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2.
Medicina (Kaunas) ; 55(9)2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31480427

RESUMO

Background and Objectives: Hot flushes and sleep disturbances are the most common vasomotor symptoms (VMS) reported by postmenopausal women. Hormonal treatment is to date referred to as the gold standard approach but not suitable for all the patients. Alternative treatments are needed in case of a contraindication to menopausal hormone therapy (MHT), adverse side effects, and poor compliance. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management of VMS. Nonetheless, few trials with low consensus are available about this topic. In this review, we aimed to evaluate the efficacy of low-dose paroxetine therapy in the treatment of vasomotor hot flushes and night sleep disturbances in postmenopausal women. Materials and Methods: We performed an electronic search from the beginning of all databases to July 2019. All results were then limited to a randomized trial. Restrictions for language or geographic location were not utilized. Inclusion criteria were randomized clinical trials of physiological or surgical postmenopausal women experiencing hot flushes and sleep disturbances who were randomized to either low-dose paroxetine or placebo (i.e., formulations without active ingredients). The primary outcome evaluated was the mean weekly reduction of hot flushes. Results: Five randomized clinical trials, including 1482 postmenopausal women, were analyzed. Significant heterogeneity (I2 = 90%) between studies was noted. Hot flushes episodes were significantly reduced in the treatment arm compared to placebo (mean difference (MD) -7.97 [-10.51, -5.92] episodes/week). Results on the improvement on sleep were limited by being reported in only two studies; however, no significant reduction of night-time awakenings was observed (MD, -0.40 awakenings/night [-1.38, 0.58 CI]). Conclusions: Low-dose paroxetine is an effective treatment for vasomotor menopause symptoms, including hot flushes.


Assuntos
Fogachos/tratamento farmacológico , Paroxetina/administração & dosagem , Pós-Menopausa , Inibidores de Captação de Serotonina/administração & dosagem , Transtornos do Sono-Vigília/tratamento farmacológico , Feminino , Humanos , Ovariectomia , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Phytother Res ; 33(11): 2979-2988, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31418933

RESUMO

Menopause, which occurs following a declined ovarian activity and reduced estrogen levels, can lead to long-term changes in lipid and glycemic profiles and increases the risk of cardiovascular disease and osteoporosis. Cornelian cherry (Cornus mas) is rich in phytochemicals and antioxidants, which appears to be useful in reducing the postmenopausal complications. This interventional, double-blinded, randomized clinical trial carried out on 84 menopaused women aged 45-60 years old. They were randomly divided into two groups. The treatment group received three capsules of 300 mg of Cornus mas extract (CME), and control group received three capsules of 300 mg of starch powder per day for 8 weeks. Then, BMI, waist circumference, glycemic indices, lipid profile, serum apoproteinase, apoprotein B100, fibrinogen, and leptin were measured. The dietary intakes were evaluated using 24-hr dietary recall questionnaire. The consumption of CME in comparison with the control group resulted in a significant reduction in weight, body mass index, waist circumference, LDL to HDL ratio, total cholesterol to HDL ratio, and fibrinogen. There was also a significant increase in HDL and ApoA1 levels in the treatment group. Furthermore, there was a significant decrease in BMI, waist circumference, fasting insulin, and insulin resistance index after 8 weeks of using CME. Summing up the results, it can be concluded that CME can have possible effects on decreasing BMI, waist circumference, and improving some aspects of lipid profile and glycemic indices in postmenopausal women.


Assuntos
Glicemia/efeitos dos fármacos , Cornus/química , Leptina/sangue , Lipídeos/sangue , Extratos Vegetais/farmacologia , Pós-Menopausa , Antioxidantes/farmacologia , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Feminino , Frutas/química , Humanos , Insulina/sangue , Resistência à Insulina/fisiologia , Metabolismo dos Lipídeos/efeitos dos fármacos , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Pós-Menopausa/efeitos dos fármacos
4.
Food Funct ; 10(8): 5228-5238, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31384878

