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1.
Menopause ; 28(3): 284-291, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33399316

RESUMO

OBJECTIVE: We investigated isolated and joint effects of early menopause (occurrence before 45 y of age) and high-sensitivity cardiac troponin T elevation (hs-cTnT ≥ 14 ng/L) on heart failure (HF) incidence in postmenopausal women. METHODS: We included 2,276 postmenopausal women, aged 67-90 years, with hs-cTnT measurements and without prevalent HF from the Atherosclerosis Risk in Communities study Visit 5 (2011-2013). Women were categorized according to early menopause and hs-cTnT group. Cox proportional hazards models were used for analysis. RESULTS: Over a median follow-up of 5.5 years, we observed 104 HF events. The incidence rates of HF were greater in women with hs-cTnT elevation when compared to those without hs-cTnT elevation. In unadjusted analysis, the hazard ratios for incident HF were threefold greater in women with hs-cTnT elevation, with or without early menopause, (3.03 [95% CI, 1.59-5.77]) and (3.29 [95% CI, 2.08-5.21]), respectively, but not significantly greater in women with early menopause without hs-cTnT elevation, when compared to women with neither early menopause nor hs-cTnT elevation at Visit 5. After adjusting for HF risk factors and NT-pro B-type natriuretic peptide, these associations were attenuated and became nonsignificant for women with hs-cTnT elevation, but became stronger and significant for women with early menopause without hs-cTnT elevation (2.39 [95% CI, 1.28-4.46]). CONCLUSIONS: Irrespective of early menopause status, hs-cTnT elevation is associated with greater HF incidence but this association is partially explained by HF risk factors. Even in the absence of hs-cTnT elevation, early menopause is significantly associated with HF incidence after accounting for HF risk factors.


Assuntos
Insuficiência Cardíaca/epidemiologia , Peptídeo Natriurético Encefálico/sangue , Troponina T/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Insuficiência Cardíaca/sangue , Humanos , Fragmentos de Peptídeos , Pós-Menopausa/sangue , Pós-Menopausa/fisiologia , Modelos de Riscos Proporcionais , Fatores de Risco
2.
JAMA Netw Open ; 4(1): e2030405, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33404618

RESUMO

Importance: Although estrogen level is positively associated with bone mineral density, there are limited data on the risk of fractures after menopause. Objective: To investigate whether female reproductive factors are associated with fractures among postmenopausal women. Design, Setting, and Participants: This population-based retrospective cohort study used data from the Korean National Health Insurance Service database on 1 272 115 postmenopausal women without previous fracture who underwent both cardiovascular and breast and/or cervical cancer screening from January 1 to December 31, 2009. Outcome data were obtained through December 31, 2018. Exposures: Information was obtained about reproductive factors (age at menarche, age at menopause, parity, breastfeeding, and exogenous hormone use) by self-administered questionnaire. Main Outcomes and Measures: Incidence of any fractures and site-specific fractures (vertebral, hip, and others). Results: Among the 1 272 115 participants, mean (SD) age was 61.0 (8.1) years. Compared with earlier age at menarche (≤12 years), later age at menarche (≥17 years) was associated with a higher risk of any fracture (adjusted hazard ratio [aHR], 1.24; 95% CI, 1.17-1.31) and vertebral fracture (aHR, 1.42; 95% CI, 1.28-1.58). Compared with earlier age at menopause (<40 years), later age at menopause (≥55 years) was associated with a lower risk of any fracture (aHR, 0.89; 95% CI, 0.86-0.93), vertebral fracture (aHR, 0.77; 95% CI, 0.73-0.81), and hip fracture (aHR, 0.88; 95% CI, 0.78-1.00). Longer reproductive span (≥40 years) was associated with lower risk of fractures compared with shorter reproductive span (<30 years) (any fracture: aHR, 0.86; 95% CI, 0.84-0.88; vertebral fracture: aHR, 0.73; 95% CI, 0.71-0.76; and hip fracture: aHR, 0.87; 95% CI, 0.80-0.95). Parous women had a lower risk of any fracture than nulliparous women (aHR, 0.96; 95% CI, 0.92-0.99). Although breastfeeding for 12 months or longer was associated with a higher risk of any fractures (aHR, 1.05; 95% CI, 1.03-1.08) and vertebral fractures (aHR, 1.22; 95% CI, 1.17-1.27), it was associated with a lower risk of hip fracture (aHR, 0.84; 95% CI, 0.76-0.93). Hormone therapy for 5 years or longer was associated with lower risk of any factures (aHR, 0.85; 95% CI, 0.83-0.88), while use of oral contraceptives for 1 year or longer was associated with a higher risk of any fractures (aHR, 1.03; 95% CI, 1.01-1.05). Conclusions and Relevance: The findings of this cohort study suggest that female reproductive factors are independent risk factors for fracture, with a higher risk associated with shorter lifetime endogenous estrogen exposure. Interventions to reduce fracture risk may be needed for women at high risk, including those without osteoporosis.


