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2.
Maturitas ; 132: 49-56, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883663

RESUMO

OBJECTIVE: Most studies of the age-related changes in body composition are cross-sectional in design: there have been few longitudinal studies. The aim of this 5-year study was to document body composition changes in perimenopausal and older women. STUDY DESIGN: Prospective, longitudinal observational study. METHODS: 489 women were randomly selected from the electoral roll and stratified into 4 age groups by decade: 40-49, 50-59, 60-69 and 70-79 years. Dual-energy x-ray absorptiometry (DXA) was performed in the first and fifth years of the study. Total body mass (TBM), total fat mass (TFM), total lean mass (TLM), abdominopelvic fat mass, and appendicular fat and lean mass were determined. RESULTS: There were significant increases in TBM (p < 0.001), TFM (p < 0.01), TLM (p < 0.05), arm fat mass (p < 0.05), leg fat mass (p < 0.001) and leg lean mass (p < 0.05) within the 40-49 age decade. TBM, TFM and abdominopelvic fat started to decline from the 50-59 decade. Abdominopelvic fat reduction was significant from the 50-59 decade to the later decades (p = 0.05 to p < 0.001). Arm lean mass showed a significant reduction from the 50-59 decade (p < 0.01). Leg lean mass declined from the 60-69 decade, reaching significance in the 70-79 decade (p = 0.05). CONCLUSION: TFM and abdominopelvic fat declined from the 50-59 age decade, which is earlier than is suggested in the literature. Conversely, the decline in appendicular lean mass with age occurred later, from the 50-59 decade, with earlier and greater loss in the arms, which has implications for exercise strategies to maintain muscle mass from midlife on.


Assuntos
Composição Corporal , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Gordura Abdominal , Absorciometria de Fóton , Adiposidade , Adulto , Idoso , Braço , Peso Corporal , Feminino , Humanos , Perna (Membro) , Estudos Longitudinais , Pessoa de Meia-Idade , Músculo Esquelético , Estudos Prospectivos
3.
Ann Agric Environ Med ; 26(4): 600-605, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885234

RESUMO

OBJECTIVE: The aim of the study was evaluation of the relationship between severity of symptoms of climacteric syndrome, depressive disorders and sleep problems, and the self-rated work ability of peri-menopausal and post-menopausal women in non-manual employment. MATERIAL AND METHODS: The study included 287 women aged 45-60 years, employed in various institutions as non-manual workers. Work Ability Index, Greene Climacteric Scale, Beck Depression Inventory, and Athens Insomnia Scale were used. RESULTS: The examined peri-menopausal and post-menopausal women in non-manual employment obtained good work ability on the Work Ability Index. The severity of menopausal syndrome, according to the Greene Climacteric Scale, was moderate, placing the examined women between results for the general population of women and the pattern for menopausal women. Depressive disorders ranked between low mood and moderate depression. No depression was observed in 59% of the women, whereas moderate depression was observed in 39%, and severe depression in only 2%. Sleep disorders were on the border of normal range. As many as 46% of the women had no sleep problems, which was on the border of normal range in 36%. Only 19% of the examined women suffered from insomnia. Work ability correlated negatively with depression and insomnia severity, as well as with psychological and vasomotor symptoms of climacteric syndrome, but not to its somatic symptoms. CONCLUSIONS: Preventing the occurrence and treatment of menopausal symptoms, sleep and mood disorders may contribute to maintaining the work ability of women in peri- and post-menopausal age.


Assuntos
Climatério/fisiologia , Depressão/fisiopatologia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Climatério/psicologia , Depressão/economia , Depressão/psicologia , Emprego , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Distúrbios do Início e da Manutenção do Sono/economia , Distúrbios do Início e da Manutenção do Sono/psicologia , Avaliação da Capacidade de Trabalho
4.
BMC Infect Dis ; 19(1): 1055, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842775