RESUMO

Obesity leads to detrimental abnormalities of iron (Fe) metabolism. So far, studies have shown that single-strain probiotic supplementation ameliorates the gut microbiota quality disrupted in the obese and improves Fe homeostasis. The effect of multistrain probiotic supplementation and its dose-dependence in obese postmenopausal women remain unknown. The study aimed to investigate the effect of multistrain probiotic supplementation in two doses on selected parameters of Fe metabolism in obese postmenopausal female patients. Three groups of obese postmenopausal women, 30 subjects each, received nine-strain oral probiotic supplement at a daily dose of 2.5 × 109 CFU (LD group), 1 × 1010 CFU (HD group), or placebo for 12 weeks (ClinicalTrails.gov no: NCT03100162). After the intervention, the hair Fe content was lower in both supplemented groups compared to the baseline, the serum zinc (Zn) concentration was higher in the LD group and lower in the HD group vs. the baseline, and the serum erythroferrone (FAM) concentration was lower in the HD group and serum ferritin (FE) concentration was higher in the LD group vs. the baseline. In the whole study population after the completion of the intervention hair Zn correlated positively with serum HEPC and FAM and negatively with serum FE. Hair Fe correlated negatively with serum FE. It is concluded that multistrain probiotic supplementation may influence iron metabolism in obese postmenopausal female patients.


Assuntos
Ferro/metabolismo , Obesidade/tratamento farmacológico , Pós-Menopausa/efeitos dos fármacos , Probióticos/administração & dosagem , Idoso , Suplementos Nutricionais/análise , Feminino , Ferritinas/sangue , Cabelo/química , Cabelo/metabolismo , Humanos , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/microbiologia , Pós-Menopausa/sangue , Zinco/metabolismo
5.
Complement Ther Med ; 45: 109-113, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331546

RESUMO

OBJECTIVES: Hypericum perforatum (St John's wort) is an herbal plant that has antidepressant activity and contains ingredients such as flavonols derivatives, bioflavonoids, proanthocyanidins, xanthones, phloroglucinol, and naphthodianthrones. This study was aimed to test the effect of Hypericum perforatum on hot flashes, menopausal symptoms, and depression in postmenopausal women. DESIGN & SETTING: This randomized controlled study was conducted on 80 postmenopausal women aged 45-60 in Izeh, Iran. INTERVENTION: Two groups received 270-330 µg of H. perforatum (n = 40) or placebo (n = 40) tablets three times a day for two months. MAIN OUTCOMES: Data were collected using a socio-demographic questionnaire, the modified Kupperman index before the intervention and 2, 4, 6 and 8 weeks after intervention. The Hamilton Depression Rating Scale was used to gather data before the intervention and in the 8th week of intervention. The data were analyzed using an independent t-test, chi-square test, and repeated measure test. RESULTS: Seventy women completed the study and five women from each group withdrew the study. The frequency and intensity of hot flashes and the score of Kupperman scale significantly decreased in the H. perforatum group compared to the control group (p < 0.001). In addition, the intensity of depression significantly decreased in the H. perforatum group compared to the control group. At the end of the study, 80% of women in the intervention group did not have depression compared to only 5.7% in the control group (p < 0.001). CONCLUSION: Treatment with Hypericum perforatum is an efficient way of reducing hot flashes, menopausal symptoms, and depression in postmenopausal women.


Assuntos
Depressão/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Hypericum/química , Extratos Vegetais/uso terapêutico , Pós-Menopausa/efeitos dos fármacos , Antidepressivos/uso terapêutico , Método Duplo-Cego , Feminino , Fogachos/tratamento farmacológico , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Fitoterapia/métodos
6.
Complement Ther Med ; 45: 57-64, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331583

RESUMO

OBJECTIVES: Sexual problems constitute a largely-overlooked problem for women during menopause. The present study was conducted to determine the effect of Ginseng on sexual function (primary outcome), quality of life and menopausal symptoms (secondary outcomes) in postmenopausal women with sexual dysfunction. DESIGN: This randomized controlled trial was conducted on 62 women who were randomly assigned to the intervention/control groups using block randomization. INTERVENTION: The intervention group received 500 mg of Panax Ginseng and the control group received placebo twice daily for four weeks. MAIN OUTCOME MEASURES: Standard questionnaires including the Female Sexual Function Index (FSFI), the Menopause-Specific Quality of Life (MENQOL) and the Greene Menopausal Symptom Scale were completed before and four weeks after the intervention. RESULTS: There were no statistically significant differences between the two groups in terms of demographic characteristics and the baseline scores of sexual function, quality of life and menopausal symptoms (P > 0.05). After the intervention, the mean total score of FSFI (Adjusted Mean Difference = 6.32, 95% CI = 3.48 to 9.16, P < 0.001) was significantly higher in the intervention group compared to the control group. The mean total score of quality of life (AMD=-20.79, 95% CI=-25.83 to -15.75, P < 0.001) and menopausal symptoms (AMD=-8.25, 95% CI=-10.55 to -5.95, P < 0.001) were significantly lower in the treatment group than the control group. CONCLUSION: Ginseng has significant effects in improving sexual function and quality of life and mitigating menopausal symptoms. As a multipotent plant, Ginseng can be a suitable alternative for conventional therapies to promote the health of menopausal women.


