: cross-sectional study (2011-2018) in a cohort of menopausal women living in Mallorca (n = 555) classified according to body mass index (BMI) : < 27.0, 27.0-29.9 and ≥ 30 kg/m2. Eating habits, toxic and lifestyle, history of breastfeeding and obesity (in childhood, time of evolution and family history) were evaluated. A body composition analysis was performed by electrical bioimpedance and fasting blood was taken for the following parameters: glucose, triglycerides, total cholesterol, LDL-cholesterol and HDL-cholesterol. RESULTS: the prevalence of overweight grade II was 26.8 % and of obesity 46.5 %. The prevalence of metabolic syndrome was 41.4 %. A family history of obesity, childhood obesity and the time of evolution (≥ 15 years with obesity) were higher in obese women. The practice of regular physical activity was low (63 % of women with null and 33 % scarce physical activity). Obese women had a higher prevalence of metabolic syndrome (55.8 %) and higher values of BMI, abdominal circumference, fat mass, visceral fat, abdominal obesity, blood pressure, glucose and triglycerides in blood, but lower values of HDL-c. CONCLUSIONS: the studied cohort of menopausal women showed inadequate dietary habits, sedentary lifestyle and a high prevalence of obesity and metabolic syndrome. The factors associated with this prevalence are family history of obesity, childhood obesity, time of evolution of obesity, sedentary lifestyle, abdominal obesity and visceral location of fat


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Síndrome Metabólica/epidemiologia , Composição Corporal/fisiologia , Menopausa/fisiologia , Estudos de Coortes , Obesidade Abdominal/dietoterapia , Estudos Transversais , Índice de Massa Corporal , Estilo de Vida , Comportamento Sedentário , Dietética/estatística & dados numéricos , Antropometria
12.
Invest Ophthalmol Vis Sci ; 61(5): 16, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32407519

RESUMO

Purpose: Glaucoma is the second leading cause of blindness worldwide. Recent work suggests that estrogen and the timing of menopause play a role in modulating the risk of developing glaucoma. Menopause is known to cause modest changes in intraocular pressure; yet, whether this change is mediated through the outflow pathway remains unknown. Menopause also affects tissue biomechanical properties throughout the body; however, the impact of menopause on ocular biomechanical properties is not well characterized. Methods: Here, we simultaneously assessed the impact of menopause on aqueous outflow facility and ocular compliance, as a measure of corneoscleral shell biomechanics. We used young (3-4 months old) and middle-aged (9-10 months old) Brown Norway rats. Menopause was induced by ovariectomy (OVX), and control animals underwent sham surgery, resulting in the following groups: young sham (n = 5), young OVX (n = 6), middle-aged sham (n = 5), and middle-aged OVX (n = 5). Eight weeks postoperatively, we measured outflow facility and ocular compliance. Results: Menopause resulted in a 34% decrease in outflow facility and a 19% increase in ocular compliance (P = 0.011) in OVX animals compared with sham controls (P = 0.019). Conclusions: These observations reveal that menopause affects several key physiological factors known to be associated with glaucoma, suggesting that menopause may contribute to an increased risk of glaucoma in women.


Assuntos
Envelhecimento/fisiologia , Humor Aquoso/metabolismo , Pressão Intraocular/fisiologia , Menopausa/fisiologia , Animais , Feminino , Modelos Animais , Modelos Estatísticos , Perfusão , Ratos
13.
J Clin Neurosci ; 77: 157-162, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32387254

RESUMO

Menopause leads to fluctuations in androgenic hormones which directly affect bone metabolism. Bone resorption, mineralization, and remodeling at fusion sites are essential in order to obtain a solid and biomechanically stable fusion mass. Bone metabolic imbalance seen in the postmenopausal state may predispose to fusion related complications. The aim of this study was to investigate fusion outcomes in lumbar spinal fusion surgery in women based on menopausal status. A retrospective analysis of all female patients who underwent posterior lumbar decompression and fusion at a single institution from 2013 to 2017 was performed. A total of 112 patients were identified and stratified into premenopausal (n = 25) and postmenopausal (n = 87) groups. Clinical and radiographic data was assessed at 1 year follow up. Postmenopausal patients had a higher rates of pseudarthrosis (11.63% vs 0%, p = 0.08), PJK (15.1% vs 4%, p = 0.14), and revision surgery (3.5% vs 0%, p = 0.35). The number of levels fused was associated with increased risk of pseudarthrosis (OR 1.4, p = 0.02); however, there was no association between age, hormonal use, prior tobacco use, or T-score. Age was associated with increased risk of developing PJK (OR = 1.11, p = 0.01); however, PJK was not associated with menopause, hormonal use, prior tobacco use, or T-score. Revision surgery was not associated with age, hormonal use, prior tobacco use, or T-score. This study suggests that postmenopausal women may be prone to have higher rates of pseudarthrosis, PJK and revision surgery, although our results were not statistically significant. Larger studies with longer follow up will help elucidate the true effects of menopause in spine surgery.