RESUMO

BACKGROUND: The risk factors for Mycobacterium avium complex lung disease (MAC-LD) are not well known. We hypothesized that low serum estradiol (E2) levels are related to MAC-LD as most patients with MAC-LD are postmenopausal women. METHODS: This cross-sectional study compared patients with MAC-LD and healthy controls. Study subjects were postmenopausal women aged 65 years or younger. Serum testosterone, dehydroepiandrosterone sulfate (DHEA-S), and E2 levels were measured and categorized as high or low based on median levels. We performed multivariate analysis, receiver operating characteristic (ROC) curve analysis, and age- and body mass index (BMI)-matched subgroup analysis to evaluate the association between low serum E2 levels and MAC-LD. Additionally, using blood samples obtained for other clinical studies, the levels of sex steroid hormones were compared between age- and BMI-matched MAC-LD and bronchiectasis female patients without non-tuberculosis mycobacterial infections (non-NTM BE). RESULTS: Forty-two patients with MAC-LD and 91 healthy controls were included. The median E2 (2.20 pg/mL vs. 15.0 pg/mL, p < 0.001), testosterone (0.230 ng/L vs. 0.250 ng/L, p = 0.005), and DHEA-S (82.5 µg/dL vs. 114.0 µg/dL, p < 0.001) levels were lower in the MAC-LD group than in the control group. Multivariate analysis revealed that low serum E2 (adjusted odds ratio = 34.62, 95% confidence interval = 6.02-199.14) was independently related to MAC-LD, whereas low DHEA-S and testosterone were not. ROC analysis illustrated a strong relationship between low serum E2 levels and MAC-LD (area under the curve = 0.947, 95% confidence interval = 0.899-0.995). Even the age- and BMI-matched subgroup analysis of 17 MAC-LD patients and 17 healthy controls showed lower serum E2 in MAC-LD patients than in healthy controls. Additionally, serum E2 levels of 20 MAC-LD patients were lower than plasma E2 levels of 11 matched non-NTM BE patients (1.79 pg/mL vs. 11.0 pg/mL, p < 0.001). CONCLUSIONS: Low serum E2 levels were strongly related to MAC-LD in postmenopausal women.


Assuntos
Estradiol/sangue , Pneumopatias/sangue , Pneumopatias/microbiologia , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/microbiologia , Índice de Massa Corporal , Bronquiectasia/sangue , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Feminino , Humanos , Japão , Pessoa de Meia-Idade , Análise Multivariada , Pós-Menopausa/fisiologia , Curva ROC , Fatores de Risco , Centros de Atenção Terciária , Testosterona/sangue
5.
Maturitas ; 130: 32-37, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31706433

RESUMO

INTRODUCTION: It is unclear how aging and menopause-induced lipid changes contribute to the elevated cardiovascular risk in menopausal women. We examined the association between lipid profiles and menopausal status and duration of menopause in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: This is a cross-sectional analysis of baseline data from women in the ELSA-Brasil, stratified by duration of menopause into 5 groups: pre-menopause, <2 years, 2-5.9 years, 6-9.9 years and ≥10 years of menopause, excluding menopause <40 years or of non-natural cause; also excluded were women using lipid-lowering drugs or hormone replacement. Comparisons were performed using ANOVA with Bonferroni correction. Associations of menopause categories and time since menopause with lipid variables obtained by vertical auto-profile were tested using multiple linear regression. RESULTS: From 1916 women, postmenopausal groups had unadjusted higher total cholesterol, LDL-c, real LDL-c, IDL-c, VLDL-c, triglycerides, non-HDL-c, VLDL3-c, triglyceride-rich lipoprotein remnants (TRL-c) and buoyant LDL-c concentrations than pre-menopausal women, with no difference among postmenopausal groups. In multiple linear regression, duration of menopause <2 years was significantly associated with TRL-c [7.21 mg/dL (95% CI 3.59-10.84)] and VLDL3-c [2.43 mg/dL (95%CI 1.02-3.83)]. No associations of menopausal categories with HDL-c or LDL-c subfractions were found, and nor were associations of time since menopause with lipid subfractions. CONCLUSIONS: In a large sample of Brazilian women, deterioration of the lipid profile following menopause was confirmed, which could contribute to the increased cardiovascular risk. Our findings suggest a postmenopausal elevation in triglyceride-rich lipoprotein remnants. How lipoprotein subfractions change after the onset of menopause warrants investigation in studies with appropriate designs.


Assuntos
Pós-Menopausa/sangue , Pré-Menopausa/sangue , Adulto , Idoso , Brasil , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Metabolismo dos Lipídeos , Lipoproteínas/sangue , Estudos Longitudinais , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Pré-Menopausa/fisiologia , Fatores de Tempo , Triglicerídeos/sangue
6.
Medicina (Kaunas) ; 55(10)2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31554294

RESUMO

Background and Objectives: Recent studies have shown that low skeletal muscle mass can contribute to non-alcoholic fatty liver disease through insulin resistance. However, the association between muscle mass/strength and hepatic fat content remains unclear in postmenopausal women. Methods: In this study, we assessed the associations between muscle mass/strength and various severities of non-alcoholic fatty liver disease. Using single-voxel proton magnetic resonance spectroscopy, 96 postmenopausal women between the ages of 50 and 65 were divided into four groups (G0-G3) by hepatic fat content: G0 (hepatic fat content <5%, n = 20), G1 (5% ≤ hepatic fat content < 10%, n = 27), G2 (10% ≤ hepatic fat content < 25%, n = 31), and G3 (hepatic fat content ≥25%, n = 18). Muscle mass indexes were estimated as skeletal muscle index (SMI)% (total lean mass/weight × 100) and appendicular skeletal muscular mass index (ASM)% (appendicular lean mass/weight × 100) by dual energy X-ray absorptiometry. Maximal isometric voluntary contraction of the handgrip, elbow flexors, and knee extensors was measured using an adjustable dynamometer chair. Fasting plasma glucose, insulin, and follicle-stimulating hormones were assessed in venous blood samples. Results: The results showed negative correlations between hepatic fat content and SMI% (r = -0.42, p < 0.001), ASM% (r = -0.29, p = 0.005), maximal voluntary force of grip (r = -0.22, p = 0.037), and knee extensors (r = -0.22, p = 0.032). Conclusions: These significant correlations almost remained unchanged even after controlling for insulin resistance. In conclusion, negative correlations exist between muscle mass/strength and the progressed severity of non-alcoholic fatty liver disease among post-menopausal women, and the correlations are independent of insulin resistance.