Assuntos
Menopausa/efeitos dos fármacos , Panax/química , Extratos Vegetais/farmacologia , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Terapias Complementares/métodos , Método Duplo-Cego , Feminino , Fogachos/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Fitoterapia/métodos , Pós-Menopausa/efeitos dos fármacos , Qualidade de Vida , Inquéritos e Questionários
7.
Complement Ther Med ; 44: 166-173, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31126551

RESUMO

OBJECTIVES: The purpose of this research was to investigate the effect of Urtica dioica in comparison with placebo, acupuncture and combined therapy on hot flashes and quality of life in postmenopausal women. METHODS: In a double-blinded randomized controlled trial, patients were treated for 7 weeks then followed up 4 weeks. Seventy-two postmenopausal women who reported at least 20 hot flashes attacks per week were randomly allocated into one of the 4 groups of Urtica dioica 450 mg/day and acupuncture 11 sessions (A), acupuncture and placebo (B), sham acupuncture and Urtica dioica (C), and sham acupuncture and placebo (D). The primary outcomes were the change in hot flashes score from baseline to the end of treatment and follow up; and the change in the quality of life (MENQOL) from baseline to the end of treatment. Secondary outcomes included changes in FSH, LH, and ESTRADIOL levels from baseline to the end of treatment. The trial was conducted from October 2017 to July 2018 in Acupuncture clinic of a teaching hospital in Iran. RESULTS: A total of 72 women 45-60 years old were enrolled, and 68 were included in the analyses. The median (IQR) hot flashes score decreased in the A group by 20.2 (31.7) and 21.1 (25.1), B group by 19 (18) and 17.3 (27), C group by 14.6 (25.4) and 20.8 (13), and D group by 1.6 (11.6) and 1 (13.3) at the end of treatment and follow up (P < 0.0001, P < 0.0001); no significant difference between A, B and C groups. The mean (SD) of MENQOL score decreased in the A group by 42.6 (21.1), B group by 40.7 (29.8), C group by 37.8 (26.8) and D group by 9.8 (14.3) at the end of treatment (P = 0.001); no significant difference between A, B and C groups. CONCLUSIONS: Urtica dioica can decrease menopausal hot flashes and increase the quality of life of postmenopausal women better than placebo-sham control but same as acupuncture. The combination of Urtica dioica and acupuncture did not add to the effects of those therapies.


Assuntos
Fogachos/tratamento farmacológico , Fogachos/terapia , Menopausa/efeitos dos fármacos , Preparações de Plantas/uso terapêutico , Urtica dioica/química , Acupuntura/métodos , Terapia por Acupuntura/métodos , Método Duplo-Cego , Feminino , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do Tratamento
8.
PLoS One ; 14(4): e0214153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939140

RESUMO

INTRODUCTION: Osteoporosis (OP) risk factor assessment and bone mineral density (BMD) testing are frequently omitted at baseline in aromatase inhibitor (AI) studies, which may lead to misinterpretation of AI associated bone loss. The present study describes bone health of South African postmenopausal women of predominantly Mixed Ancestry, prior to AI treatment. METHODS: This descriptive baseline study, nested in a prospective AI cohort study, included postmenopausal women with endocrine sensitive breast cancer, aged 50 to 80 years. A baseline questionnaire documented demographic-, medical-, lifestyle- and fracture history. Body weight was assessed clinically, and body composition and BMD measured via dual energy absorptiometry (DXA). Data was analysed in STATA 14 using descriptive and inferential statistics. RESULTS: 101 participants were recruited, with a mean age of 61±7 years. Nearly a third (n = 32) of women at baseline fulfilled global criteria for bone protection (BMD T-score ≥-2SD (n = 18); BMD T-score -1.5SD to < -2SD with risk factors (n = 14). Lower body weight, body mass index (BMI), fat mass index and lean mass index were significantly associated with the participants with a BMD measurement in keeping with a diagnosis of OP (p <0.001). Low vitamin D was present in 93% of the cohort tested (n = 95), whilst deficient vitamin D status (<20ng/ml) was documented in 52 women (55%). CONCLUSIONS: In this study, a third of postmenopausal women considered for AI therapy fulfilled international criteria for bone protective pharmacological intervention. This emphasizes the need for clinical risk and BMD assessment in postmenopausal breast cancer patients at baseline. Body composition and bone health associations highlight bone fragility associated with lower body weight.