Assuntos
Descompressão Cirúrgica/efeitos adversos , Cifose/cirurgia , Menopausa/fisiologia , Complicações Pós-Operatórias/epidemiologia , Pseudoartrose/epidemiologia , Fusão Vertebral/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Cifose/epidemiologia , Vértebras Lombares/cirurgia , Pessoa de Meia-Idade
14.
Am J Physiol Heart Circ Physiol ; 318(6): H1461-H1473, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32383991

RESUMO

There is a sharp rise in cardiovascular disease (CVD) risk and progression with the onset of menopause. The 4-vinylcyclohexene diepoxide (VCD) model of menopause recapitulates the natural, physiological transition through perimenopause to menopause. We hypothesized that menopausal female mice were more susceptible to CVD than pre- or perimenopausal females. Female mice were treated with VCD or vehicle for 20 consecutive days. Premenopausal, perimenopausal, and menopausal mice were administered angiotensin II (ANG II) or subjected to ischemia-reperfusion (I/R). Menopausal females were more susceptible to pathological ANG II-induced cardiac remodeling and cardiac injury from a myocardial infarction (MI), while perimenopausal, like premenopausal, females remained protected. Specifically, ANG II significantly elevated diastolic (130.9 ± 6.0 vs. 114.7 ± 6.2 mmHg) and systolic (156.9 ± 4.8 vs. 141.7 ± 5.0 mmHg) blood pressure and normalized cardiac mass (15.9 ± 1.0 vs. 7.7 ± 1.5%) to a greater extent in menopausal females compared with controls, whereas perimenopausal females demonstrated a similar elevation of diastolic (93.7 ± 2.9 vs. 100.5 ± 4.1 mmHg) and systolic (155.9 ± 7.3 vs. 152.3 ± 6.5 mmHg) blood pressure and normalized cardiac mass (8.3 ± 2.1 vs. 7.5 ± 1.4%) compared with controls. Similarly, menopausal females demonstrated a threefold increase in fibrosis measured by Picrosirus red staining. Finally, hearts of menopausal females (41 ± 5%) showed larger infarct sizes following I/R injury than perimenopausal (18.0 ± 5.6%) and premenopausal (16.2 ± 3.3, 20.1 ± 4.8%) groups. Using the VCD model of menopause, we provide evidence that menopausal females were more susceptible to pathological cardiac remodeling. We suggest that the VCD model of menopause may be critical to better elucidate cellular and molecular mechanisms underlying the transition to CVD susceptibility in menopausal women.NEW & NOTEWORTHY Before menopause, women are protected against cardiovascular disease (CVD) compared with age-matched men; this protection is gradually lost after menopause. We present the first evidence that demonstrates menopausal females are more susceptible to pathological cardiac remodeling while perimenopausal and cycling females are not. The VCD model permits appropriate examination of how increased susceptibility to the pathological process of cardiac remodeling accelerates from pre- to perimenopause to menopause.


Assuntos
Remodelamento Atrial/fisiologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , Cicloexenos , Menopausa/fisiologia , Compostos de Vinila , Angiotensina II , Animais , Doenças Cardiovasculares/induzido quimicamente , Feminino , Camundongos , Modelos Animais
15.
Complement Ther Clin Pract ; 39: 101150, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32379682