Assuntos
Fraturas por Osteoporose/epidemiologia , Pós-Menopausa/fisiologia , Idoso , Aleitamento Materno/estatística & dados numéricos , Terapia de Reposição de Estrogênios/estatística & dados numéricos , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Incidência , Menarca/fisiologia , Menopausa/fisiologia , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos , Fatores de Risco
3.
Nat Commun ; 12(1): 565, 2021 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495474

RESUMO

Accumulating evidence indicates that obesity with its associated metabolic dysregulation, including hyperinsulinemia and aberrant circadian rhythms, increases the risk for a variety of cancers including postmenopausal breast cancer. Caloric restriction can ameliorate the harmful metabolic effects of obesity and inhibit cancer progression but is difficult to implement and maintain outside of the clinic. In this study, we aim to test a time-restricted feeding (TRF) approach on mouse models of obesity-driven postmenopausal breast cancer. We show that TRF abrogates the obesity-enhanced mammary tumor growth in two orthotopic models in the absence of calorie restriction or weight loss. TRF also reduces breast cancer metastasis to the lung. Furthermore, TRF delays tumor initiation in a transgenic model of mammary tumorigenesis prior to the onset of obesity. Notably, TRF increases whole-body insulin sensitivity, reduces hyperinsulinemia, restores diurnal gene expression rhythms in the tumor, and attenuates tumor growth and insulin signaling. Importantly, inhibition of insulin secretion with diazoxide mimics TRF whereas artificial elevation of insulin through insulin pumps implantation reverses the effect of TRF, suggesting that TRF acts through modulating hyperinsulinemia. Our data suggest that TRF is likely to be effective in breast cancer prevention and therapy.


Assuntos
Neoplasias da Mama/prevenção & controle , Modelos Animais de Doenças , Jejum , Hiperinsulinismo/prevenção & controle , Obesidade/prevenção & controle , Pós-Menopausa/fisiologia , Animais , Neoplasias da Mama/sangue , Neoplasias da Mama/fisiopatologia , Restrição Calórica/métodos , Linhagem Celular Tumoral , Dieta Hiperlipídica , Feminino , Humanos , Hiperinsulinismo/sangue , Hiperinsulinismo/fisiopatologia , Resistência à Insulina/fisiologia , Camundongos Endogâmicos C57BL , Camundongos Obesos , Obesidade/sangue , Obesidade/fisiopatologia , Ovariectomia , Pós-Menopausa/sangue
4.
BMJ Case Rep ; 14(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414114

RESUMO

We present an unusual case of mucinous cystadenoma presenting with severe virilisation in a postmenopausal woman. A 71-year-old woman was referred to our outpatient endocrinology clinic because of rapidly progressive androgenic alopecia, clitoromegaly and male pattern pubic hair growth for 1 year. Her medical history was unremarkable. The serum testosterone level was 3.35 µg/L (normal range, <0.4 µg/L), and the dehydroepiandrosterone sulfate level was 267 µg/L (normal range, 100-800 µg/L). MRI of the abdomen revealed a 4×4 cm cystic ovarian mass. A bilateral salpingo-oophorectomy was performed, and histopathology showed a unilocular cystic structure with a yellowish content, compatible with mucinous cystadenoma. Postoperative testosterone levels quickly normalised (<0.4 µg/L).Rapidly developing postmenopausal hyperandrogenism easily turns into a diagnostic challenge for the clinician. Hormone-secreting neoplasms of the ovary are most commonly of sex cord stromal derivation, but atypical causes must be recognised as well. Cystadenomas are among the most common benign ovarian neoplasms and are classically considered 'non-functional' tumours. Most of these tumours are asymptomatic and found incidentally on pelvic examination or with ultrasound. To date and to the best of our knowledge, there are only five cases of mucinous adenoma causing virilisation in postmenopausal women identified in the literature. This sixth case adds strength to the link between ovarian mucinous cystadenoma and severe, rapidly progressive hyperandrogenism during menopause. In this case, surgical resection is the treatment of choice.


Assuntos
Cistadenoma Mucinoso/complicações , Hiperandrogenismo/etiologia , Neoplasias Ovarianas/complicações , Pós-Menopausa/fisiologia , Idoso , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Neoplasias Ovarianas/cirurgia , Salpingo-Ooforectomia , Testosterona/sangue , Virilismo/etiologia
5.
Support Care Cancer ; 29(1): 311-322, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32358778

RESUMO

PURPOSE: To assess the feasibility and efficacy of a non-hormonal hyaluronic acid (HLA) vaginal gel in improving vulvovaginal estrogen-deprivation symptoms in postmenopausal women with a history of hormone receptor-positive (HR+) cancer. METHODS: For this single-arm, prospective longitudinal trial, we identified disease-free patients with a history of HR+ breast cancer treated with aromatase inhibitors or HR+ endometrial cancer treated with surgery and postoperative radiation. Participants used HLA daily for the first 2 weeks, and then 3×/week until weeks 12-14; dosage was then increased to 5×/week for non-responders. Vulvovaginal symptoms and pH were assessed at 4 time points (baseline [T1], 4-6 weeks [T2], 12-14 weeks [T3], 22-24 weeks [T4]) with clinical evaluation, the Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), Female Sexual Function Index (FSFI), and Menopausal Symptom Checklist (MSCL). RESULTS: Of 101 patients, mean age was 55 years (range, 31-78), 68% (n = 69) were partnered, and 60% (n = 61) were sexually active. In linear mixed models, VAS/VuAS scores significantly improved at all assessment points (all p < 0.001). MSCL scores similarly improved (all p < 0.001). FSFI scores significantly improved from T1 to T2 (p < 0.03), T3 (p < 0.001), and T4 (p < 0.001). Severe vaginal pH (> 6.5) decreased from 26% at T1 to 19% at T4 (p = 0.18). CONCLUSIONS: HLA moisturization improved vulvovaginal health/sexual function of cancer survivors. While HLA administration 1-2×/week is recommended for women in natural menopause, a 3-5×/week schedule appears to be more effective for symptom relief in cancer survivors.