Assuntos
Inibidores da Aromatase/efeitos adversos , Doenças Ósseas Metabólicas/tratamento farmacológico , Neoplasias da Mama/tratamento farmacológico , Fraturas Ósseas/tratamento farmacológico , Osteoporose Pós-Menopausa/tratamento farmacológico , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Peso Corporal/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Doenças Ósseas Metabólicas/induzido quimicamente , Osso e Ossos/efeitos dos fármacos , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Estudos de Coortes , Feminino , Fraturas Ósseas/induzido quimicamente , Fraturas Ósseas/fisiopatologia , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/induzido quimicamente , Osteoporose Pós-Menopausa/fisiopatologia , Pós-Menopausa/efeitos dos fármacos , Vitamina D/administração & dosagem
9.
Gynecol Endocrinol ; 35(9): 767-771, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30935252

RESUMO

ß-endorphin is a neuropeptide involved in several brain functions: its plasma levels are higher in obese women and its release increases after oral glucose tolerance test (OGTT) in normal or obese women. The study included 46 healthy women and evaluated the effect of oral dehydroepiandrosterone [DHEA] (50 mg/day) in early postmenopausal women (50-55 years) both of normal weight (group A, n = 12, BMI = 22.1 ± 0.5) and overweight (group B, n = 12, BMI = 28.2 ± 0.5), and late postmenopausal women (60-65 years) both normal weight (group C, n = 11, BMI = 22.5 ± 0.6) and overweight (group D, n = 11, BMI = 27.9 ± 0.4) undergone OGTT, in order to investigate if DHEA could restore/modify the control of insulin and glucose secretion and ß-endorphin release in response to glucose load. The area under the curve (AUC) of OGTT evaluated plasma levels of different molecules. DHEA, DHEAS, and ß-endorphin plasma levels were lower in baseline conditions in older women than younger women. Considering the AUC of ß-endorphin response to OGTT, all groups showed a progressive significant increase after 3 and also after 6 months of treatment in comparison to baseline and 3 months of treatment.


Assuntos
Desidroepiandrosterona/administração & dosagem , Glucose/farmacologia , Pós-Menopausa/sangue , Pós-Menopausa/efeitos dos fármacos , beta-Endorfina/metabolismo , Administração Oral , Idoso , Androgênios/sangue , Feminino , Teste de Tolerância a Glucose , Humanos , Peso Corporal Ideal/efeitos dos fármacos , Peso Corporal Ideal/fisiologia , Insulina/sangue , Pessoa de Meia-Idade , Sobrepeso/sangue , Sobrepeso/metabolismo , Sobrepeso/fisiopatologia , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/sangue , Fatores de Tempo , beta-Endorfina/sangue
10.
J Bone Miner Metab ; 37(5): 864-870, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30868270

RESUMO

Aromatase inhibitors (AIs) are the gold standard therapy for breast cancer in postmenopausal women. AI suppresses the conversion of androgens to estrogens; however, this results in osteopenia, osteoporosis, and bone fracture, thus reducing the patient's quality of life. The use of adjuvant denosumab reduces the risk of clinical fractures in postmenopausal patients with breast cancer receiving AI. However, the efficacy of denosumab in the treatment of AI-associated bone loss has not been prospectively evaluated in Japan. In this study, we aimed to investigate the predictive factors for the efficacy of denosumab in postmenopausal patients with breast cancer treated with AI by analyzing the results of two prospective trials. The patients received 60 mg denosumab subcutaneously every 6 months. The primary endpoint was percentage change in lumbar spine bone mineral density (BMD) from baseline to month 12 in lumbar spine. Post hoc analysis and T tests were performed. A total of 205 patients were enrolled. At 12 and 24 months, the lumbar spine BMD increased by 5.6% [95% confidence interval (CI) 4.9-6.3] and 8.3% (95% CI 7.5-9.1), respectively. Subgroup analysis was conducted according to the time of AI therapy initiation, type of AI therapy, age, time since menopause, baseline body mass index, and BMD. The results showed that baseline lumbar and left femoral BMD was significantly associated with a percentage change in these sites, respectively. In addition, baseline left femoral BMD was also associated with a change in lumbar BMD. In conclusion, the baseline BMD in the lumbar spine was a predictive indicator for the efficacy of denosumab in this site and the baseline BMD in left femoral neck was a predictive indicator in lumbar spine and left femur.