Assuntos
Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Pós-Menopausa/fisiologia , Absorciometria de Fóton , Idoso , Composição Corporal , Cotovelo/fisiologia , Feminino , Força da Mão , Humanos , Contração Isométrica , Joelho/fisiologia , Fígado , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/complicações , Espectroscopia de Prótons por Ressonância Magnética , Sarcopenia/etiologia
7.
Ann Agric Environ Med ; 26(3): 425-428, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559798

RESUMO

INTRODUCTION AND OBJECTIVE: Physical effort plays a positive role in reducing the risk of cardiovascular diseases. The aim of this study was to assess the cardiovascular status in postmenopausal women after several years of regular amateur training. MATERIAL AND METHODS: A total of 55 generally healthy females aged 50-70 years, of whom 38 were members of a senior exercise group and 17 comprised a control group, were enrolled in the study. Parameters of blood flow, vascular resistance, myocardial contractility and thoracic fluid content were measured in a 10-minute supine resting test by impedance cardiography. Thereafter, central blood pressure, augmentation index and pulse wave velocity were measured by applanation tonometry. RESULTS: Exercising women have a better outcome than the control group, when evaluated both with impedance cardiography and with applanation tonometry. They have a lower heart rate - HR (65.1 vs 71.5; p = 0.033), higher blood flow (stroke index - SI, 58.6 vs 50.3; p = 0.040), better myocardial contractility (acceleration index - ACI, 108.8 vs 88.1; p = 0.027), higher preload (thoracic fluid content index - TFCI, 20.5 vs 18.1; p = 0.002), lower afterload (systemic vascular resistance index - SVRI, 1972.9 vs 2110.5; p = 0.026), lower central systolic blood pressure - cBPsys (119.0 vs 129.5; p = 0.037), lower augmentation pressure - AP (10.3 vs 15.0; p = 0.044) and lower pulse wave velocity - PWV (7.4 vs 8.4; p = 0.001). CONCLUSIONS: Regular moderate continuous aerobic exercise training has a beneficial impact on the cardiovascular system in postmenopausal women.


Assuntos
Fenômenos Fisiológicos Cardiovasculares , Exercício , Pós-Menopausa/fisiologia , Idoso , Pressão Sanguínea , Cardiografia de Impedância , Feminino , Hemodinâmica , Humanos , Pessoa de Meia-Idade
8.
Medicina (Kaunas) ; 55(10)2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31547180

RESUMO

The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of genitourinary syndrome (GSM). This condition has a high prevalence among post-menopausal women and negatively affects a woman's quality of life. Epidemiology, signs, symptoms, diagnostic criteria of VVA and target treatments for restoring vaginal health are discussed in light of the most recent literature. Issues related to this condition in menopausal women are under-diagnosed, lack objective diagnostic criteria, and consequently under-treated. Over the years, many treatments have been developed but their long-term effectiveness and safety have yet to be clearly defined. Patients are often dissatisfied and stop treatment, suggesting the need for a more personalized and tailored approach to achieve better compliance and thereby effectiveness. The aim of this paper is to provide an overview of the most recent literature on VVA in order to help the gynecologist in the management of this condition.


Assuntos
Emolientes/administração & dosagem , Terapia de Reposição Hormonal , Lubrificantes/administração & dosagem , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Vagina/patologia , Doenças Vaginais/terapia , Administração Intravaginal , Atrofia/epidemiologia , Atrofia/terapia , Feminino , Humanos , Terapia a Laser , Vagina/fisiopatologia , Doenças Vaginais/diagnóstico , Doenças Vaginais/epidemiologia
9.
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
10.
Osteoporos Int ; 30(9): 1799-1806, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31367948