RESUMO

OBJECTIVES: The objective of this review was to evaluate systematically the effectiveness of Lavender aromatherapy on physical and psychological symptoms in menopausal women. METHODS: A comprehensive systematic literature search in the electronic databases including the Cochrane Library, MEDLINE (PubMed), Ovid, Embase, Scopus, ProQuest, Web of science, and Google scholar, as well as Magiran, SID, and Irandoc for Persian literature review up to January 2020. All Randomized controlled trials, and quasi-experimental studies that evaluated the impact of aromatherapy with lavender alone or in combination with other aromas on physical and psychological symptoms in menopausal women were included in this systematic review. RESULTS: Sixteen interventional studies consisted of 1092 postmenopausal women included in systematic review. Eight of eligible studies with 493 participants included in meta-analysis. There were significant between group differences in menopausal symptoms (standardized mean difference (SMD) = -1.39, 95% confidence interval (CI): 1.98 to -0.80, I2 = 76%; four trials, 236 participants); sleep quality score (SMD = -2.16, 95%CI: -3.77 to -0.54, I2 = 95%; three studies, 199 participants); systolic blood pressure (MD = -5.34 mmHg, 95% CI: -7.40 to -3.29, I2 = 10%; two study, 114 participants); diastolic blood (MD = -5.06 mmHg, 95% CI: -7.55 to -2.57, I2 = 0%; two study, 114 participants). Aromatherapy had positive effect on sexual function, self-esteem, anxiety, hot flash, but it had negative impact on triglyceride and high density lipoprotein compared to placebo (p < 0.05). CONCLUSIONS: Aromatherapy with Lavender in postmenopausal women may cause an improvement in most of physical and psychological symptoms. Further high quality studies especially with focus on the adverse events are suggested globally.


Assuntos
Aromaterapia/métodos , Lavandula , Menopausa/fisiologia , Menopausa/psicologia , Ansiedade/terapia , Pressão Sanguínea , Ensaios Clínicos como Assunto , Feminino , Fogachos/terapia , Humanos , Lipídeos/sangue , Autoimagem , Sono , Triglicerídeos
16.
Neurobiol Aging ; 92: 61-72, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32388179

RESUMO

In the Look AHEAD trial, randomization to Intensive Lifestyle Intervention (ILI) or Diabetes Support and Education (DSE) did not result in differences in cognitive outcomes. However, menopause and APOE genotype are factors that affect the response to this intervention. The effect of this intervention on a single cognitive assessment was examined in 3 groups of women: premenopausal or <5 years postmenopausal (N = 594), within 5-10 years (n = 388), and ≥10 years postmenopausal (n = 963), and as a function of continuous years since menopause. The late postmenopausal group in the ILI had worse composite z-scores compared to those in the DSE, whereas the younger premenopausal or early postmenopausal women in the ILI had better composite z-scores than the DSE. A significant interaction between years since menopause and intervention arm, but not baseline age, was observed on executive function domains. ILI appeared only to benefit cognitive function among non-APOE4 carriers during premenopause or early postmenopause. These findings emphasize the importance of assessing menopause and APOE status to understand how weight loss impacts cognition.


Assuntos
Apolipoproteína E4/genética , Cognição , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/psicologia , Genótipo , Estilo de Vida , Menopausa/genética , Menopausa/fisiologia , Perda de Peso/fisiologia , Idoso , Feminino , Heterozigoto , Humanos , Pessoa de Meia-Idade , Fatores de Tempo
17.
Arq Gastroenterol ; 57(1): 107-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294744

RESUMO

BACKGROUND: Celiac disease (CD) is a chronic enteropathy in response to ingestion of gluten. CD was associated with gynecological disorders. OBJECTIVE: In this retrospective study, we aimed to investigate the age of menarche, age of menopause, number of pregnancies and abortions in Brazilian celiac patients. METHODS: We studied 214 women diagnosed with CD and as control group 286 women were investigated. RESULTS: Regarding the mean age of menarche, a significant difference was found (12.6±1.40 in CD and 12.8±1.22 years in healthy group; P=0.04). Regarding abortions, in CD women 38/214 (17.8%) and 28/286 (9.8%) in the control group reported abortion (P=0.0092, OR:1.98; CI95%=1.1- 3.3). There was no significant difference in the mean age of menopause nor number of pregnancies per woman. CONCLUSION: In this study, we found that celiac women had a higher mean age of menarche and higher risk of spontaneous abortions.


Assuntos
Aborto Espontâneo/fisiopatologia , Doença Celíaca/fisiopatologia , Menarca/fisiologia , Menopausa/fisiologia , Paridade/fisiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
19.
PLoS One ; 15(3): e0229576, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134933