Assuntos
Inibidores da Aromatase/uso terapêutico , Grupo com Ancestrais do Continente Asiático , Neoplasias da Mama/tratamento farmacológico , Denosumab/uso terapêutico , Pós-Menopausa , Idoso , Inibidores da Aromatase/efeitos adversos , Inibidores da Aromatase/farmacologia , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/uso terapêutico , Neoplasias da Mama/fisiopatologia , Quimioterapia Adjuvante , Denosumab/efeitos adversos , Denosumab/farmacologia , Feminino , Colo do Fêmur/efeitos dos fármacos , Colo do Fêmur/fisiopatologia , Fraturas Ósseas/induzido quimicamente , Fraturas Ósseas/tratamento farmacológico , Humanos , Japão , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Análise Multivariada , Pós-Menopausa/efeitos dos fármacos , Estudos Prospectivos , Resultado do Tratamento
11.
Int J Cancer ; 145(8): 2114-2121, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-30901076

RESUMO

One of the most common adverse events (AEs) occurring during treatment with aromatase inhibitors (AIs) is musculoskeletal pain. The aim of our study was to analyze the influence of preexisting muscle/limb pain and joint pain on the development of AI-induced musculoskeletal AEs. Women eligible for upfront adjuvant endocrine therapy with letrozole were included in the PreFace study, a multicenter phase IV trial. During the first treatment year, they were asked to record musculoskeletal AEs monthly by answering questions regarding pain symptoms and rating the pain intensity on a numeric rating scale from 0 (no pain) to 10 (very strong pain). Pain values were compared using nonparametric statistical tests. Overall, 1,416 patients were evaluable. The average pain value over all time points in women with preexisting muscle/limb pain was 4.3 (median 4.3); in those without preexisting pain, it was 2.0 (median 1.7). In patients without preexisting muscle/limb pain, pain levels increased relatively strongly within the first 6 months (mean increase +0.9, p < 0.00001) in comparison with those with preexisting pain (mean increase +0.3, p < 0.001), resulting in a statistically significant difference (p < 0.00001) between the two groups. The development of joint pain was similar in the two groups. Women without preexisting muscle/limb pain or joint pain have the greatest increase in pain after the start of adjuvant AI therapy. Women with preexisting pain have significantly higher pain values. The main increase in pain values takes place during the first 6 months of treatment.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Letrozol/uso terapêutico , Dor Musculoesquelética/fisiopatologia , Pós-Menopausa/efeitos dos fármacos , Idoso , Inibidores da Aromatase/efeitos adversos , Inibidores da Aromatase/uso terapêutico , Artralgia/induzido quimicamente , Artralgia/fisiopatologia , Neoplasias da Mama/fisiopatologia , Feminino , Humanos , Letrozol/efeitos adversos , Pessoa de Meia-Idade , Dor Musculoesquelética/induzido quimicamente , Medição da Dor/métodos , Pós-Menopausa/fisiologia , Fatores de Tempo
12.
Holist Nurs Pract ; 33(4): 207-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30768439

RESUMO

The aim of this study is to identify the effects of kefir, an alternative treatment method, on quality of life and sleep disturbances in postmenopausal women. In this study, it is seen that kefir has positive effects on sleep disturbances, depression, and quality of life in postmenopausal women.


Assuntos
Kefir , Qualidade de Vida/psicologia , Transtornos do Sono-Vigília/dietoterapia , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/psicologia , Transtornos do Sono-Vigília/psicologia , Turquia
13.
Endocrinology ; 160(4): 899-914, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30753523