RESUMO

We report that compared with normoglycaemia, post-menopausal women (non-obese and obese) with diabetes had higher lumbar spine bone mineral density (LSBMD). Femoral neck bone mineral density (FNBMD) was higher in obese post-menopausal women with diabetes. Only non-obese post-menopausal women with impaired fasting glucose (IFG) had a higher LSBMD than normoglycaemia. No other associations with IFG were observed. INTRODUCTION: Individuals with diabetes have a higher or normal bone mineral density (BMD) compared with those without diabetes. However, paradoxically, they also have a higher fracture risk. It is not clear whether those with IFG also have altered BMD. This study aimed to determine whether individuals with IFG have elevated or normal BMD. METHODS: Women (n = 858) and men (n = 970) (aged 20-80 years) from the Geelong Osteoporosis Study were included. IFG was defined as fasting plasma glucose (FPG) 5.5-6.9 mmol/L and diabetes as FPG ≥ 7.0 mmol/L, use of antihyperglycaemic medication and/or self-report. Using multivariable linear regression, the relationships between glycaemia and BMD at the femoral neck and lumbar spine were examined, and adjusted for age, body mass index (BMI), and other variables. In women, two interaction terms were identified: menopause × glycaemia and BMI × glycaemia, and thus, the analyses were stratified by menopause and obesity status (BMI cut point ≥ 30 kg/m2). RESULTS: There were no associations between glycaemic status and BMD for pre-menopausal women. For non-obese post-menopausal women, there was no association between FNBMD and glycaemic status, but women with IFG or diabetes had higher LSBMD than those with normoglycaemia (7.1% and 9.7%, respectively, both p < 0.01). Obese post-menopausal women with diabetes had a higher FNBMD (8.8%, p = 0.008) and LSBMD (12.2%, p < 0.001), but those with IFG were not different from the normoglycaemia group. There were no associations detected between glycaemic status and BMD in men. CONCLUSIONS: In this study, we report that compared with normoglycaemia, post-menopausal women (non-obese and obese) with diabetes had higher LSBMD. FNBMD was higher in obese post-menopausal women with diabetes. Only non-obese post-menopausal women with IFG had a higher LSBMD than normoglycaemia. No other associations with IFG were observed.


Assuntos
Glicemia/análise , Densidade Óssea/fisiologia , Diabetes Mellitus/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Índice de Massa Corporal , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Jejum/sangue , Feminino , Colo do Fêmur/fisiopatologia , Humanos , Hipoglicemiantes/uso terapêutico , Estudos Longitudinais , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/fisiopatologia , Pós-Menopausa/sangue , Pós-Menopausa/fisiologia , Fatores Sexuais , Adulto Jovem
11.
J Dermatol ; 46(10): 874-878, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373068

RESUMO

Hyperhidrosis can seriously impair patients' quality of life. Medical history, including heredity and hyperhidrosis during youth, as well as current age and time elapsed since menopause, is important to consider when distinguishing between postmenopausal hyperhidrosis and vasomotor symptoms to enable adequate treatment. This report concerns a subgroup of eight postmenopausal patients participating in a randomized controlled trial regarding botulinum toxin (Btx) type B treatment in craniofacial hyperhidrosis. Even though the sample size is small and the enrolment is not yet completed, the promising data collected hitherto are interesting to present in advance because this subtype of craniofacial hyperhidrosis is often underrecognized and challenging to treat. Patients were randomized to receive Btx type B or placebo. Measurements were performed before treatment and 3 ± 1 weeks after. The Dermatology Life Quality Index (DLQI) score was improved for all patients after Btx type B treatment (n = 3) with a median decrease of 9 points (90% median improvement). The placebo group (n = 5) had a median increase of 2 points (-18% median decline). When the same group (n = 5) received Btx type B (open) the DLQI score decreased with a median of 7 points compared with baseline (91% median improvement). Treatment-related adverse events were temporary and did not prevent improvement of life quality. Furthermore, background data evaluation uncovered interesting findings regarding vasomotor symptoms in relation to postmenopausal hyperhidrosis. In conclusion, the results indicated that Btx type B seems to be a safe and effective treatment in postmenopausal craniofacial hyperhidrosis. Further research is encouraged.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Hiperidrose/tratamento farmacológico , Pós-Menopausa/fisiologia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Toxinas Botulínicas Tipo A/efeitos adversos , Face , Feminino , Cabeça , Humanos , Hiperidrose/complicações , Hiperidrose/fisiopatologia , Injeções Intradérmicas , Pessoa de Meia-Idade , Placebos/administração & dosagem , Placebos/efeitos adversos , Resultado do Tratamento
12.
Cells ; 8(7)2019 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261822

RESUMO

Recent studies support the existence of oogonial stem cells (OSCs) in the ovarian cortex of different mammals, including women.These cells are characterized by small size, membrane expression of DEAD(Asp-Glu-Ala-Asp)-box polypeptide-4 (Ddx4), and stemness properties (such as self-renewal and clonal expansion) as well as the ability to differentiate in vitro into oocyte-like cells. However, the discovery of OSCs contrasts with the popular theory that there is a numerically defined oocyte pool for female fertility which undergoes exhaustion with menopause. Indeed, in the ovarian cortex of postmenopausal women OSCs have been detected that possess both viability and capability to differentiate into oocytes, which is similar to those observed in younger patients. The pathophysiological role of this cell population in aged women is still debated since OSCs, under appropriate stimuli, differentiate into somatic cells, and the occurrence of Ddx4+ cells in ovarian tumor samples also suggests their potential involvement in carcinogenesis. Although further investigation into these observations is needed to clarify OSC function in ovary physiology, clinical investigators and researchers studying female infertility are presently focusing on OSCs as a novel opportunity to restore ovarian reserve in both young women undergoing early ovarian failure and cancer survivors experiencing iatrogenic menopause.