Assuntos
Inibidores da Aromatase/uso terapêutico , Sobreviventes de Câncer , Ácido Hialurônico/uso terapêutico , Vagina/patologia , Doenças Vaginais/tratamento farmacológico , Vulva/patologia , Adulto , Idoso , Atrofia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/terapia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Estudos Prospectivos , Cremes, Espumas e Géis Vaginais/uso terapêutico
6.
Maturitas ; 143: 65-71, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308638

RESUMO

OBJECTIVE: To evaluate the three-dimensional (3D) ultrasound characteristics of the pelvic floor muscles (PFM) in two groups of postmenopausal women: users and nonusers of menopausal hormone therapy (MHT). STUDY DESIGN: Observational, cross-sectional cohort study. MAIN OUTCOME MEASURES: In this study 226 sexually active heterosexual women, aged 45-60 years with amenorrhea >12 months and without clinical pelvic floor disorders or urinary incontinence were included. Women using MHT ≥ 6 months were classified as systemic users. PFM strength was assessed by digital vaginal palpation and scored on the Modified Oxford Scale. Biometry of the PFM was performed by 3D transperineal ultrasound for evaluation of total urogenital hiatus area, transverse and anteroposterior diameters, and levator ani muscle thickness. RESULTS: The participants were divided into users (n = 78) and nonusers (n = 148) of MHT. There were no differences in clinical or anthropometric parameters between groups. The mean age was 55 years and the time since menopause was six years in both groups. The mean duration of MHT use was 43.4 ± 33.3 months. Users of MHT had greater levator ani muscle thickness (p = 0.001) and higher PFM strength (p = 0.029) than nonusers. Risk analysis adjusted for age, time since menopause, BMI, parity, and type of delivery showed an association of MHT use with greater levator ani muscle thickness (OR = 2.69; 95% CI 1.42-5.11, p = 0.029), and higher PFM strength (OR = 1.78; 95% CI1.01-3.29, p = 0.046). There was a weak positive correlation between levator ani muscle thickness and duration of MHT use (r = 0.25, p = 0.0002) and PFM strength (r = 0.12, p = 0.043). CONCLUSIONS: Postmenopausal women using MHT had a greater levator ani muscle thickness associated with higher PFM strength than nonusers.


Assuntos
Terapia de Reposição Hormonal , Diafragma da Pelve/diagnóstico por imagem , Pós-Menopausa , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Força Muscular , Diafragma da Pelve/fisiologia , Pós-Menopausa/fisiologia , Ultrassonografia/métodos
7.
PLoS One ; 15(9): e0237925, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911496

RESUMO

BACKGROUND: Invasive Breast Cancer (IBC) risk estimates continue to be based on data collated from cancer registries, i.e., retrospective research that excludes disease-free women. For women without a prior diagnosis, these estimates inflate both risk and screening frequency recommendations and inadvertently increase recently recognized harms from overdiagnosis and overtreatment. OBJECTIVE: To estimate the likelihood that pre or postmenopausal women with no prior diagnosis will remain free of IBC in order to enable evidence-based screening recommendations. METHODS: Prospective data from 21 studies of 2,402,672 women were analyzed, updating our previously published systematic search of 19 studies. This second systematic search included PubMed and The Cochrane Library from 2012 through April 2019. Inclusion criteria: only studies reporting the number of women enrolled, length of follow-up, and number of women diagnosed with IBC. Linear regression was used to estimate the percentage of women expected to remain free from an IBC diagnosis based on follow-up duration. To minimize non-response bias and selective outcome bias, only studies reporting outcomes for all enrolled women followed for similar, specific lengths of time were included. Sensitivity analyses confirm that the overall findings were unchanged by age at enrollment, menopausal status, screened women, variation in sample size, duration of follow-up, and heteroskedasticity. RESULTS: The calculated percentage of women remaining IBC-free after follow-ups of 5, 10, 15, 20 and 25 years decreases uniformly by about one-fourth of one percent per year, i.e., 0.255% (95% CI: -0.29, -0.22; p < .0001). At 25 years, the expected percentage of women with no invasive breast cancer is 93.41% (95% CI: 92.75, 94.07). CONCLUSIONS: Over 99.7% of pre/postmenopausal women with no prior diagnosis continued with no IBC each year, with 93.41% still free after 25 years. Our study supports the medical justification for reducing the frequency of mammograms for menopausal women with no prior IBC diagnosis.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Pós-Menopausa/fisiologia , Viés , Detecção Precoce de Câncer , Feminino , Seguimentos , Humanos , Invasividade Neoplásica , Probabilidade , Fatores de Risco , Tamanho da Amostra , Reino Unido
8.
Apunts, Med. esport (Internet) ; 55(207): 97-103, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194710