RESUMO

Whether hormone replacement therapy has beneficial metabolic effects in postmenopausal women remains controversial because of between-study differences in menopausal duration, estrogen formulations, and diet. Additionally, animal studies have not reflected the typical human obesogenic, Western-style diet (WSD). In this study, we determined the effects of immediate 17ß-estradiol (ImE) or delayed 17ß-estradiol treatment on weight and metabolism parameters in old ovo-hysterectomized rhesus macaques consuming a WSD over a 30-month period. The placebo and ImE groups exhibited progressive gains in weight and fat mass, which ImE initially attenuated but did not prevent. Progression of insulin resistance (IR) was lessened by ImE compared with placebo under both fasting and IV glucose-stimulated conditions, plateauing in all groups between 24 and 30 months. Consequently, relative euglycemia was maintained through lower stimulated insulin levels with ImE than with placebo. Bone mineral density decreased in the placebo group but was maintained in the ImE group, whereas bone mineral content was unaffected by placebo and increased with ImE. Daily activity was reduced while macaques consumed a WSD and was not affected by ImE. Over time, total cholesterol, triglyceride, very-low-density cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and IL-8 levels increased or trended upward in all animals, with only the change in HDL-C affected by ImE. Delayed estrogen treatment (months 24 to 30) had no significant impact on body composition or glucometabolic parameters. In summary, detrimental WSD-induced changes in body composition and metabolism were only temporarily ameliorated by ImE, with the important exception of glucose homeostasis, which benefited from E replacement even as body composition worsened.


Assuntos
Composição Corporal/fisiologia , Metabolismo Energético/fisiologia , Estradiol/administração & dosagem , Terapia de Reposição de Estrogênios/métodos , Pós-Menopausa/metabolismo , Animais , Glicemia/metabolismo , Composição Corporal/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Peso Corporal/fisiologia , Densidade Óssea/efeitos dos fármacos , Dieta , Dieta Ocidental , Metabolismo Energético/efeitos dos fármacos , Feminino , Insulina/sangue , Resistência à Insulina/fisiologia , Macaca , Pós-Menopausa/efeitos dos fármacos
14.
Breast Cancer Res Treat ; 175(2): 297-303, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30747308

RESUMO

PURPOSE: UGT2B17 gene deletion (UGT2B17*2) has been reported to affect bone health as well as the pharmacokinetics of aromatase inhibitor (AI) drugs such as exemestane. The goal of this study was to assess associations between UGT2B17 gene deletion and bone health prior to and after 24 months of AI treatment in postmenopausal women with hormone receptor positive (HR+) breast cancer. METHODS: Bone health in women with HR+ breast cancer enrolled on the prospective randomized Exemestane and Letrozole Pharmacogenetics (ELPh) trial was determined by measuring bone turnover markers (BTM) and bone mineral density (BMD) pre-treatment and after 3 BTM and 24 BMD months of treatment with either the steroidal AI exemestane or the nonsteroidal AI letrozole. DNA samples were genotyped for UGT2B17*2. RESULTS: Of the 455 subjects included in the analyses, 244 (53.6%) carried at least one copy of UGT2B17*2. UGT2B17*2 was associated with lower pre-treatment BMD at the hip (P = 0.01) and spine (P = 0.0076). Letrozole treatment was associated with a greater decrease in BMD of the hip (P = 0.03) and spine (P = 0.03) than exemestane. UGT2B17 genotype was not associated with changes in BMD from 24 months of AI treatment, though in UGT2B17*2 homozygous patients, there was a trend toward greater decreases in BMD of the spine from treatment with letrozole compared with exemestane (P = 0.05). CONCLUSION: UGT2B17*2 may be associated with lower baseline BMD in women with HR+ breast cancer. Exemestane is less detrimental to bone health than letrozole in postmenopausal women treated with AI, and this effect may be confined to patients carrying UGT2B17*2, though this finding requires independent validation.


Assuntos
Androstadienos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Glucuronosiltransferase/genética , Letrozol/administração & dosagem , Antígenos de Histocompatibilidade Menor/genética , Androstadienos/efeitos adversos , Inibidores da Aromatase/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Densidade Óssea/genética , Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/patologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Deleção de Genes , Estudos de Associação Genética , Genótipo , Humanos , Letrozol/efeitos adversos , Pessoa de Meia-Idade , Farmacogenética , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/genética , Tamoxifeno/administração & dosagem
15.
J Complement Integr Med ; 16(1)2019 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-30661055