Assuntos
Plasticidade Celular/fisiologia , RNA Helicases DEAD-box/metabolismo , Células-Tronco de Oogônios/fisiologia , Ovário/fisiologia , Pós-Menopausa/fisiologia , Animais , Feminino , Humanos , Ovário/citologia
13.
Environ Health Prev Med ; 24(1): 48, 2019 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-31301734

RESUMO

AIMS: To investigate the association of four single-nucleotide polymorphisms (SNPs) of the IL-6 gene with osteoporosis (OST) susceptibility. METHODS: PCR restriction fragment length polymorphism (PCR-RFLP) was carried out for SNPs detection. Generalized multifactor dimensionality reduction (GMDR) model and logistic regression model were used to examine the interaction between SNP and obesity on OST. RESULTS: Logistic regression model revealed that G allele of rs1800796 and the T allele of rs2069849 were associated with increased OST risk, compared to those with wild genotype. However, no significant correlations were found when analyzing the association of rs1800795 and rs1554606 with OST risk. GMDR analysis suggested that the interaction model composed of the rs1800796 and obesity was the best model with statistical significance (P value from sign test [Psign] = 0.012), indicating a potential gene-environment interaction between rs1800796 and obesity. Overall, the two-locus models had a cross-validation consistency of 10/10 and had the testing accuracy of 0.641. We also conducted stratified analysis for rs1800796 genotype and obesity, and found that obese subjects with CG or GG genotype have the highest OST risk, compared to subjects with CC genotype, and normal BMI OR (95% CI) = 2.21 (1.52-3.49), after adjustment for age, smoke, and alcohol consumption status. CONCLUSIONS: Our results suggested that the C allele of rs1800796 and the C allele of rs2069849 of IL-6 gene interaction between rs1800796 and abdominal obesity were all associated with increased OST risk.


Assuntos
Interleucina-6/genética , Obesidade/genética , Osteoporose/epidemiologia , Polimorfismo de Nucleotídeo Único , Pós-Menopausa/fisiologia , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Interação Gene-Ambiente , Humanos , Interleucina-6/metabolismo , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etiologia , Osteoporose/etiologia , Osteoporose/genética , Pós-Menopausa/genética , Fatores de Risco
14.
Yonsei Med J ; 60(8): 742-750, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31347329

RESUMO

PURPOSE: Muscle mass, strength, and composition determine muscle quantity and quality. However, data on muscle properties in relation to bone mass or insulin resistance are limited in Asian populations. This study aimed to investigate the relative importance of muscle measurements in regards to their relationship with lower bone mass and insulin resistance. MATERIALS AND METHODS: In this study, 192 postmenopausal women (age, 72.39±6.07 years) were enrolled. We measured muscle cross-sectional area (CSA) and attenuation at the gluteus maximus and quadriceps muscles through quantitative computed tomography. Muscle strength and physical performance were evaluated with the hand grip test and Short Physical Performance Battery (SPPB). Pearson correlation analysis and linear regression were performed to evaluate the relationship between muscle properties and homeostatic model assessment-insulin resistance (HOMA-IR) or bone mineral density (BMD). RESULTS: Muscle CSA, hand grip strength, and SPPB score held positive correlations with spine and hip BMDs, but not with insulin resistance. In contrast, muscle attenuation of the gluteus maximus or quadriceps was inversely related to HOMA-IR (r=-0.194, p=0.018 and r=-0.292, p<0.001, respectively), but not BMD. Compared with the control group, muscle CSA was significantly decreased in patients with osteoporosis; however, decreased muscle attenuation, indicating high fat infiltration, was found only in patients with diabetes. CONCLUSION: Muscle mass, strength, and physical performance were associated with low bone mass, and accumulation of intramuscular fat, a histological hallmark of persistently damaged muscles, may play a major role in the development of insulin resistance in Korean postmenopausal women.


Assuntos
Osso e Ossos/anatomia & histologia , Resistência à Insulina , Força Muscular/fisiologia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Pós-Menopausa/fisiologia , Idoso , Índice de Massa Corporal , Densidade Óssea/fisiologia , Estudos Transversais , Diabetes Mellitus/fisiopatologia , Feminino , Força da Mão/fisiologia , Humanos , Tamanho do Órgão , Osteoporose/fisiopatologia , República da Coreia
15.
Yonsei Med J ; 60(8): 791-795, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31347335