RESUMO

It appears that little consistent information is available on medical interventions and the use of appropriate intensity and exercise mode to improve physiological and psychological menopause complications. The aim of this study was to compare the effect of eight weeks of low, moderate and high intensity TRX training on hot flashes, mood, fat percentage and muscular endurance of postmenopausal women. Forty non-athletic postmenopausal healthy women participated in the study and were randomly and equally divided into four groups: (1) control, (2) low-intensity TRX training (LI TRX) (40–55% HHR), (3) moderate-intensity TRX training (MI TRX) (55-70 HHR), and (4) high-intensity TRX training (HI TRX) (70-85 HHR). The research variables were measured 48 h before and after the intervention. The experimental groups performed their own training program for 8 weeks, 3 sessions per week, and 60min each session. Symptoms of hot flashes, mood, fat percentage, and muscular endurance in the experimental groups significantly improved compared to the control group (P ≤ 0.05). A decrease in fat percentage was observed in the MI TRX group compared to other training groups (P = 0.045). Adaptation to regular exercise training reduced menopausal symptoms. There was no significant difference between using different intensity of exercise. Probably due to the physiological and psychological aspects of menopause, the most important factor in improving menopausal symptoms is participating in exercise and the frequency of exercise training. Also, TRX can be used as a safe method in different intensities in this group of women


No disponible


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Esforço Físico/fisiologia , Teste de Esforço/métodos , Resistência Física/fisiologia , Treinamento de Resistência/métodos , Inquéritos e Questionários , Protocolos
9.
PLoS One ; 15(5): e0233703, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469976

RESUMO

BACKGROUND: Over a third of menopausal hormone therapy (HT) prescriptions in the US are written for women over age 60. Use of HT more than 5 years is associated with increased risk for cardiovascular disease; breast, ovarian, and endometrial cancers; thromboembolic stroke; gallbladder disease; dementia; and incontinence. OBJECTIVES: To explore older women's perceptions of the benefits and risks of long-term HT and examine factors influencing their decisions to use HT > 5 years despite medical risks. METHODS: A qualitative approach was selected to broadly explore thought processes and social phenomena underlying long-term users' decisions not to discontinue HT. Interviews were conducted with 30 women over age 60 reporting use of systemic HT more than 5 years recruited from an urban area in California and a small city in the Rocky Mountain region. Transcripts of interviews were analyzed using conventional grounded theory methods. RESULTS: Women reported using HT to preserve youthful physical and mental function and prevent disease. Gynecologists had reassured participants regarding risk, about which all 30 expressed little concern. Participants, rather than providers, were the principal drivers of long-term use. CONCLUSIONS: Participants perceived estrogen to have anti-aging efficacy, and using HT imparted a sense of control over various aspects of aging. Maintaining this sense of control was prioritized over potential risk from prolonged use. Our findings provide an additional perspective on previous work suggesting the pharmaceutical industry has leveraged older women's self-esteem, vanity, and fear of aging to sell hormones through marketing practices designed to shape the beliefs of both clinicians and patients. Efforts are needed to: 1) address misconceptions among patients and providers about medically supported uses and risks of prolonged HT, and 2) examine commercial influences, such as medical ghostwriting, that may lead to distorted views of HT efficacy and risk.


Assuntos
Envelhecimento/psicologia , Terapia de Reposição de Estrogênios , Pós-Menopausa/fisiologia , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/psicologia , Cultura , Terapia de Reposição de Estrogênios/efeitos adversos , Terapia de Reposição de Estrogênios/psicologia , Feminino , Humanos , Pessoa de Meia-Idade
10.
Cuad. psicol. deporte ; 20(2): 63-70, mayo 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-198040

RESUMO

Physical inactivity is main cause of disease worldwide. Identify the physical exercise preference, resulting in increases adherence and future intention to perform physical activity. The preference of the intensity of exercise questionnaire (PRETIE-Q) is the main tool used to assess preference in physical exercise. Variables as age, body mass index (BMI), usual physical activity level (PAL), maximal oxygen uptake (VO2máx), can influence in PRETIE-Q answers. The purpose of this study was investigate if there is relation between preference for exercise intensity with maximal aerobic speed (MAS), PAL and heart rate variability (HRV) in postmenopausal women phase. Participated of study 30 subjects who answer PRETIE-Q together with analyses of MAS, PAL and HRV. Preference was large correlated with MAS (r = 0.63), PAL (r = 0.57) and HRVRMSSD (r = 0.52). Together, MAS (40.4%), PAL (10.7%) and HRVRMSSD (6.4%) explained 57.5% of the preference score. This results study allow to health professional, that prescribe physical exercise, understand that subjects with high aerobic capacity, cardiovagal modulation and usual PAL will have preference for high intensity exercise. In consequence, can increase the adherence to systematic practice of physical exercise. Conclude that preference of exercise intensity for women in postmenopausal phase is related with aerobic capacity, high HRV and physical activity level