RESUMO

Background Estrogen deficiency in postmenopausal period causes severe neuroendocrine changes in brain which influences memory and other nervous functions. Anthocleista schweinfurthii is used traditionally to treat female infertility and menopause related symptoms. This study was performed to investigate the potential neuroprotective effects of aqueous extract of Anthocleista schweinfurthii on brain in a postmenopause-like model of ovariectomized Wistar rats. Methods Thirty animals were sham-operated or ovariectomized (Ovx) 84 days after surgery, six groups of five rats each were daily treated orally during 28 days with: distilled water for groups 1 (sham-operated) and 2 (Ovx), estradiol valerate (group 3) and the three doses of extracts {groups 4, 5 and 6 (Ovx)}. Biochemical and histological evaluations focused on brain. Results Compared to sham-operated control, ovariectomy decreased total protein levels in brain (p<0.01) which was increased by plant extract at the dose of 300 mg/kg (p<0.05), underlying its anabolic properties. Ovariectomy significantly decreased magnesium levels in brain (p<0.001). Anthocleista schweinfurthii increased significantly magnesium levels (p<0.01), showing its capacity to act on synaptic conduction. Ovariectomy induced oxidative stress by increasing malondialdehyde levels (p<0.05) and decreasing reduced glutathione levels (p<0.05) in brain. The plant extract exhibited antioxidative activity by reducing malondialdehyde levels and increasing glutathione levels in brain. Damage in brain structure which was caused by ovariectomy disappeared following the treatment. Conclusions Results suggest that Anthocleista schweinfurthii may have neuroprotective effects in Ovx Wistar rats by increasing total protein, magnesium levels and reducing oxidative stress in brain.


Assuntos
Loganiaceae/química , Fármacos Neuroprotetores/administração & dosagem , Casca de Planta/química , Extratos Vegetais/administração & dosagem , Pós-Menopausa/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Feminino , Glutationa/metabolismo , Humanos , Magnésio/metabolismo , Malondialdeído/metabolismo , Modelos Animais , Fármacos Neuroprotetores/química , Ovariectomia , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/química , Pós-Menopausa/metabolismo , Ratos , Ratos Wistar
16.
Nitric Oxide ; 85: 10-16, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30668996

RESUMO

PURPOSE: Consumption of nitrate-rich beetroot juice can lower blood pressure in peripheral as well as central arteries and may exert additional hemodynamic benefits (e.g. reduced aortic wave reflections). The specific influence of nitrate supplementation on arterial pressures and aortic wave properties in postmenopausal women, a group that experiences accelerated increases in these variables with age, is unknown. Accordingly, the primary aim of this study was to determine the effect of consuming nitrate-rich beetroot juice on resting brachial and aortic blood pressures (BP) and pulse wave characteristics in a group of healthy postmenopausal women, in comparison to a true (nitrate-free beetroot juice) placebo. METHODS: Brachial (oscillometric cuff) and radial (SphygmoCor) pressures and derived-aortic waveforms were measured during supine rest in thirteen healthy postmenopausal women (63 ±â€¯1 yr) before and 100 min after consumption of 140 ml of either nitrate-rich (9.7 mmol, 0.6 gm NO3-) or nitrate-depleted beetroot juice on randomized visits approximately 10 days apart (cross-over design). Ten young premenopausal women (22 ±â€¯1 yr) served as a reference (non-supplemented) cohort. RESULTS: Brachial and derived-aortic variables showed the expected age-associated differences in these women (all p < 0.05). In post-menopausal women, nitrate supplementation reduced (p < 0.05 vs. placebo visit) brachial systolic BP (BRnitrate -4.9 ±â€¯2.1 mmHg vs BRplacebo +1.1 ± 1.8 mmHg), brachial mean BP (BRnitrate -4.1 ±â€¯1.7 mmHg vs BRplacebo +0.9 ± 1.3 mmHg), aortic systolic BP (BRnitrate -6.3 ±â€¯2.0 mmHg vs BRplacebo +0.5 ± 1.7 mmHg) and aortic mean BP (BRnitrate -4.1 ±â€¯1.7 mmHg vs BRplacebo +0.9 ± 1.3 mmHg), and increased pulse pressure amplification (BRnitrate +4.6 ± 2.0% vs BRplacebo +0.7 ± 2.5%, p = 0.04), but did not alter aortic pulse wave velocity or any other derived-aortic variables (e.g., augmentation pressure or index). CONCLUSIONS: Dietary nitrate supplementation favorably modifies aortic systolic and mean blood pressure under resting conditions in healthy postmenopausal women. Acute supplementation of nitrate does not, however, appear to restore indices of aortic stiffness in this group. Future work should evaluate chronic, long-term effects of this non-pharmacological supplement.