RESUMO

PURPOSE: To determine the relationship between uterine leiomyoma and female sexual dysfunction (FSD) among premenopausal and postmenopausal women. MATERIALS AND METHODS: The study population consisted of consecutive women who underwent gynecologic screening tests, including transvaginal ultrasound, and completed the questionnaires on FSD. A total of 841 women were included from January 2010 to December 2011. FSD was defined as Female Sexual Function Index (FSFI) ≤26.55. The relationship between uterine leiomyoma and FSD were compared according to menopausal status. RESULTS: In premenopausal group (n=564), there were no differences in the frequency of FSD (55.0% vs. 58.8%, p=0.387) and total FSFI score. However, in postmenopausal group (n=277), women with uterine leiomyoma had a lower frequency of FSD than those without uterine leiomyoma (71.3% vs. 86.4%, p=0.003). This relationship between uterine leiomyoma and lower frequency of FSD in postmenopausal women remained significant after adjusting for confounding variables. CONCLUSION: The relationship between uterine leiomyoma and FSD is different depending on the menopausal status.


Assuntos
Leiomioma/complicações , Leiomioma/fisiopatologia , Pós-Menopausa/fisiologia , Disfunções Sexuais Fisiológicas/complicações , Neoplasias Uterinas/complicações , Neoplasias Uterinas/fisiopatologia , Adulto , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Medicina (Kaunas) ; 55(7)2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31248050

RESUMO

Background and objectives: Justification for application of 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines to detect hypertension (HTN) among Bangladeshi population is understudied. This prompted us to examine the level of agreement between 2017 ACC/AHA and Joint National Committee 7 (JNC 7) guidelines to detect postmenopausal HTN in a rural area of Bangladesh. Materials and Methods: This cross-sectional study recruited 265 postmenopausal women of 40-70 years of age who visited a rural primary health care centre of Bangladesh. HTN was diagnosed based on two definitions: the JNC 7 guidelines (SBP ≥ 140 or DBP ≥ 90 mmHg), and the 2017 ACC/AHA guidelines (SBP ≥ 130 mmHg, or DBP ≥ 80 mmHg). The prevalence of postmenopausal HTN, its sub-types and stages were reported and compared using frequency and percentage. Agreement was evaluated using Cohen's Kappa (κ), Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) and First-order Agreement Coefficient (AC1). Results: The prevalence of postmenopausal HTN was 67.5% and 41.9% using 2017 ACC/AHA and JNC 7 guidelines respectively. Among the HTN sub-types and stages, the new 2017 ACC/AHA guideline classified higher proportion of respondents as having isolated systolic hypertension (ISH) (42.6%) and stage 2 HTN (35.8%) compared to JNC 7 (28.7% and 6.8% respectively). On the other hand, the JNC 7 guideline identified more respondents as pre-hypertensive (32.5%) when compared with the 2017 ACC/AHA guideline (3.8%). Between two guidelines, highest agreement was observed for ISH (86.03%) and those had pre-hypertension/elevated blood pressure (71.3%). Similarly, Landis & Koch's approach detected highest agreement for ISH (κ = 0.74, substantial; PABAK = 0.76, substantial; AC1 = 0.84, excellent; p < 0.001) and pre-hypertension/elevated blood pressure (κ= 0.12, slight; PABAK = 0.42, moderate; AC1 = 0.83, excellent; p < 0.001). Conclusions: The 2017 ACC/AHA HTN guideline reported high agreement and detected more participants as hypertensive when compared with JNC 7 guideline for Bangladeshi postmenopausal women that demands further large-scale study in general population to clarify the current findings more precisely.


Assuntos
Hipertensão/diagnóstico , Pós-Menopausa/fisiologia , Adulto , Idoso , Bangladesh/epidemiologia , Pressão Sanguínea , Determinação da Pressão Arterial/métodos , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos
17.
Med Sci Sports Exerc ; 51(7): 1413-1419, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31210647

RESUMO

INTRODUCTION: Menopause is accompanied by body composition changes that include a decrease in lean mass and aerobic fitness and an increase in fat mass. Sprint interval training (SIT) may be able to reverse these changes. PURPOSE: To examine the effect of an 8-wk SIT program on body composition and aerobic fitness of overweight postmenopausal women. METHODS: Forty postmenopausal women were randomized into SIT (n = 20) or control (n = 20) groups. The SIT group completed three SIT sessions a week for 8 wk with each session consisting of 20 min of alternating 8-s sprints and 12-s of light pedaling. Total mass, regional lean mass, and fat mass were assessed using dual-energy x-ray absorptiometry. Maximal oxygen uptake (V˙O2max) was predicted using a submaximal test. RESULTS: Total lean mass was significantly increased from pretest (48.1 ± 5.81 kg) to posttest (48.8 ± 5.96 kg) and fat mass was significantly reduced (pre, 29.5 ± 7.29 kg; post, 29.1 ± 7.61 kg) for the SIT group. Lean mass was mostly increased in the trunk (pre, 24.4 ± 2.79 kg; post, 24.8 ± 2.93 kg) and legs (pre, 15.6 ± 2.31 kg; post, 15.9 ± 2.34 kg). V˙O2max was significantly increased from pretest (21.7 ± 4.89 mL⋅kg⋅min) to posttest (24.4 ± 5.96 mL⋅kg⋅min) for the SIT group only. CONCLUSIONS: The SIT intervention increased total lean mass, decreased fat mass, and increased aerobic fitness of postmenopausal women after only 8 h of actual exercise over 8 wk.