La inactividad física es la principal causa de enfermedades en todo el mundo. Identificar la preferencia al ejercicio físico da como resultado una mayor adherencia y una futura intención de realizar actividad física. El cuestionario de preferencia para al ejercicio físico (PRETIE-Q) es la herramienta principal utilizada para evaluar la preferencia en el ejercicio físico. Las variables como la edad, el índice de masa corporal (IMC), el nivel de actividad física habitual (NAFH), la captación máxima de oxígeno(VO2max) pueden influir en las respuestas de PRETIE-Q. El objetivo de este estudio fue investigar si existe una relación entre la preferencia por la intensidad del ejercicio y la velocidad aeróbica máxima (VAM), la NAFH y la variabilidad de la frecuencia cardíaca (VFC) en mujeres posmenopáusicas. El estudio incluyó a 30 individuos que respondieron a PRETIE-Q junto con análisis de VAM, NAFH y HRV. La preferencia tenía una gran correlación con VAM (r = 0.63), NAFH (r = 0.57) y VFCRMSSD(r = 0.52). VAM (40,4%), NAFH (10,7%) y VFCRMSSD(6,4%) juntos explican el 57,5% de la preferencia del resultado. Los resultados de este estudio permiten que los profesionales de la salud, que prescriben el ejercicio físico, comprendan que las personas con alta capacidad aeróbica, la modulación cardiovagal y la NAFH tendrán preferencia por el ejercicio de alta intensidad. En consecuencia, puede aumentar la adherencia a la práctica sistemática del ejercicio físico. Se concluye que la preferencia de intensidad de ejercicio para las mujeres posmenopáusicas está relacionada con la capacidad aeróbica, alta VFC y nivel de actividad física


Inatividade física é a principalcausa de doenças ao redor do mundo. Identificar a preferência ao exercício físico, resulta em aumento da aderência e intenção futura para realizar a atividade física. O questionário de preferência do exercício físico (PRETIE-Q) é a principal ferramenta usada para avaliar preferência em exercício físico. Variáveis como idade, índice de massa corporal (IMC), nível de atividade física habitual (NAFH), consumo máximo de oxigênio (VO2máx), podem influenciar nas respostas do PRETIE-Q. O objetivo deste presente estudo foi investigar se existe relação entre preferência pela intensidade do exercício com a velocidade aeróbia máxima (VAM), NAFH, e variabilidade da frequência cardíaca (VFC) em mulheres na fase de pós-menopausa. Participaram do estudo 30 indivíduas que responderam PRETIE-Q junto com análises de VAM, NAFH, e VFC. A preferência teve grande correlação com VAM (r= 0.63), NAFH (r= 0.57) e VFCRMSSD(r= 0.52). A VAM (40,4%), NAFH (10,7%), e VFCRMSSD(6,4%) juntos explicam 57,5% da preferênciado resultado. Os resultados deste estudo permitem profissionais de saúde, que prescrevem exercício físico, entender que indivíduos com alta capacidade aeróbia, modulação cardiovagal e NAFH terão preferência por exercício de alta intensidade. Em consequência, pode aumentar a aderência para a prática sistemática de exercício físico. Conclui-se que preferência da intensidade de exercício para mulheres em fase pós-menopausa está relacionada com capacidade aeróbia, alta VFC e nível de atividade física


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Frequência Cardíaca/fisiologia , Atividade Motora/fisiologia , Pós-Menopausa/fisiologia
11.
J Clin Neurosci ; 78: 259-263, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32340844

RESUMO

INTRODUCTION: Asymptomatic intracranial atherosclerotic stenosis (AICAS) is a common cause of stroke. Elderly women were more likely than men to develop AICAS, although it indicated that a lifelong exposure to estrogen could lower the risks of cardiovascular disease (CVDs). OBJECTIVE: The present study aims to ascertain whether postmenopausal time is a risk factor of AICAS. Fostering a correct perception of menopause is of great significance for the overall well-being of the elderly women. METHODS: All participants received a questionnaire, physical examination, laboratory testing and transcranial Doppler. The menopausal population (n = 701) was divided into three groups by tertiles of postmenopausal time. Two-tailed testing and trend test were used to reveal the relationship between postmenopausal time and newly discovered AICAS. Other potential risk factors were also analyzed to ascertain whether there was a relation between postmenopausal time and the newly discovered ICAS. RESULTS: Both mean age and mean postmenopausal time were gradually increased from G0 to G2. The same trend occurred in hypertension, diabetes mellitus, total cholesterol, triglyceride, C-reactive protein and serum homocysteine. Adjusting for various confounding factors, postmenopausal time was not a risk factor for newly discovered AICAS. Multifactor analysis and stratifying analysis showed no correlation between newly discovered AICAS and postmenopausal time. CONCLUSIONS: Postmenopausal time is not an independent risk factor of AICAS. No relationship was detected between postmenopausal time and newly discovered AICAS, while vigorous control of body weight, blood pressure/glucose/lipids and smoke cessation are vital for preventing the occurrence of AICAS.


Assuntos
Doenças Assintomáticas , Arteriosclerose Intracraniana/diagnóstico por imagem , Arteriosclerose Intracraniana/fisiopatologia , Pós-Menopausa/fisiologia , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas/epidemiologia , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Fatores de Tempo , Ultrassonografia Doppler Transcraniana/tendências , Adulto Jovem
12.
Sci Rep ; 10(1): 6584, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32313098