Assuntos
Pressão Arterial/efeitos dos fármacos , Suplementos Nutricionais , Nitratos/farmacologia , Pós-Menopausa/efeitos dos fármacos , Análise de Onda de Pulso , Feminino , Humanos , Nitratos/administração & dosagem , Nitratos/sangue
19.
Int Urogynecol J ; 30(2): 251-256, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29946829

RESUMO

INTRODUCTION AND HYPOTHESIS: The impact of estradiol-based hormone therapy (HT) on the incidence of stress urinary incontinence (SUI) is unknown. Therefore, we compared the use of such HT regimens and tibolone in women with and without SUI. METHODS: The women with a history of SUI operation (N = 15,002) were identified from the Finnish National Hospital Discharge Register, and the control women without such an operation (N = 44,389) from the Finnish Central Population Register. The use of HT was traced from the National Drug Reimbursement Register, and the odd ratios (ORs) with 95% confidence intervals (95% CIs) for SUI were calculated by using the conditional logistic regression analysis. RESULTS: The cases had used any HT more often than the controls. The use of systemic estradiol-only or estradiol-progestin therapy was accompanied by an increased SUI risk (OR 3.8, 95% CI: 3.6-4.0 and OR 2.7, 95% CI: 2.6-2.9 respectively). The use of estradiol with noretisterone acetate showed a higher risk of increase than that with medroxyprogesterone acetate. Age over 55 years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55 years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk. CONCLUSIONS: The use of HT regimens may predispose to the de novo development or worsening of pre-existing SUI. Thus, caution is needed when these regimens are prescribed to women with mild stress-related urine leakage or with established SUI risk factors.


Assuntos
Estradiol/efeitos adversos , Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Norpregnenos/efeitos adversos , Incontinência Urinária por Estresse/epidemiologia , Terapia de Reposição de Estrogênios/métodos , Feminino , Finlândia/epidemiologia , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos , Sistema de Registros , Fatores de Risco , Incontinência Urinária por Estresse/induzido quimicamente
20.
Clin Interv Aging ; 13: 2367-2374, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30532527

RESUMO

Objective: This study aimed to determine the effect of calcitriol on serum concentrations of fibroblast growth factor-23 (FGF-23), sclerostin, intact parathyroid hormone (PTH), and handgrip strength in postmenopausal women with low bone mass. Methods: A randomized, double-blind controlled trial was carried out among 141 postmenopausal women with low bone mass. Participants were randomized into two groups: 75 participants received calcitriol 0.5 µg/day and 66 participants received a placebo for 12 weeks. Results: After 12-week calcitriol treatment, significant decreases in serum intact PTH (P=0.035) and sclerostin (P=0.039), as well as significant increases in serum creatinine (P=0.027), uric acid (P=0.032), 24-hour urinary calcium (P=0.0026), and left handgrip strength (P=0.03), were observed, compared to placebo group. Level of serum sclerostin was weakly but significantly positively correlated with serum PTH (r=0.277; P=0.01) and negatively correlated with 24-hour urinary calcium (r=-0.221; P=0.04) and left handgrip strength (r=-0.338; P=0.03) after calcitriol treatment. Multiple regression analysis demonstrated that decrease in serum sclerostin was associated with decrease in PTH serum level after calcitriol treatment (OR, 7.90; 95% CI, 2.28-27.42; P=0.002). However, no significant change in FGF-23 level was observed after calcitriol treatment. Conclusion: Calcitriol treatment yields a considerable decrease in serum sclerostin and significant increase of handgrip strength, and the change in serum sclerostin is regulated by serum PTH and by muscle strength.


Assuntos
Proteínas Morfogenéticas Ósseas , Calcitriol , Fatores de Crescimento de Fibroblastos , Marcadores Genéticos , Força Muscular , Hormônio Paratireóideo , Pós-Menopausa , Idoso , Proteínas Morfogenéticas Ósseas/sangue , Proteínas Morfogenéticas Ósseas/metabolismo , Calcitriol/administração & dosagem , Calcitriol/farmacocinética , Cálcio/sangue , Cálcio/metabolismo , Hormônios e Agentes Reguladores de Cálcio/administração & dosagem , Hormônios e Agentes Reguladores de Cálcio/farmacocinética , Método Duplo-Cego , Monitoramento de Medicamentos , Feminino , Fatores de Crescimento de Fibroblastos/sangue , Fatores de Crescimento de Fibroblastos/metabolismo , Força da Mão/fisiologia , Humanos , Pessoa de Meia-Idade , Força Muscular/efeitos dos fármacos , Força Muscular/fisiologia , Hormônio Paratireóideo/sangue , Hormônio Paratireóideo/metabolismo , Pós-Menopausa/sangue , Pós-Menopausa/efeitos dos fármacos , Resultado do Tratamento
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