Assuntos
Composição Corporal/fisiologia , Treinamento Intervalado de Alta Intensidade/métodos , Sobrepeso/fisiopatologia , Sobrepeso/terapia , Pós-Menopausa/fisiologia , Absorciometria de Fóton , Pressão Sanguínea/fisiologia , Distribuição da Gordura Corporal , Aptidão Cardiorrespiratória/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Pessoa de Meia-Idade , Consumo de Oxigênio
18.
Eur J Radiol ; 116: 205-211, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31153566

RESUMO

PURPOSE: To assess the association of fatty acid levels in mammary adipose tissue of postmenopausal women with the presence of breast cancer using the Gradient-echo Spectroscopic Imaging (GSI). MATERIALS AND METHODS: Unilateral GSI was performed at 3 T in 61 postmenopausal women undergoing breast MRI exams. The study included 19 women with breast cancer, 23 women with benign/high risk lesions, and 19 women with a history of cancer. Voxel-wise spectral analysis of fatty acids was conducted to measure relative portions of monounsaturated (MUFA), polyunsaturated (PUFA), and saturated fatty acids (SFA) in each voxel. The voxels within mammary adipose tissue were automatically selected and their median fatty acid fractions were used for quantitative analysis. Statistical analyses were performed using χ2 test, one-way analysis of variance (ANOVA) with Tukey-Kramer multiple comparison tests, and linear regression. RESULTS: Postmenopausal women with malignancies had significantly higher SFA (0.336 ± 0.038) in mammary adipose tissue compared to those with benign disease (0.283 ± 0.046, p = 0.0008) and to those with a history of breast cancer (0.287 ± 0.050, p = 0.0038). Postmenopausal women with malignant lesions had significantly lower MUFA (0.352 ± 0.041) compared to those with benign disease (0.401 ± 0.043, p = 0.0032) and with history of breast cancer (0.388 ± 0.055, p = 0.0484). The history of cancer group had a significant correlation (r = 0.60, p = 0.006) between SFA and BMI, and the cancer group had a significant correlation (r = 0.57, p = 0.010) between PUFA and BMI. CONCLUSIONS: Fatty acid composition of mammary adipose tissue, particularly higher SFA and lower MUFA, may be associated with breast cancer. The GSI method utilizes an automated voxel-based analysis to measure fatty acid composition, and may be used to assess the role of mammary adipose tissue in cancer development and progress.


Assuntos
Tecido Adiposo/química , Neoplasias da Mama/metabolismo , Mama/química , Ácidos Graxos/metabolismo , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Estudos Retrospectivos
19.
Prog. obstet. ginecol. (Ed. impr.) ; 62(3): 230-236, mayo-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185003

RESUMO

Objective: To describe the clinical progress of women with vaginal atrophy who receive nonhormonal treatment. Material and methods: Single-center retrospective longitudinal observational descriptive study in postmenopausal women aged 45-60 years with symptoms of vaginal atrophy who required nonhormonal treatment. Results: We included 98 women with a mean (SD) age of 54.6 (3.2) years and a mean time of 5.6 (3.0) years without menstrual periods. Of these, 63.3% were treated with hyaluronic acid and Centella asiatica cell lysate and the other 36.7% with glycerin and polycarbophil. The vaginal maturation index improved significantly after 3 months of treatment with hyaluronic acid and Centella asiatica: the parabasal cell count declined (-8.4%; 95%CI, -10.6 to -6.2; p=0.001) and the intermediate cell count increased (3.6%; 95%CI, 2.0-5.3; p=0.001), as did that of superficial cells (4.8%; 95%CI, 3.8-5.7; p=0.001). In addition, all symptoms and signs of vaginal atrophy improved after 3 months with treatment with hyaluronic acid and Centella asiatica lysate. There was no significant change in the vaginal maturation index or in symptoms and signs after 3 months of treatment with glycerin and polycarbophil. Conclusions: Three months of nonhormonal treatment with hyaluronic acid and Centella asiatica lysate significantly improved the vaginal maturation index


