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KAN Y, PENG YL, ZHAO ZH, DONG ST, XU YX, MA XT, LIU XL, LIU YY, ZHOU YJ. The impact of female sex hormones on cardiovascular disease: from mechanisms to hormone therapy. J Geriatr Cardiol 2024; 21:669-681. [PMID: 38973823 PMCID: PMC11224657 DOI: 10.26599/1671-5411.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Cardiovascular disease remains the leading cause of mortality in women, yet it has not raised the awareness from the public. The pathogenesis of cardiovascular disease differs significantly between females and males concerning the effect of sex hormones. Estrogen and progestogen impact cardiovascular system through genomic and non-genomic effects. Before menopause, cardiovascular protective effects of estrogens have been well described. Progestogens were often used in combination with estrogens in hormone therapy. Fluctuations in sex hormone levels, particularly estrogen deficiency, were considered the specific risk factor in women's cardiovascular disease. However, considerable heterogeneity in the impact of hormone therapy was observed in clinical trials. The heterogeneity is likely closely associated with factors such as the initial time, administration route, dosage, and formulation of hormone therapy. This review will delve into the pathogenesis and hormone therapy, summarizing the effect of female sex hormones on hypertension, pre-eclampsia, coronary heart disease, heart failure with preserved ejection fraction, and cardiovascular risk factors specific to women.
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Affiliation(s)
- Yi KAN
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yu-Lu PENG
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Ze-Hao ZHAO
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Shu-Tong DONG
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yin-Xiao XU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Xiao-Teng MA
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Xiao-Li LIU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yu-Yang LIU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yu-Jie ZHOU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
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Lee CK, Lee JH, Kang S, Ha MS. Adlay Consumption Combined with Suspension Training Improves Blood Lipids and Pulse Wave Velocity in Middle-Aged Women. Healthcare (Basel) 2023; 11:healthcare11101426. [PMID: 37239711 DOI: 10.3390/healthcare11101426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/16/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Middle-aged women have an increased risk of chronic degenerative diseases and reduced physical strength, which can lead to decreased vascular function and an increased risk of cardiovascular disease. However, these problems can be treated or prevented with healthy nutrition and regular exercise. We focused on these benefits as recent studies have reported the potential synergistic effects of suspension training and nutrition. Therefore, in this study, we investigated the effects of 12 weeks of adlay intake and suspension training on improvements in body composition, physical fitness, blood lipids, and arterial stiffness in middle-aged women. Neither the adlay + suspension exercise (ASEG) nor suspension exercise groups (SEG) showed significant changes in body composition. Nonetheless, with respect to physical fitness, there was a difference in time among all variables except flexibility, though the ASEG showed a more significant effect than the SEG. Regarding blood lipids, significant interaction effects were found for triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, while only the ASEG significantly improved these parameters. Furthermore, pulse wave velocity was only significantly decreased in the ASEG. In summary, performing suspension exercises for 12 weeks improved physical strength in middle-aged women. Additionally, when adlay was consumed simultaneously, blood lipids and arterial stiffness were improved.
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Affiliation(s)
- Chae Kwan Lee
- Department of Physical Therapy, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan 46252, Republic of Korea
| | - Jae-Hoon Lee
- Department of Sports Science, College of the Arts and Sports, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, Republic of Korea
| | - Shuho Kang
- Graduate School, Busan University of Foreign Studies, 65 Geumsaem-ro 485-gil, Geumjeong-gu, Busan 46234, Republic of Korea
| | - Min-Seong Ha
- Department of Sports Science, College of the Arts and Sports, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, Republic of Korea
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Tang Z, Găman MA, Prabahar K, Mei H. The effect of 17β-estradiol plus norethisterone acetate treatment on lipoprotein (a), atherogenic and anti-atherogenic apolipoproteins levels in postmenopausal women: A meta-analysis of randomized controlled trials. Exp Gerontol 2023; 172:112055. [PMID: 36521567 DOI: 10.1016/j.exger.2022.112055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/12/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM The administration of 17β-estradiol plus norethisterone acetate seems to confer women cardioprotection, however, its impact on lipoprotein (a) and apolipoproteins' concentrations remains unclear. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) to investigate the effect of 17β-estradiol plus norethisterone acetate treatment on lipoprotein (a) and apolipoproteins' values in females. METHODS We systematically searched four databases (PubMed/MEDLINE, Scopus, Embase, and Web of Science) to identify relevant publications published until March 9th, 2022. No language restrictions were applied. The random-effects model (the DerSimonian and Laird methods) was employed to calculate the weighted mean difference (WMD). RESULTS The administration of 17β-estradiol plus norethisterone acetate resulted in a significant decrease of lipoprotein (a) (WMD: -67.59 mg/L, 95 % CI: -106.39 to -28.80; P < 0.001) and apolipoprotein B concentrations (WMD: -3.71 mg/dL, 95 % CI: -6.68 to -0.75; P = 0.014), respectively. No effect of 17β-estradiol plus norethisterone acetate on apolipoprotein AI (WMD: 0.23 mg/dL, 95 % CI: -3.99 to 4.46; P = 0.91) or AII (WMD: 0.21 mg/dL, 95 % CI: -2.24 to 2.68; P = 0.86) concentrations was detected. In the stratified analysis, there was a notable reduction in lipoprotein (a) levels in the RCTs with a duration of ≥6 months (WMD: -73.34 mg/L), in postmenopausal women with a BMI ≥25 kg/m2 (WMD: -69.85 mg/L) and in postmenopausal women aged ˂60 years (WMD: -61.93 mg/L). CONCLUSION The present meta-analysis of RCTs demonstrates that 17β-estradiol plus norethisterone acetate treatment reduces lipoprotein (a) and apolipoprotein B levels in postmenopausal women.
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Affiliation(s)
- Zengyao Tang
- Department of Cardiovascular Internal Medicine, Jiujiang First People's Hospital, Jiujiang City, Jiangxi Province, China
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - HanYing Mei
- Department of Rheumatology Immunology, Jiujiang First People's Hospital, Jiujiang City, Jiangxi Province, China.