RESUMO

Breastfeeding is related to maternal health. However, the association of women's breastfeeding duration with cognitive function in their later life is limited and inconsistent. The aim of this study was to accurately evaluate the association in Chinese postmenopausal women. We analyzed the data from Zhejiang Ageing and Health Cohort Study including 5487 postmenopausal women. Cognitive impairment was assessed via the Mini-Mental State Examination. Data on breastfeeding duration was collected in the reproductive history section within the questionnaire. Generalized additive models (GAMs) and logistic regression models, controlled for an extensive range of potential confounders, were generated to examine the associations. A U-shaped association was identified between breastfeeding duration and cognitive impairment based on GAM. The nadir with lowest odds of cognitive impairment was ascertained by quadratic model as 12 months. The logistic models showed that compared with women breastfeeding 12 months per child, the fully adjusted odds ratios (ORs) were 1.50 (95% Confidence Interval (CI): 1.20-1.88), 1.58 (95% CI: 1.29-1.93), 1.33 (95% CI: 1.06-1.68), 2.08 (95% CI: 1.64-2.65) for those averagely breastfeeding <6, 6-<12,>12-18,>18 months, respectively. Furthermore, we did not observe significant effect modification of the association. Future longitudinal studies are needed to confirm the association.


Assuntos
Aleitamento Materno , Disfunção Cognitiva/fisiopatologia , Pós-Menopausa/fisiologia , Adulto , Idoso , China/epidemiologia , Cognição/fisiologia , Disfunção Cognitiva/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo
13.
Internist (Berl) ; 61(6): 558-564, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32333087

RESUMO

Peri- and postmenopausal disorders can have a significant impact on quality of life. Hormone replacement therapy (HRT) might be necessary in order to decrease women's symptoms. The German S3 guideline "Peri- and Postmenopause-Diagnostics and Therapy" (2020) provides recommendations that include the most recent evidence as well as the Women's Health Initiative (WHI) study results from 2002 and 2004. These results led to reduced prescription patterns due to a high risk of cardiovascular diseases as well as an increased risk for breast cancer if HRT had been administered. Both ongoing analyses of subgroups and other studies extenuated the WHI data, since the increased risks were neither generalizable to the typical postmenopausal patient (regarding age and risk profile) nor to the medication being used today. This article summarizes all aspects of HRT in peri- and postmenopausal women (indications, contraindications, practical approaches, risks, prevention) and provides recommendations with respect to the most recent S3 guideline.


Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Terapia de Reposição Hormonal , Perimenopausa/efeitos dos fármacos , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/psicologia , Progesterona/efeitos adversos , Idoso , Terapia de Reposição de Estrogênios/métodos , Estrogênios/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Perimenopausa/psicologia , Pós-Menopausa/fisiologia , Progesterona/uso terapêutico , Qualidade de Vida , Saúde da Mulher
14.
Medicine (Baltimore) ; 99(14): e19529, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243369

RESUMO

Resting heart rate, a simple and useful indicator of autonomic function, and its imbalance has emerged as an independent predictor of cardio metabolic diseases. Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed worldwide and is strongly associated with the features of cardiometabolic diseases. This study aimed to examine the association between resting heart rate and NAFLD in postmenopausal women.The cross-sectional study included 1017 postmenopausal women aged ≥46 years, who attended a health examination program. Resting heart rate and NAFLD were measured in all subjects who underwent a medical examination. Resting heart rate quartiles were categorized as follows: Q1: 56 to 65, Q2: 66 to 71, Q3: 72 to 78, and Q4: 79 to 99 beats/min. The odds ratios and 95% confidence intervals for NAFLD were calculated after adjusting for confounding variables across resting heart rate quartiles using multiple logistic regression analysis.The prevalence of NAFLD increased with increasing resting heart rate quartiles: 28.2% for Q1, 31.5% for Q2, 33.4% for Q3, and 38.1% for Q4 (P < .001). Compared to the 1st quartile, the odds ratio (95% confidence intervals) of NAFLD in the 4th quartile of resting heart rates was 2.11 (1.17-3.42) after adjusting for age, body mass index, cigarette smoking, regular exercise, blood pressure, total cholesterol, triglyceride, aspartate aminotransferase, and alanine aminotransferase levels.Resting heart rate was positively associated with NAFLD in postmenopausal women, suggesting that it could be a useful additional measure to assess the risk for NAFLD in postmenopausal women.


Assuntos
Frequência Cardíaca/fisiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Pós-Menopausa/fisiologia , Fatores Etários , Idoso , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Lipídeos/sangue , Testes de Função Hepática , Pessoa de Meia-Idade
15.
BMC Womens Health ; 20(1): 71, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32290849

RESUMO

BACKGROUND: Pro-health behaviours aim at disease prevention, recovery from an illness and maintenance of good health in a physical, mental and social sphere. The study had two main objectives: (a) to analyse health behaviours of postmenopausal women and their understanding of the notion of health, and (b) to analyse the relationship between individual categories of health behaviours and prophylactic activities undertaken by postmenopausal women. METHODS: A cross-sectional study was conducted among a convenience sample of 510 postmenopausal women. Three study instruments were used: an original questionnaire and two instruments designed by Juczynski: the List of Health Criteria and the Health Behaviour Inventory. RESULTS: In the view of the respondents health was primarily synonymous with a feature, because the following three associations were given the highest priority when defining health: to be healthy means 'have all body parts functioning well' (M = 1.82), 'do not experience any physical problems' (M = 1.43) and 'not be sick, only occasionally suffer from flu, cold or indigestion'. The score for health behaviours was average (M = 86.18). The highest score was achieved in the area of prophylactic behaviours. General indicator of health-related behaviours was higher in women who rated their health as very good (p < 0.05). Women whose general indicator of health-related behaviours was higher regularly performed prophylactic gynaecological examinations (p < 0.05). CONCLUSIONS: Results showed that women after menopause treat health mainly as a feature of their body and condition specific for this period of life. The analysis of postmenopausal women's health behaviours and their perception of health helped to identify areas that require the focus of medical personnel in regard to health promotion and prophylaxis. The average general indicator of health-related behaviours is positive for this group of women as it shows that they care about their health, especially in terms of prophylaxis.