Objetivo: describir la evolución clínica de mujeres con atrofia vaginal que reciben un tratamiento no hormonal.Material y métodos:estudio descriptivo observacional retrospectivo longitudinal unicéntrico en mujeres posmenopáusicas de 45 a 60 años con síntomas de atrofia vaginal que hubieran requerido tratamiento no hormonal. Resultados: se incluyeron 98 mujeres con una edad media de 54,6 ± 3,2 años y un tiempo medio sin menstruación de 5,6 ± 3,0 años. El 63,3% de las mujeres eran tratadas con ácido hialurónico y lisado celular de centella asiática y el 36,7% con glicerol y policarbofil. El índice de maduración vaginal fue significativamente mejor tras tres meses de tratamiento con ácido hialurónico y lisado de centella asiática: descienden las células parabasales (-8,4%, IC95% (-10,6 - -6,2), p=0,001) y aumentan las intermedias (3,6%, IC95% (2,0 - 5,3), p=0,001) y las superficiales (4,8%, IC95% (3,8 - 5,7), p=0,001). Además, se redujeron todos los síntomas y signos de atrofia vaginal tras 3 meses con el tratamiento con ácido hialurónico y lisado de centella asiática. No se encontraron cambios tras tres meses de tratamiento con glicerol y policarbofil en el índice de maduración vaginal y de los síntomas y signos. Conclusiones: El tratamiento no hormonal con ácido hialurónico y lisado de centella asiática mejora significativamente el índice de maduración vaginal y los síntomas y signos de atrofia vaginal tras tres meses de tratamiento


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Vaginite Atrófica/tratamento farmacológico , Ácido Hialurônico/uso terapêutico , Maturidade Sexual , Centella , Pós-Menopausa/fisiologia , Estudos Retrospectivos , Segurança do Paciente , Resultado do Tratamento
20.
Prog. obstet. ginecol. (Ed. impr.) ; 62(3): 247-253, mayo-jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185006

RESUMO

Objetivo: estimar el número de exploraciones evitables al comparar un algoritmo diagnóstico clásico de la metrorragia posmenopáusica (MPM) frente a un algoritmo que incorpore un test molecular como GynEC(R)-Dx. Material y métodos: estudio de cohortes, prospectivo y aleatorizado por centros realizado en mujeres que presentaron MPM. Las pacientes fueron aleatorizadas a seguir un algoritmo de estudio de MPM clásico vs GynEC(R)-Dx. Se registraron variables demográficas y se comparó el uso de recursos tales como biopsias, ecografías, histeroscopias y visitas entre ambos grupos. Adicionalmente se revalidó la sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) del test. Resultados: se incluyeron un total de 94 pacientes, 51 en grupo clásico y 43 en grupo GynEC(R)-Dx. En el grupo clásico se realizaron 95 exploraciones más respecto al grupo de GynEC(R)-Dx clasificadas en: 11 biopsias, 17 ecografías, 24 histeroscopias y 89 visitas. En el grupo GynEC(R)-Dx se realizaron 92 exploraciones innecesarias consideradas "fuera de protocolo". En la revalidación se observó una S 100%, E 92.5%, VPP 50%, VPN 100%. Conclusiones: la incorporación de un test molecular como GynEC(R)-DX para el estudio de la metrorragia posmenopáusica permite disminuir el número de exploraciones y visitas respecto a los algoritmos convencionales


Objective: The histopathology remains the gold standard to diagnose endometrial cancer (EC) from endometrial biopsy. Molecular tests have recently emerged as a useful tool to classify EC according to its prognosis. However, there is currently no published protocol that includes molecular diagnosis of postmenopausal women with abnormal uterine bleeding (AUB). We hypothesized that the incorporation of a molecular test in the management of postmenopausal women with AUB improves the cost-efectiveness of the diagnostic process. Material and methods: We present a prospective study performed in postmenopausal women who presented AUB between 2009-2014. Seven centers recruited the patients. Three of them follow the classical diagnosis algorithm (group 1) and four centers follow the one that incorporates a molecular test (Gynec(R)-Dx) performed on the remnants of aspirates (group 2). In group 2, when both the endometrial biopsy and the molecular test were negative, the consequent explorations were considered as "out of procotol". Clinical data, number of biopsies, ultrasounds, hysteroscopies and visits were compared between groups. In addition, the sensitivity (S), specificity (E), positive and negative predictive values (PPV and NPV) of the molecular test were calculated. Results: 94 patients were recruited. 51 vs 43 women were included in the classical and the molecular algorithm respectively. There were no differences in age, BMI, parity, use of tamoxifen or hormonal treatment. The detailed outcomes of explorations between classical vs molecular group are shown in Table 1. 324 vs 229 explorations were performed respectively (table 2). In the molecular group, 92 explorations were considered "out of protocol". The test validations showed a 100% S, 92.5% E, 50% PPV and 100% NPV. Conclusions: According to our results, the incorporation of a molecular test for the diagnosis of EC in postmenopausal women who complained with AUB reduces the number of explorations. Consequently, the molecular algorithm is more cost-effective than conventional algorithms


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias do Endométrio/diagnóstico , Metrorragia/etiologia , Técnicas de Diagnóstico Molecular/métodos , Hiperplasia Endometrial/diagnóstico , Pós-Menopausa/fisiologia , Sensibilidade e Especificidade , Valor Preditivo dos Testes , Estudos de Coortes , Atenção Primária à Saúde/estatística & dados numéricos
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