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Harraqui K, Oudghiri DE, Mrabti HN, Hannoun Z, Lee LH, Assaggaf H, Qasem A, Goh KW, Ming LC, Tan CS, Bouyahya A, Bour A. Association between Physical Activity, Body Composition, and Metabolic Disorders in Middle-Aged Women of Ksar el Kebir (Morocco). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1739. [PMID: 36767104 PMCID: PMC9914767 DOI: 10.3390/ijerph20031739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to examine the association between physical activity (PA), body composition, and metabolic disorders in a population of Moroccan women classified by menopausal status. This cross-sectional study comprised 373 peri- and postmenopausal women aged 45-64 years old. PA levels were assessed using the short version of the International Physical Activity Questionnaire (IPAQ-SF). Body composition and metabolic disorders were assessed by measurements of anthropometric and biological parameters: weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), WC/HC ratio, percent body fat, systolic and diastolic blood pressure, fasting blood glucose, and serum lipids (total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C). Metabolic syndrome (MetS) was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Pearson correlations were used to test for associations. The mean total PA score of perimenopausal women was 1683.51 ± 805.36 MET-min/week, and of postmenopausal women was 1450.81 ± 780.67 MET-min/week. In all participants, peri- and postmenopausal women, PA was significantly and inversely associated with BMI, weight, percent body fat, HC, WC, and number of MetS components (p < 0.01), and with fasting blood glucose, TC, TG, and LDL-C (p < 0.05). The frequencies of metabolic disorders, obesity, abdominal obesity, type 2 diabetes, dyslipidemia, and MetS were significantly lower at moderate and intense levels of PA (p < 0.05), in also all participants. In middle-aged women, particularly those who are peri-menopausal, PA at moderate and intense levels is associated with more favorable body composition and less frequent metabolic disorders. However, in this particular study, PA does not appear to be associated with blood pressure and HDL-C concentrations. Future studies may be needed to further clarify these findings.
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Affiliation(s)
- Khouloud Harraqui
- Laboratory of Biology and Health (LBS), Nutrition, Food and Health Sciences Team, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Dia Eddine Oudghiri
- Biology and Health UAE/U23FS Team, Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Avenue de Sebta, Mhannech II, Tetouan 93002, Morocco
| | - Hanae Naceiri Mrabti
- High Institute of Nursing Professions and Health Techniques Casablanca, Casablanca 20250, Morocco
| | - Zineb Hannoun
- Laboratory of Biology and Health (LBS), Nutrition, Food and Health Sciences Team, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway City 47500, Malaysia
| | - Hamza Assaggaf
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Ahmed Qasem
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia
| | - Long Chiau Ming
- School of Medical and Life Sciences, Sunway University, Sunway City 47500, Malaysia
| | - Ching Siang Tan
- School of Pharmacy, KPJ Healthcare University College, Nilai 71800, Malaysia
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat 10100, Morocco
| | - Abdellatif Bour
- Laboratory of Biology and Health (LBS), Nutrition, Food and Health Sciences Team, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
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Abstract
The association between a dietary pattern characterised by high alcohol intake and dyslipidaemia has not been fully investigated. Therefore, the present study aimed to investigate the association between alcohol dietary patterns and the prevalence of dyslipidaemia and its components. This cross-sectional study enrolled 2171 men and women aged ≥40 years who were alumni of a Japanese university. To identify dietary patterns, a principal component analysis was performed based on the energy-adjusted food intake estimated by a brief-type self-administered diet history questionnaire. Three dietary patterns were identified, the second of which was named the alcohol dietary pattern and was characterised by a high intake of alcoholic beverages, liver, chicken and fish. This alcohol dietary pattern was associated with reduced LDL-cholesterol levels. The fully adjusted OR (95 % CI) of high LDL-cholesterol for the lowest through highest quartile of alcohol dietary pattern score were 1·00 (reference), 0·83 (0·64, 1·08), 0·84 (0·64, 1·10) and 0·68 (0·49, 0·94), respectively. Subgroup analysis showed that the alcohol dietary pattern was inversely associated with the prevalence of dyslipidaemia in women, whereas it was positively associated with high TAG levels in men. In conclusion, the alcohol dietary pattern, characterised by a high intake of alcoholic beverages, liver, chicken and fish, was associated with the prevalence of dyslipidaemia and its components. This finding provides useful information for the prevention and treatment of dyslipidaemia by modifying the diet.
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Frequency of Metabolic Syndrome and Study of Anthropometric, Clinical and Biological Characteristics in Peri- and Postmenopausal Women in the City of Ksar El Kebir (Northern Morocco). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106109. [PMID: 35627646 PMCID: PMC9140909 DOI: 10.3390/ijerph19106109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to determine the frequency of metabolic syndrome and to identify its predictive factors in peri- and post-menopausal women in the city of Ksar El Kebir, in northern Morocco. A total of 373 peri- and post-menopausal women between 45 and 64 years old participated in the study. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition. Body mass index (BMI) was calculated to assess the degree of obesity in women; anthropometric, clinical and biological parameters were collected during interviews. The mean ages of peri- and postmenopausal women were 48.84 ± 2.4 years and 56.65 ± 4.29 years, respectively. Postmenopausal women had higher means of anthropometric and biological parameters than peri-menopausal women. We also noted a predominance of metabolic syndrome in postmenopausal women (n = 158) compared to peri-menopausal women (n = 81). Waist circumference was the predominant marker in the subjects studied, whereas triglycerides were the lower marker. In the overall population, the incidence of metabolic syndrome and its associated factors were higher in postmenopausal women than in peri-menopausal women, from which it can be concluded that post menopause may be a predictor of metabolic syndrome.
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Tanisawa K, Ito T, Kawakami R, Usui C, Kawamura T, Suzuki K, Sakamoto S, Ishii K, Muraoka I, Oka K, Higuchi M. Association Between Dietary Patterns and Different Metabolic Phenotypes in Japanese Adults: WASEDA'S Health Study. Front Nutr 2022; 9:779967. [PMID: 35155537 PMCID: PMC8829333 DOI: 10.3389/fnut.2022.779967] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/03/2022] [Indexed: 12/12/2022] Open
Abstract
Although many studies have reported that a posteriori dietary pattern is associated with metabolic health, there is little evidence of an association between dietary patterns and different metabolic phenotypes. The present study aimed to examine the association between major dietary patterns and different metabolic phenotypes (metabolically healthy non-obese [MHNO], metabolically unhealthy non-obese [MUNO], metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) in middle-aged and elderly Japanese adults. This cross-sectional study enrolled 2,170 Japanese adults aged ≥40 years. The four different metabolic phenotypes were determined based on the presence of obesity, abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. The major dietary patterns were determined using principal component analysis based on energy-adjusted food intake. Two dietary patterns were identified: the healthy dietary pattern, which was characterized by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweeds, and fish; and the alcohol dietary pattern, which was characterized by a high intake of alcoholic beverages, liver, chicken, and fish. The healthy dietary pattern was associated with the MHNO and MHO phenotypes (MUNO and MUO as reference groups, respectively), and the multivariate-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in the highest quartile of healthy dietary pattern score with the lowest quartile as the reference category were 2.10 (1.40–3.15) and 1.86 (1.06–3.25), respectively. Conversely, the alcohol dietary pattern was inversely associated with the MHNO and MHO phenotypes, while the multivariate-adjusted ORs (95% CIs) in the highest quartile of the alcohol dietary pattern score with the lowest quartile as the reference category were 0.63 (0.42–0.94) and 0.45 (0.26–0.76), respectively. There were no significant interactions between sex and healthy/alcohol dietary patterns in the prevalence of the MHNO and MHO phenotypes. In conclusion, the present study's findings suggest that major dietary patterns are associated with different metabolic phenotypes in middle-aged and elderly Japanese adults. These findings provide useful evidence for maintaining metabolic health through diet regardless of obesity status.