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women worldwide. The cardiovascular risk profile deteriorates after women enter menopause. By definition, women diagnosed with premature ovarian insufficiency (POI) experience menopause before 40 years of age, which may render these women even more susceptible to develop CVD later in life. However, prospective long-term follow up data of well phenotyped women with POI are scarce. In the current study we compare the CVD profile and risk of middle aged women previously diagnosed with POI, to a population based reference group matched for age and BMI. METHODS AND FINDINGS: We compared 123 women (age 49.0 (± 4.3) years) and diagnosed with POI 8.1 (IQR: 6.8-9.6) years earlier, with 123 population controls (age 49.4 (± 3.9) years). All women underwent an extensive standardized cardiovascular screening. We assessed CVD risk factors including waist circumference, BMI, blood pressure, lipid profile, pulse wave velocity (PWV), and the prevalence of diabetes mellitus, metabolic syndrome (MetS) and carotid intima media thickness (cIMT), in both women with POI and controls. We calculated the 10-year CVD Framingham Risk Score (FRS) and the American Heart Association's suggested cardiovascular health score (CHS). Waist circumference (90.0 (IQR: 83.0-98.0) versus 80.7 (IQR: 75.1-86.8), p < 0.01), waist-to-hip ratio (0.90 (IQR: 0.85-0.93) versus 0.79 (IQR: 0.75-0.83), p < 0.01), systolic blood pressure (124 (IQR 112-135) versus 120 (IQR109-131), p < 0.04) and diastolic blood pressure (81 (IQR: 76-89) versus 78 (IQR: 71-86), p < 0.01), prevalence of hypertension (45 (37%) versus 21 (17%), p < 0.01) and MetS (19 (16%) versus 4 (3%), p < 0.01) were all significantly increased in women with POI compared to healthy controls. Other risk factors, however, such as lipids, glucose levels and prevalence of diabetes were similar comparing women with POI versus controls. The arterial stiffness assessed by PWV was also similar in both populations (8.1 (IQR: 7.1-9.4) versus 7.9 (IQR: 7.1-8.4), p = 0.21). In addition, cIMT was lower in women with POI compared to controls (550 µm (500-615) versus 684 µm (618-737), p < 0.01). The calculated 10-year CVD risk was 5.9% (IQR: 3.7-10.6) versus 6.0% (IQR: 3.9-9.0) (p = 0.31) and current CHS was 6.1 (1.9) versus 6.5 (1.6) (p = 0.07), respectively in POI versus controls. CONCLUSIONS: Middle age women with POI presented with more unfavorable cardiovascular risk factors (increased waist circumference and a higher prevalence of hypertension and MetS) compared to age and BMI matched population controls. In contrast, the current study reveals a lower cIMT and similar 10-year cardiovascular disease risk and cardiovascular health score. In summary, neither signs of premature atherosclerosis nor a worse cardiovascular disease risk or health score were observed among middle age women with POI compared to population controls. Longer-term follow-up studies of women of more advanced age are warranted to establish whether women with POI are truly at increased risk of developing CVD events later in life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02616510.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Insuficiência Ovariana Primária/fisiopatologia , Aterosclerose/sangue , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Sistema Cardiovascular/metabolismo , Estudos de Casos e Controles , Diabetes Mellitus/fisiopatologia , Feminino , Glucose/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Lipídeos/sangue , Menopausa/sangue , Menopausa/metabolismo , Menopausa/fisiologia , Menopausa Precoce/sangue , Menopausa Precoce/metabolismo , Menopausa Precoce/fisiologia , Pessoa de Meia-Idade , Insuficiência Ovariana Primária/sangue , Insuficiência Ovariana Primária/metabolismo , Estudos Prospectivos , Análise de Onda de Pulso/métodos , Fatores de Risco , Rigidez Vascular/fisiologia , Circunferência da Cintura/fisiologia , Relação Cintura-Quadril/métodos
20.
Cien Saude Colet ; 25(2): 645-654, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32022204

RESUMO

The hormonal changes in climacteric women may affect the vestibular system; however, it is not clear in the literature whether the presence of vestibular dysfunction associated with climacteric is related to poorer quality of life. The study sample was composed of 374 women (40-65 years). Socioeconomic and demographic data, menopausal status, practice of physical exercises, presence or absence of vestibular dysfunction, hypertension and diabetes, anthropometric measurements and quality of life (using the Utian Quality of Life Scale - UQoL) were collected. Statistical analyses were performed using the Pearson test, Anova, T-test, and multiple regression considering a significance level of 5%. A significant relationship was found between vestibular dysfunction and health (p = 0.02) and emotional (p = 0.01) domains of the UQoL. In addition, physical activity, menopausal status, body mass index (BMI), waist-hip ratio (WHR), household income and diastolic blood pressure (DBP) mean also remained significantly related to quality of life. A relationship between vestibular dysfunction and quality of life for health and emotional domains in climacteric women was observed.


Assuntos
Menopausa/fisiologia , Qualidade de Vida , Doenças Vestibulares/epidemiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Estudos Transversais , Exercício Físico/fisiologia , Feminino , Humanos , Renda , Pessoa de Meia-Idade , Relação Cintura-Quadril
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