Assuntos
Comportamentos Relacionados com a Saúde , Menopausa , Pós-Menopausa , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Pós-Menopausa/psicologia , Inquéritos e Questionários
16.
PLoS One ; 15(4): e0230917, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236147

RESUMO

This study examined the effects of a 6-week Nordic Walking (NW) training, at the intensity corresponding to the dominance of lipid metabolism, on the levels of selected physiological indices, the haemodynamic indices of the cardiovascular system and physical fitness in sedentary women older than 55 years of age. In addition, the physiological response of the female body to the walking effort on treadmill with poles (NW) and without poles (W) was compared and the influence of training on this response was determined. A single group study with a pre-test/post-test study design was conducted. Eighteen women performed NW controlled intensity training 3 times a week for 6 weeks. Body composition, resting blood pressure (BP), heart rate (HR), maximum oxygen uptake (VO2max) as well as circulatory and respiratory indices in two graded walking efforts on mechanical treadmill NW and W were measured before and after training period. The intensity of workouts, which considered the dominance of lipid metabolism, was determined individually, based on the dynamics of changes in the level of physiological indices during the graded intensity NW. After the course of training, body mass, fat mass, resting BP and HR decreased significantly (p < 0.05). HR and respiratory exchange ratio recorded during NW and W at 1.75 m.s-1 walking speed decreased, while the oxygen pulse increased (p < 0.05). VO2max increased significantly (p < 0.05). Before and after the training period HR, oxygen uptake per minute, and energy expenditure during NW were significantly higher than in W (p < 0.05). The study showed that 6-week NW training at the intensity corresponding to the dominance of lipid metabolism can provide improvement in body composition, cardiovascular function and physical performance in previously sedentary women. NW compared to the regular walk with the same speed revealed higher energy expenditure.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Metabolismo Energético/fisiologia , Teste de Esforço , Caminhada/fisiologia , Idoso , Pressão Sanguínea/fisiologia , Composição Corporal/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia , Pós-Menopausa/fisiologia
17.
Gene ; 741: 144543, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32165300

RESUMO

INTRODUCTION: Collagen cross-linking, which is regulated by lysyl oxidase (LOX), plays critical roles in bone mechanical strength. LOX can influence bone remodeling by modulating osteoblast and osteoclast activity. This study aimed to explore the effect of LOX gene polymorphisms on osteoporotic fractures susceptibility in postmenopausal Chinese women. METHODS: This was a prospective study of postmenopausal women who visited the outpatient and community clinics of the local Hospital. Five tagging single nucleotide polymorphisms (SNPs) in the LOX gene were determined. Bone mineral density (BMD) was measured at the lumbar spine, femoral neck, and hip using dual-energy X-ray absorptiometry. Fractures were confirmed by X-ray and divided into: vertebral compression fracture (OVCF) and non-OVCF (all other fractures). RESULTS: This study included 602 patients with non-traumatic fractures and 1343 healthy volunteers. The rs1800449 was significantly associated with vertebral compression fracture (OVCF) after adjusting for age and BMI (P = 0.012). Compared with subjects with the GG genotype, the risk of having OVCF was 1.28 and 1.74, respectively for subjects with the GA and AA genotypes (P = 0.043 and P = 0.018). A recessive genetic model showed that carriers of the AA genotype had higher fracture risk compared to G carriers (GA and GG genotypes) (P = 0.015). The rs2288393 SNP exhibited marginally significant association with OVCF (P = 0.051). Haplotype analyses corroborated our single SNP results: both haplotype CGA and CCG contained rs10519694, rs2288393, and rs1800449, and were significant associated with OVCF (P = 0.048 and P = 0.032, respectively). On the other hand, we found no evidence of an association of LOX gene allelic variants with either BMD or non-OVCF (all P > 0.05). CONCLUSION: The results suggest that genetic polymorphisms in LOX may contribute to susceptibility to OVCF in Chinese postmenopausal women.


Assuntos
Fraturas por Compressão/genética , Osteoporose Pós-Menopausa/genética , Fraturas por Osteoporose/genética , Proteína-Lisina 6-Oxidase/genética , Absorciometria de Fóton , Idoso , Densidade Óssea/genética , Feminino , Colo do Fêmur/diagnóstico por imagem , Colo do Fêmur/fisiopatologia , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/fisiopatologia , Genótipo , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/fisiopatologia , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/fisiopatologia , Pós-Menopausa/genética , Pós-Menopausa/fisiologia , Fatores de Risco
18.
Artigo em Inglês | MEDLINE | ID: mdl-32110899