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Affiliation(s)
- Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- *Correspondence: Kumpei Tanisawa
| | - Tomoko Ito
- Waseda Institute for Sport Sciences, Tokorozawa, Japan
- Department of Food and Nutrition, Tokyo Kasei University, Tokyo, Japan
| | - Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chiyoko Usui
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takuji Kawamura
- Waseda Institute for Sport Sciences, Tokorozawa, Japan
- Research Center for Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | | | - Shizuo Sakamoto
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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The effect of menopause on metabolic syndrome: cross-sectional results from the Canadian Longitudinal Study on Aging. ACTA ACUST UNITED AC 2020; 27:999-1009. [DOI: 10.1097/gme.0000000000001575] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Metabolic syndrome and its components in premenopausal and postmenopausal women: a comprehensive systematic review and meta-analysis on observational studies. Menopause 2019; 25:1155-1164. [PMID: 29787477 DOI: 10.1097/gme.0000000000001136] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To perform a meta-analysis on the global prevalence of metabolic syndrome (MetS) in postmenopausal women. The meta-analysis also sought to measure the relationship menopause status has with MetS and its components. METHODS The Web of Science, Medline, PubMed, Scopus, Embase, CINAHL, DOAJ, and Google Scholar were all searched using the relevant keywords. Articles published during the period 2004 to 2017 that met our inclusion criteria and reported the prevalence of MetS among premenopausal and postmenopausal women were included. In the presence of heterogeneity, random-effects models were used to pool the prevalence and odds ratios (ORs), as measures of association in cross-sectional and comparative cross-sectional studies, respectively. RESULTS The prevalence of MetS among postmenopausal women (119 studies [n = 95,115]) and the OR comparing the prevalence of MetS among postmenopausal and premenopausal women (23 studies [n = 66,801]) were pooled separately. The pooled prevalence of MetS among postmenopausal women was found to be 37.17% (95% confidence interval [CI] 35.00%-39.31%), but varied from 13.60% (95% CI 13.55%-13.64%) to 46.00% (95% CI 1.90%-90.09%), depending upon the diagnostic criteria used. The overall pooled OR for MetS in postmenopausal women, compared with premenopausal women, was OR 3.54 (95% CI 2.92-4.30), but this ranged from OR 2.74 (95% CI 1.32-5.66) to OR 5.03 (95% CI 2.25-11.22), depending upon the criteria used. Furthermore, the odds of high fasting blood sugar (OR 3.51, 95% CI 2.11-5.83), low high-density lipoprotein cholesterol (OR 1.45, 95% CI 1.03-2.03), high blood pressure (OR 3.95, 95% CI 2.01-7.78), high triglycerides (OR 3.2, 95% CI 2.37-4.31), and high waist circumference (OR 2.75, 95% CI 1.80-4.21) were all found to be higher in postmenopausal women than in premenopausal women. CONCLUSIONS The prevalence of MetS is relatively high in postmenopausal women and was more prevalent among postmenopausal than premenopausal women. Menopausal hormone therapy should be used with caution in patients with MetS, as its safety has not yet been evaluated among MetS patients and meticulous evaluation of each individual patient before starting MHT is needed.
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Zhou H, Zhang C, Ni J, Han X. Prevalence of cardiovascular risk factors in non-menopausal and postmenopausal inpatients with type 2 diabetes mellitus in China. BMC Endocr Disord 2019; 19:98. [PMID: 31601203 PMCID: PMC6787985 DOI: 10.1186/s12902-019-0427-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To investigate the prevalence of cardiovascular disease (CVD) risk factors and assess the 10-year risk of CVD in non-menopausal and postmenopausal women with type 2 diabetes mellitus (T2DM). METHODS A total of 569 patients with T2DM at a Chinese tertiary hospital were investigated using the Framingham Risk Score (FRS). We evaluated the 10-year risk of CVD, clinical and menopause characteristics in all subjects. RESULTS Among the 569 diabetic patients, the incidence of smoking, dyslipidemia, hypertension, overweight or obesity, and nonalcoholic fatty liver disease (NAFLD) was 0.7, 36.2, 38.1 56.6 and 58.2%, respectively. The usage rate of hypoglycemic agents, antihypertensive agents, lipid modulators and antithrombotic drugs was 88.6, 78.3, 50.0 and 27.1%, respectively. However, only 1.2% of inpatients achieved the three target goals for the control of blood glucose (HbA1c < 7%), blood pressure (systolic blood pressure < 130 mmHg, diastolic blood pressure < 80 mmHg), and blood lipids (total cholesterol < 174 mg/dL). The 10-year risk of CVD was (1.6 ± 1.5%) and tended to increase along with age (F = 27.726, P < 0.001). For all subjects (n = 569), multiple linear regression analysis showed that menopause (β = 0.275, P < 0.001), low-density lipoprotein cholesterol (LDL-C) (β = 0.212, P < 0.001), fasting plasma glucose (FPG) (β = 0.093, P = 0.018) and waist-to-hip-ratio (β = - 0.078, P = 0.047) were risk factors of 10-year risk of CVD, which may explain the variance of 14.3%. In the postmenopausal group (n = 397), LDL-C (β = 0.227, P < 0.001), FPG (β = 0.139, P = 0.003) and time since menopause (β = 0.230, P < 0.001) were found to be associated with CVD, which may explain the variance of 14.6%. CONCLUSION The incidence of dyslipidmia, hypertension, overweight or obesity and NAFLD is high. The level of control of blood glucose, blood pressure, and blood lipids was found to be extremely low and the treatment status was not ideal. Besides menopause, LDL-C, FPG and time since menopause were found to be independent risk factors for the 10-year risk of CVD. Therefore, it is necessary to focus on comprehensive control of multiple risk factors, such as plasma glucose, blood pressure and serum lipid.
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Affiliation(s)
- Huanhuan Zhou
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Chenghuan Zhang
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Jingyu Ni
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Xiaoyun Han
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China.
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Wu XM, Broadwin R, Basu R, Malig B, Ebisu K, Gold EB, Qi L, Derby C, Park SK, Green S. Associations between fine particulate matter and changes in lipids/lipoproteins among midlife women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 654:1179-1186. [PMID: 30841392 PMCID: PMC6413864 DOI: 10.1016/j.scitotenv.2018.11.149] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/09/2018] [Accepted: 11/10/2018] [Indexed: 05/30/2023]
Abstract
Fine particles (PM2.5) are known to increase risks of cardiovascular diseases, but it is unclear how they affect plasma lipid levels. In this study, we examined the associations between PM2.5 exposure and lipid/lipoprotein levels from 2289 midlife women enrolled in the longitudinal Study of Women's Health Across the Nation. The average exposure to PM2.5 and gaseous co-pollutants during the prior one year, six months, 30 days, and one day were estimated for each woman based on U.S. Environmental Protection Agency ambient monitoring data. Blood samples were collected annually from 1999 to 2005 and analyzed for lipids/lipoproteins. Mixed-effect models were used to account for repeated measures for each woman, adjusted for demographic, health and behavior covariates. PM2.5 exposures, especially the long-term exposure, were negatively associated with protective lipoproteins, and positively associated with atherogenic lipoproteins. For example, each 3 μg/m3 increase of one-year PM2.5 exposure was associated with decreases of -0.7% (-1.4%, -0.1%) in high-density lipoprotein cholesterols and -0.6% (-1.1%, -0.1%) in apolipoprotein A1 (ApoA1), as well as increases of 3.8% (1.0%, 6.6%) in lipoprotein(a) and 1.4% (0.5%, 2.3%) in the ratio of apolipoprotein B (ApoB)/ApoA1. In stratified analysis, increased atherogenic lipoproteins were mainly observed in women without dyslipidemia, and both increased atherogenic lipoproteins and reduced protective lipoproteins were observed among women in perimenopause. In summary, PM2.5 exposure was associated with adverse lipid level changes, and thus, may increase cardiovascular risks in midlife women.
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Affiliation(s)
- Xiangmei May Wu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Rachel Broadwin
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Brian Malig
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Keita Ebisu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Ellen B Gold
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA.
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA.
| | - Carol Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Shelley Green
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
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Karvinen S, Jergenson MJ, Hyvärinen M, Aukee P, Tammelin T, Sipilä S, Kovanen V, Kujala UM, Laakkonen EK. Menopausal Status and Physical Activity Are Independently Associated With Cardiovascular Risk Factors of Healthy Middle-Aged Women: Cross-Sectional and Longitudinal Evidence. Front Endocrinol (Lausanne) 2019; 10:589. [PMID: 31543865 PMCID: PMC6729112 DOI: 10.3389/fendo.2019.00589] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/12/2019] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease (CVD) is the primary cause of mortality in women in developed countries. CVD risk rises with age, yet for women there is a rapid increase in CVD risk that occurs after the onset of menopause. This observation suggests the presence of factors in the middle-aged women that accelerate the progression of CVD independent of chronological aging. Leisure time physical activity (LTPA) is a well-established protective factor against CVD. However, its role in attenuating atherogenic lipid profile changes and CVD risk in post-menopausal women has not been well-established. The present study is part of the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, a population-based cohort study in which middle-aged Caucasian women (47-55) were classified into pre-menopausal, peri-menopausal, and post-menopausal groups based on follicle stimulating hormone levels and bleeding patterns. Comprehensive questionnaires, laboratory visits, anthropometric measurements, and physical activity monitoring by accelerometers were used to characterize the menopausal groups and serum lipid profiles were analyzed to quantify CV (cardiovascular) risk factors. Based on our findings, LTPA may attenuate menopause-associated atherogenic changes in the serum CV risk factors of healthy middle-aged women. However, LTPA does not seem to entirely offset the lipid profile changes associated with the menopausal transition.
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Affiliation(s)
- Sira Karvinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Matthew J Jergenson
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Matti Hyvärinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Pelvic Floor Research and Therapy Unit, Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Vuokko Kovanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K Laakkonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Sanz-Paris A, Rodriguez-Valle A, Navarro MA, Puzo-Foncillas J, Arbones-Mainar JM. Post-lunch triglyceridaemia associates with HDLc and insulin resistance in fasting normotriglyceridaemic menopausal women. J Hum Nutr Diet 2017; 30:700-708. [PMID: 28419643 DOI: 10.1111/jhn.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Post-prandial hypertriglyceridaemia (P-HTG) is associated with cardiovascular disease. This association is of paramount importance during menopause, which is also related to reduced high-density lipoprotein-cholesterol (HDLc) and elevated triglyceride (TG) levels. We aimed to provide a self-assesing tool to screen for P-HTG in menopausal women who were normotriglyceridaemic at fasting and adhered to a Mediterranean-style eating pattern. METHODS We performed oral fat loading tests (OFLT) in combination with self-measurements of diurnal capillary TG at fixed time-points (DC-TG) in 29 healthy menopausal women. TG levels >220 mg dL-1 at any given time during the OFLT served as diagnostic criteria for P-HTG. Subsequently, DC-TG profiles were examined to determine the best mealtime (breakfast, lunch or dinner), as well as optimal cut-off points to classify these women as having P-HTG according to the OFLT. Insulin resistance was defined as the upper tertile of the homeostatic model assessment of insulin resistance. RESULTS We found that, despite having normal fasting TG levels, P-HTG was highly prevalent (approximately 40%). Moreover, self-assessed 3-h post-lunch TG levels >165 mg dL-1 increased the odds of having hypo-HDL cholesterolaemia by 14.1-fold (P = 0.026) and the odds of having insulin resistance by 31.6-fold (P = 0.007), adjusted for total fat intake in women adhering to a Mediterranean eating pattern having their highest energy intake at lunch. CONCLUSIONS Self-assessed 3-h post-lunch TG can be used to study post-prandial TG metabolism in Southern European menopausal women who are normotriglyceridaemic at fasting. Characterising an individual's post-prandial response may help menopausal women to evaluate their risk of cardiovascular disease.