RESUMO

In the reproductive phase, women experience cyclic changes in the ovaries and uterus, and hormones regulate these changes. Menopause is the permanent loss of menstruation after 12 months of amenorrhea. Menopause is also linked to a decrease in estrogen production, causing an imbalance in oxidative stress. We aimed to compare the three stages of lipid peroxidation, protein oxidative damage, and total antioxidant capacity (TAC) between reproductive-aged women (RAW) and postmenopausal women (PMW) in Mexico. We carried out a cross-sectional study with 84 women from Mexico City, including 40 RAW and 44 PMW. To determine the oxidative stress of the participants, several markers of lipid damage were measured: dienes conjugates (DC), lipohydroperoxides (LHP), and malondialdehyde (MDA); exposure to protein carbonyl is indicative of oxidative modified proteins, and TAC is indicative of the antioxidant defense system. Biomarkers of oxidative stress were significantly lower in RAW vs. PMW. DC were 1.31 ± 0.65 vs. 1.7 ± 0.51 pmol DC/mg dry weight (p = 0.0032); LHP were 4.95 ± 2.20 vs. 11.30 ± 4.24 pmol LHP/mg dry weight (p < 0.0001); malondialdehyde was 20.37 ± 8.20 vs. 26.10 ± 8.71 pmol MDA/mg dry weight (p = 0.0030); exposure of protein carbonyl was 3954 ± 884 vs. 4552 ± 1445 pmol PC/mg protein (p = 0.042); and TAC was 7244 ± 1512 vs. 8099 ± 1931 pmol Trolox equivalent/mg protein (p = 0.027). PMW display significantly higher oxidative stress markers compared to RAW; likewise, PMW show a higher TAC.


Assuntos
Peroxidação de Lipídeos , Estresse Oxidativo , Pós-Menopausa , Reprodução , Adulto , Antioxidantes , Estudos Transversais , Feminino , Humanos , Malondialdeído , México , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Reprodução/fisiologia , Adulto Jovem
19.
Sci Rep ; 10(1): 3838, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32123242

RESUMO

The objective of this study was to determine if 15 weeks of resistance training (RT) can alter the levels of blood lipids, body iron status, and oxidative stress in postmenopausal women with vasomotor symptoms. Postmenopausal women enrolled in a randomised controlled trial were allocated to either a sedentary control group (n = 29) or a RT group (n = 26). Blood samples were taken at week-0 and week-15 for all participants. Blood lipids and iron status were measured via routine clinical analyses. Immunoassays were used to measure oxidative stress markers. The RT group, with good compliance, was associated with significant reductions in ferritin, total cholesterol, low-density lipoprotein, and non-high-density lipoprotein cholesterol. Moreover, ferritin was positively correlated with atherogenic lipids while negatively correlated with high-density lipoprotein in RT women. This occurred without alterations in serum iron, transferrin, transferrin-saturation, C-reactive protein and oxidative stress markers. No differences were found in control women. This study suggests that RT in postmenopausal women both reduces levels of ferritin and counteracts atherogenic lipid profiles independent of an apparent oxidative mechanism. RT may be a beneficial intervention in postmenopausal women via an interaction between ferritin and lipids; however, further investigation in a larger cohort is essential.


Assuntos
Aterosclerose/sangue , Ferritinas/sangue , Lipídeos/sangue , Pós-Menopausa/sangue , Pós-Menopausa/fisiologia , Treinamento de Resistência , Feminino , Humanos , Ferro/metabolismo , Pessoa de Meia-Idade , Estresse Oxidativo , Pós-Menopausa/metabolismo
20.
Maturitas ; 134: 41-46, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32143775

RESUMO

OBJECTIVES: The purpose of this study was to assess the association between fruit intake and abnormalities in body composition (bone, muscle, and adipose tissue) related to osteosarcopenic obesity (OSO) in postmenopausal women. STUDY DESIGN: The data of 1420 postmenopausal women aged 50-64 years were collected from cross-sectional studies conducted by the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2010. MAIN OUTCOME MEASURES: A dietary intake survey was administered using the 24-h dietary recall method, and intakes of nutrients and food groups were analyzed. Body composition was evaluated using dual-energy x-ray absorptiometry (DEXA). Body composition abnormalities include low bone mass (T-score<-1.0), low muscle mass (weight-adjusted appendicular skeletal muscle mass below the mean reference value of healthy young adults), and obesity (waist circumference ≥85 cm). The associations between nutrient intake and fruit groups and the number of abnormalities in body composition were tested by logistic regression analysis. RESULTS: The intakes of vitamin C and potassium per 1000 kcal of total energy intake were significantly lower in women with a larger number of abnormalities in body composition (p = 0.0155 and p = 0.0037, respectively). After controlling for covariates, women with a high intake of fruit (≥257.4 g/d) had a significantly reduced likelihood of multiple abnormalities in body composition compared with women with no fruit intake (p for trend: p < 0.01 for those with one, two, or three abnormalities). CONCLUSIONS: Intake of fruits rich in vitamin C and potassium may help to decrease OSO-related risks in middle-aged postmenopausal women.


Assuntos
Doenças Ósseas Metabólicas/fisiopatologia , Dieta , Ingestão de Energia , Frutas , Obesidade/fisiopatologia , Pós-Menopausa/sangue , Sarcopenia/fisiopatologia , Absorciometria de Fóton , Ácido Ascórbico , Composição Corporal/fisiologia , Peso Corporal , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Pós-Menopausa/fisiologia , República da Coreia/epidemiologia , Vitaminas , Circunferência da Cintura
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