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Affiliation(s)
- A Sanz-Paris
- Nutrition Department, University Hospital Miguel Servet, Zaragoza, Spain
| | - A Rodriguez-Valle
- Clinical Biochemistry Department, University Hospital Miguel Servet, Zaragoza, Spain
| | - M A Navarro
- Department of Biochemistry and Molecular Biology, University of Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - J Puzo-Foncillas
- Clinical Biochemistry Department, University Hospital Miguel Servet, Zaragoza, Spain
| | - J M Arbones-Mainar
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragonés de Ciencias de la Salud (IACS), University Hospital Miguel Servet, Zaragoza, Spain
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de Kat AC, Dam V, Onland-Moret NC, Eijkemans MJC, Broekmans FJM, van der Schouw YT. Unraveling the associations of age and menopause with cardiovascular risk factors in a large population-based study. BMC Med 2017; 15:2. [PMID: 28049531 PMCID: PMC5210309 DOI: 10.1186/s12916-016-0762-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although the association between menopause and cardiovascular disease (CVD) risk has been studied extensively, the simultaneous role of chronological aging herein remains underexposed. This study aims to disentangle the relationships of menopausal status and chronological aging with CVD risk factors in the largest study population to date. METHODS In this cross-sectional study, CVD risk factors were compared between women with a different menopausal status within the same yearly age strata. The study population comprised female participants of the baseline visit of the population-based LifeLines Cohort Study. A total of 63,466 women, aged between 18 and 65 years, was included. Of them, 39,379 women were considered to be premenopausal, 8669 were perimenopausal, 14,514 were naturally postmenopausal, and 904 were surgically postmenopausal. RESULTS Compared to postmenopausal women aged 45 years, average total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) were 0.5 and 0.4 mmol/L higher, respectively, in postmenopausal women aged 50. Systolic and diastolic blood pressure levels were 4 and 1 mmHg higher, respectively. At all ages between 46 and 55 years, and after adjustment for confounders, naturally postmenopausal women had 0.2 to 0.4 mmol/L higher TC and 0.1 to 0.3 mmol/L higher LDL-c levels compared to premenopausal women in the same age range. Systolic blood pressure levels were up to 4 mmHg lower in naturally post- compared to premenopausal women at all ages between 29 and 52 years. Body mass index levels were up to 3.2 kg/m2 higher in women with surgical menopause compared to all other women between the ages 32 and 52 years. All aforementioned results were statistically significant. CONCLUSIONS Chronological age and menopausal status are both independently associated with CVD risk factors. Based on the comparatively smaller observed differences associated with menopausal status than with chronological aging, the significance of a more unfavorable lipid profile in a later reproductive stage may be less obvious than previously thought.
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Affiliation(s)
- A C de Kat
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - V Dam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - M J C Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - F J M Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands.
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Abstract
The clustering of metabolic risk factors, overweight and hypertension is of particular importance in postmenopausal women due to the negative effect of menopause on bodyweight, glucose metabolism and the development of hypertension. Menopause acts directly as a risk factor by reducing the direct beneficial effect of ovarian hormones on cardiovascular functions, and indirectly by negatively influencing traditional risk factors for coronary artery disease. All changes occurring after the menopause must be regarded under a unifying mechanism that induces unfavorable changes in cardiovascular risk factors and vascular functions, which interact with each other, amplifying the effect of ovarian hormone deficiency and aging.
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Affiliation(s)
- Giuseppe MC Rosano
- Centre for Clinical and Basic Research, Department of Internal Medicine, IRCCS San Raffaele Hospital, Via Della Pisana 235, Roma 00163, Italy, Tel.: +39 065 225 2309; Fax: +39 065 225 2344
| | - Cristiana Vitale
- Centre for Clinical and Basic Research, Department of Internal Medicine, IRCCS San Raffaele Hospital, Via Della Pisana 235, Roma 00163, Italy, Tel.: +39 065 225 2309; Fax: +39 065 225 2344
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Cui Y, Ruan X, Jin J, Jin F, Brucker S, Mueck AO. The pattern of lipids and lipoproteins during the menopausal transition in Chinese women. Climacteric 2016; 19:292-8. [DOI: 10.3109/13697137.2015.1130694] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mogarekar MR, Kulkarni SK. Small Dense Low Density Lipoprotein Cholesterol, Paraoxonase 1 and Lipid Profile in Postmenopausal Women: Quality or Quantity? Arch Med Res 2015; 46:534-8. [PMID: 26348135 DOI: 10.1016/j.arcmed.2015.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 08/27/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Atherosclerosis, the root cause of cardiovascular disease (CVD), has a number of risk factors-some modifiable and some not. CVD increases in women particularly during the postmenopausal period. Small dense low-density lipoprotein (sdLDL), a subclass of LDL, is an important determinant of atherosclerosis in postmenopausal women. Paraoxonase1 (PON1) is a high-density lipoprotein (HDL)-associated enzyme that prevents oxidative modifications in LDL and HDL. With this background, we studied the sdLDL-C, PON1 and lipid profile in postmenopausal women to compare between quality and quantity of LDL. METHODS We studied 80 pre- and postmenopausal women (40/group). The following parameters were studied: lipid profile, sdLDL-C and PON1 levels. With proper statistical tools the correlation between these parameters was studied. RESULTS Postmenopausal women, in comparison with premenopausal women, have significantly increased levels of serum triglycerides and sdLDL-C and very-low-density lipoprotein cholesterol (VLDL-C) and significantly decreased levels of HDL-C and PON1. PON1 activity was negatively correlated with age, TC, TG, LDL-C and sdLDL-C (r = -0.574, -0.119, -0.226, -0.473 and -0.455, respectively) and positively correlated with HDL-C (r = 0.368), whereas sdLDL-C was positively correlated with age, TC, TG, LDL-C (r = 0.633, 0.485, 0.561 and 0.705, respectively) and negatively with HDL-C (r = -0.235). Stepwise multiple regression analysis demonstrated HDL-C and menopausal status as the best determinant for PON1 (R(2) = 0.320, p < 0.05) and menopausal status, LDL-C, TG, and TC were the best determinants for sdLDL-C (R(2) = 0.606, p < 0.05). CONCLUSION The results of the present study suggest quality, i.e., sdLDL-C, is more important than only LDL-C levels. Similarly, decrease in PON1 and increase in sdLDL-C go hand in hand. This shows that antioxidant capacity is compromised with a qualitative downfall in lipoproteins in postmenopausal women.
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Abstract
OBJECTIVE Menopause is defined as the permanent cessation of menses. Although previous studies demonstrated a slight production of androgens and estrogens by postmenopausal ovaries, the impact of hormone production on lipid metabolism is still uncertain. The aim of this study was to evaluate whether the postmenopausal ovary is hormonally active and whether hormone status contributes to lipid metabolism. METHODS This was a prospective study of 87 women who were treated for gynecological diseases (29% had cervical cancer, 49% had endometrial cancer, 7% had fibroid tumors, and 15% had cervical intraepithelial neoplasia). They were categorized as early postmenopausal (n = 40; mean [SD], 56.8 [3.8] y) or late postmenopausal (n = 47; mean [SD], 66.6 [5.7] y) women. Serum specimens were collected from the peripheral and ovarian veins of participants undergoing bilateral oophorectomy. Sex steroid hormone levels and lipid profiles were determined. RESULTS Statistically significant differences in estradiol (E2) and testosterone were seen between the ovarian samples and the peripheral samples in all groups. E2 and estrone obtained from ovarian venous samples gradually decreased with age in postmenopausal women. There was a significant correlation between ovarian E2 and high-density lipoprotein cholesterol levels and the low-density lipoprotein-to-high-density lipoprotein ratio. However, there was no correlation between peripheral E2 levels and any of the lipid parameters examined. CONCLUSIONS Although this study investigates women with gynecological diseases, the postmenopausal ovary is hormonally active, and the E2 produced by postmenopausal ovaries may therefore contribute to the maintenance of lipid metabolism.
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Tian J, Chen H, Jia F, Yang G, Li S, Li K, Zhang L, Wu J, Liu D. Trends in the Levels of Serum Lipids and Lipoproteins and the Prevalence of Dyslipidemia in Adults with Newly Diagnosed Type 2 Diabetes in the Southwest Chinese Han Population during 2003-2012. Int J Endocrinol 2015; 2015:818075. [PMID: 26089896 PMCID: PMC4451154 DOI: 10.1155/2015/818075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 09/27/2014] [Indexed: 12/18/2022] Open
Abstract
Objective. To determine the trends of serum lipid levels and dyslipidemia in adults newly diagnosed with type 2 diabetes mellitus during 2003-2012 in Southwest China. Methods. Serum lipid measurements of 994 adults were obtained from 5 independent, cross-sectional studies (2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012). The main outcome measures were mean serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels; body mass index; hemoglobin A1C level; and the percentages of patients with dyslipidemia, hypertension, coronary heart disease, and cerebrovascular disease. Results. The mean total cholesterol and low-density lipoprotein cholesterol levels increased from 4.92 ± 1.15 to 5.30 ± 1.17 mmol/L (P = 0.039) and 2.72 ± 0.83 to 3.11 ± 1.09 mmol/L (P = 0.004), respectively, and the mean HDL cholesterol level declined from 1.22 ± 0.30 to 1.06 ± 0.24 mmol/L (P < 0.001). The percentages of patients with dyslipidemia increased gradually. The incidence of coronary heart and cerebrovascular diseases increased from 8.2% to 19.1% and 6.6% to 15.3%, respectively (P < 0.05). Conclusion. Unfavorable upward trends were observed in serum lipid levels and the prevalence of dyslipidemia, coronary heart disease, and cerebrovascular disease in adults newly diagnosed with type 2 diabetes mellitus in Southwest China during 2003-2012.
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Affiliation(s)
- Jing Tian
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Hewen Chen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Fang Jia
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Gangyi Yang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Shengbing Li
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Ke Li
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Lili Zhang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Jinlin Wu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Dongfang Liu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
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Cannoletta M, Cagnacci A. Modification of blood pressure in postmenopausal women: role of hormone replacement therapy. Int J Womens Health 2014; 6:745-57. [PMID: 25143757 PMCID: PMC4136980 DOI: 10.2147/ijwh.s61685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The rate of hypertension increases after menopause. Whether estrogen and progesterone deficiency associated with menopause play a role in determining a worst blood pressure (BP) control is still controversial. Also, studies dealing with the administration of estrogens or hormone therapy (HT) have reported conflicting evidence. In general it seems that, despite some negative data on subgroups of later postmenopausal women obtained with oral estrogens, in particular conjugated equine estrogens (CEE), most of the data indicate neutral or beneficial effects of estrogen or HT administration on BP control of both normotensive and hypertensive women. Data obtained with ambulatory BP monitoring and with transdermal estrogens are more convincing and concordant in defining positive effect on BP control of both normotensive and hypertensive postmenopausal women. Overall progestin adjunct does not hamper the effect of estrogens. Among progestins, drospirenone, a spironolactone-derived molecule, appears to be the molecule with the best antihypertensive properties.
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Affiliation(s)
- Marianna Cannoletta
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences of the Mother, Child and Adult, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Emilia-Romagna, Italy
| | - Angelo Cagnacci
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences of the Mother, Child and Adult, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Emilia-Romagna, Italy
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Lee YH, Lee SG, Lee MH, Kim JH, Lee BW, Kang ES, Lee HC, Cha BS. Serum cholesterol concentration and prevalence, awareness, treatment, and control of high low-density lipoprotein cholesterol in the Korea National Health and Nutrition Examination Surveys 2008-2010: Beyond the Tip of the Iceberg. J Am Heart Assoc 2014; 3:e000650. [PMID: 24572249 PMCID: PMC3959713 DOI: 10.1161/jaha.113.000650] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The mortality rate from cardiovascular disease (CVD) among young adults has declined less than that in the older population, raising concerns about the increasing prevalence of obesity‐related conditions including hypercholesterolemia in the younger population. We investigated the age‐standardized mean levels of serum cholesterols and the prevalence, awareness, treatment and control rates of hyper‐low‐density lipoprotein (LDL)‐cholesterolemia based on age. Methods and Results Nationally representative samples of 19 489 subjects aged ≥20 years were analyzed from the Korea National Health and Nutrition Examination Surveys 2008–2010. Hyper‐LDL‐cholesterolemia was individually evaluated by the 2004 National Cholesterol Education Program Adult Treatment Panel III guidelines. Age‐standardized mean levels of total cholesterol, high‐density lipoprotein‐cholesterol, LDL‐cholesterol, and triglycerides were 186.8, 48.0, 112.9, and 136.0 mg/dL, respectively. Age‐standardized prevalence of hyper‐LDL‐cholesterolemia was 23.2% (men, 25.5%; women, 21.8%). Among subjects with hyper‐LDL‐cholesterolemia, awareness and treatment rates were significantly lower in younger adults (<50 years) compared to older adults ≥50 years (awareness, 8.0% versus 21.5%; treatment, 5.1% versus 18.5%, all Ps<0.001), indicating significant discrepancies in awareness and treatment rates of hypercholesterolemia between younger and older adults. Among subjects aware of their hyper‐LDL‐cholesterolemia, younger adults were more likely to have controlled LDL‐cholesterol than the elderly (82.1% versus 67.5%, P<0.001). Conclusions Compared to the elderly, significant proportions of young and middle‐aged adults are unaware of their hypercholesterolemia and are not treated with proper lipid‐lowering medications. Early screening, education, and proper management should be stressed in national public healthcare policies to reduce the increasing burden of CVD in the younger population with undiagnosed hypercholesterolemia.
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Affiliation(s)
- Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Dosi R, Bhatt N, Shah P, Patell R. Cardiovascular disease and menopause. J Clin Diagn Res 2014; 8:62-4. [PMID: 24701484 DOI: 10.7860/jcdr/2014/6457.4009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 12/09/2013] [Indexed: 11/24/2022]
Abstract
AIM The aim of the study was to study the abnormalities in the cardiovascular profile in postmenopausal Indian women and to compare the same with the cardiovascular profile of pre menopausal Indian women belonging to the same age group; taken as controls. The goal was to throw some light on the cardiovascular risk in postmenopausal women of the Indian population as this population is thought to be at higher risk than their western counterparts and significant studies of the same kind in this population have been few. MATERIALS AND METHODS A cross-sectional comparative study on 100 women who were either postmenopausal or premenopausal and were between the age group of 40 to 55 years was carried out over a period of ten months at our hospital. The variations in the cardiovascular profile between both groups were studied. All the women were subjected to a detailed history, thorough examination, investigations and imaging studies. RESULTS The evaluation revealed that Coronary Artery Disease (CAD), hypertension, abnormal Body Mass Index (BMI) and abnormal Waist Hip Ratio (WHR) were significantly higher in the postmenopausal group as compared to the premenopausal group. The post menopausal women had significantly higher prevalence of abnormal lipid profiles as compared to their premenopausal counterparts. The postmenopausal women with a normal lipid profile also had increased prevalence of CAD and SAHT, which emphasizes the non-lipid cardiovascular benefits of estrogen. CONCLUSION Thus, we can conclude that cardiovascular disease was more common in postmenopausal women of age group 40-55 years as compared to those not yet achieved menopause in a population of western Indian women. And this risk was significantly associated with central obesity, an abnormal lipid profile and the postmenopausal state in itself.
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Affiliation(s)
- Rupal Dosi
- Professor, Department of Medicine, Medical College Baroda, Gujrat, India
| | - Nikita Bhatt
- Intern, Department of Medicine, Medical College Baroda, Gujrat, India
| | - Priyanki Shah
- Ex-Senior Resident, Department of Medicine, Medical College Baroda, Gujrat, India
| | - Rushad Patell
- Senior Resident, Department of Medicine, Medical College Baroda, Gujrat, India
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Tadic MV, Ivanovic BA, Petrovic M, Celic V, Neskovic A. Gender influence on left ventricular structure and function in metabolic syndrome. Are women at greater risk? JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:538-545. [PMID: 23303723 DOI: 10.1002/jcu.22016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/22/2012] [Indexed: 06/01/2023]
Abstract
PURPOSE The aim of this study was to investigate the influence of metabolic syndrome (MS) on left ventricular (LV) structure and function depending on gender. METHODS The study included 235 never-treated MS subjects and 138 controls. MS was defined as the presence of three or more National Cholesterol Education Program's Adult Treatment Panel III criteria. All the subjects underwent laboratory blood tests and complete two-dimensional, pulsed, and tissue Doppler echocardiography. RESULTS LV structure, diastolic function, and global function were significantly impaired in all MS subjects. Multivariate analysis of individual MS factors showed that increased blood pressure (BP) and impaired fasting glucose were independently associated with LV hypertrophy in women, whereas the only independent predictor in men was increased BP. The same analysis revealed that the combination of impaired glucose level, abdominal obesity, and dyslipidemia was associated with LV hypertrophy only in women. Higher BP, impaired fasting glucose, and triglycerides level were independently associated with LV diastolic dysfunction in women, whereas higher BP was the only independent predictor in men. The combination of increased BP, fasting glucose, and dyslipidemia was independently associated with LV diastolic dysfunction only in women. CONCLUSIONS Different MS factors are responsible for LV remodeling in women and men. The metabolic sequence of MS is more important for LV remodeling in women.
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Affiliation(s)
- Marijana V Tadic
- Clinical Centre of Serbia, Clinic for Cardiology, Koste Todorovic 8, 11000 Belgrade, Serbia
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Olsen KS, Fenton C, Frøyland L, Waaseth M, Paulssen RH, Lund E. Plasma fatty acid ratios affect blood gene expression profiles--a cross-sectional study of the Norwegian Women and Cancer Post-Genome Cohort. PLoS One 2013; 8:e67270. [PMID: 23825649 PMCID: PMC3692510 DOI: 10.1371/journal.pone.0067270] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 05/16/2013] [Indexed: 11/23/2022] Open
Abstract
High blood concentrations of n-6 fatty acids (FAs) relative to n-3 FAs may lead to a “physiological switch” towards permanent low-grade inflammation, potentially influencing the onset of cardiovascular and inflammatory diseases, as well as cancer. To explore the potential effects of FA ratios prior to disease onset, we measured blood gene expression profiles and plasma FA ratios (linoleic acid/alpha-linolenic acid, LA/ALA; arachidonic acid/eicosapentaenoic acid, AA/EPA; and total n-6/n-3) in a cross-section of middle-aged Norwegian women (n = 227). After arranging samples from the highest values to the lowest for all three FA ratios (LA/ALA, AA/EPA and total n-6/n-3), the highest and lowest deciles of samples were compared. Differences in gene expression profiles were assessed by single-gene and pathway-level analyses. The LA/ALA ratio had the largest impact on gene expression profiles, with 135 differentially expressed genes, followed by the total n-6/n-3 ratio (125 genes) and the AA/EPA ratio (72 genes). All FA ratios were associated with genes related to immune processes, with a tendency for increased pro-inflammatory signaling in the highest FA ratio deciles. Lipid metabolism related to peroxisome proliferator-activated receptor γ (PPARγ) signaling was modified, with possible implications for foam cell formation and development of cardiovascular diseases. We identified higher expression levels of several autophagy marker genes, mainly in the lowest LA/ALA decile. This finding may point to the regulation of autophagy as a novel aspect of FA biology which warrants further study. Lastly, all FA ratios were associated with gene sets that included targets of specific microRNAs, and gene sets containing common promoter motifs that did not match any known transcription factors. We conclude that plasma FA ratios are associated with differences in blood gene expression profiles in this free-living population, and that affected genes and pathways may influence the onset and progression of disease.
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Crandall CJ, Barrett-Connor E. Endogenous sex steroid levels and cardiovascular disease in relation to the menopause: a systematic review. Endocrinol Metab Clin North Am 2013; 42:227-53. [PMID: 23702399 DOI: 10.1016/j.ecl.2013.02.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Heart disease remains a major cause of death among women in the United States. This article focuses on physiologic endogenous estrogen levels with a systematic review of literature related to endogenous sex steroid levels and coronary artery disease (CAD) among postmenopausal women with natural or surgical menopause. There is adequate reason to seek evidence for associations of circulating estrogen levels and CAD. In the future, even if ovarian senescence-associated hormonal changes are confirmed to be associated with CAD in cohort studies of postmenopausal women, there may be other components explaining the gender differences in CAD patterns.
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Affiliation(s)
- Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024, USA.
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Abstract
Increases in weight have been associated with corresponding increases in insulin resistance in postmenopausal women. Although estrogen has significant impact on body fat and body fat distribution, the cellular mechanisms that influence this process are not yet known. We measured adipose tissue fatty acid (FA) storage and FA storage factors in 12 premenopausal and 11 postmenopausal women matched for age and body composition. Postmenopausal women had lower postprandial FA oxidation (indirect calorimetry), greater meal FA, and direct free FA (FFA) storage than premenopausal women, including two-fold greater meal FA storage in the femoral depot. The fed/fasted activities of adipose tissue lipoprotein lipase were not significantly different between premenopausal and postmenopausal women. In contrast, adipocyte acyl-CoA synthetase and diacylglycerol acyltransferase activities in postmenopausal women were significantly upregulated and were positively correlated with direct FFA storage rates. These findings suggest that the propensity for subcutaneous adipose tissue FA storage is increased in postmenopausal women, more so from changes in adipocyte FA storage factors than from adipose tissue lipoprotein lipase activity. Our results suggest that female sex steroids, most likely estrogen, have important effects on adipose tissue FA storage and FA oxidation that could promote fat gain in postmenopausal women.
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Affiliation(s)
- Sylvia Santosa
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
- Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
| | - Michael D. Jensen
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
- Corresponding author: Michael D. Jensen,
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Burra P, De Martin E, Gitto S, Villa E. Influence of age and gender before and after liver transplantation. Liver Transpl 2013; 19:122-34. [PMID: 23172830 DOI: 10.1002/lt.23574] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/08/2012] [Indexed: 12/15/2022]
Abstract
Women constitute a particular group among patients with chronic liver disease and in the post-liver transplantation (LT) setting: they are set apart not only by traditional differences with respect to men (ie, body mass index, different etiologies of liver disease, and accessibility to transplantation) but also in increasingly evident ways related to hormonal changes that characterize first the fertile age and subsequently the postmenopausal period (eg, disease course variability and responses to therapy). The aim of this review is, therefore, to evaluate the role of the interplay of factors such as age, gender, and hormones in influencing the natural history of chronic liver disease before and after LT and their importance in determining outcomes after LT. As the population requiring LT ages and the mean age at transplantation increases, older females are being considered for transplantation. Older patients are at greater risk for nonalcoholic steatohepatitis, osteoporosis, and a worse response to antiviral therapy. Female gender per se is associated with a greater risk for osteoporosis because of metabolic changes after menopause, the bodily structure of females, and, in the population of patients with chronic liver disease, the greater prevalence of cholestatic and autoimmune liver diseases. With menopause, the fall of protective estrogen levels can lead to increased fibrosis progression, and this represents a negative turning point for women with chronic liver disease and especially for patients with hepatitis C. Therefore, the notion of gender as a binary female/male factor is now giving way to the awareness of more complex disease processes within the female gender that follow hormonal, social, and age patterns and need to be addressed directly and specifically.
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Affiliation(s)
- Patrizia Burra
- Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy.
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A prospective, case–control study on the lipid profile and the cardiovascular risk of menopausal women on oestrogen plus progestogen therapy in a northern Italy province. Arch Gynecol Obstet 2013; 288:91-7. [DOI: 10.1007/s00404-012-2702-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 12/21/2012] [Indexed: 10/27/2022]
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Benz V, Kintscher U, Foryst-Ludwig A. Sex-specific differences in Type 2 Diabetes Mellitus and dyslipidemia therapy: PPAR agonists. Handb Exp Pharmacol 2013:387-410. [PMID: 23027460 DOI: 10.1007/978-3-642-30726-3_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The influence of sex on the development of obesity, Type 2 Diabetes Mellitus (T2DM), and dyslipidemia is well documented, although the molecular mechanism underlying those differences reminds elusive. Ligands of peroxisome proliferator-activated receptors (PPARs) are used as oral antidiabetics (PPARgamma agonists: thiazolidinediones, TZDs), or for the treatment of dyslipidemia and cardiovascular diseases, due to their lipid-lowering properties (PPARalpha agonists: fibrates), as PPARs control transcription of a set of genes involved in the regulation of lipid and carbohydrate metabolism. Given a high prevalence of those metabolic disorders, and thus a broad use of PPAR agonists, the present review will discuss distinct aspects of sex-specific differences in antiobesity treatment using those groups of PPAR ligands.
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Affiliation(s)
- Verena Benz
- Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Ryou SH, Kang MS, Kim KI, Kang YH, Kang JS. Effects of green tea or Sasa quelpaertensis bamboo leaves on plasma and liver lipids, erythrocyte Na efflux, and platelet aggregation in ovariectomized rats. Nutr Res Pract 2012; 6:106-12. [PMID: 22586498 PMCID: PMC3349031 DOI: 10.4162/nrp.2012.6.2.106] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 01/11/2012] [Accepted: 01/28/2012] [Indexed: 11/04/2022] Open
Abstract
This study was conducted to investigate the effects of Sasa quelpaertensis bamboo and green tea on plasma and liver lipids, platelet aggregation, and erythrocyte membrane Na channels in ovariectomized (OVX) rats. Thirty female rats were OVX, and ten female rats were sham-operated at the age of 6 weeks. The rats were divided into four groups at the age of 10 weeks and fed the experiment diets: sham-control, OVX-control, OVX-bamboo leaves (10%), or OVX-green tea leaves (10%) for four weeks. Final body weight increased significantly in the OVX groups compared with that in the sham-control, whereas body weight in the OVX-green tea group decreased significantly compared with that in the OVX-control (P < 0.01). High density lipoprotein (HDL)-cholesterol level decreased in all OVX groups compared with that in the sham-control rats (P < 0.05) but without a difference in plasma total cholesterol. Plasma triglycerides in the OVX-green tea group were significantly lower than those in the sham-control or OVX-control group (P < 0.05). Liver triglycerides increased significantly in the OVX-control compared with those in the sham-control (P < 0.01) but decreased significantly in the OVX-green tea group compared with those in the OVX-control or OVX-bamboo group (P < 0.01). Platelet aggregation in both maximum and initial slope tended to be lower in all OVX rats compared with that in the sham-control rats but was not significantly different. Na-K ATPase tended to increase and Na-K cotransport tended to decrease following ovariectomy. Na-K ATPase decreased significantly in the OVX-green tea group compared with that in the OVX-control group (P < 0.01), and Na-K cotransport increased significantly in the OVX-bamboo and OVX-green tea groups compared with that in the OVX-control (P < 0.05). Femoral bone mineral density tended to be lower in OVX rats than that in the sham-control, whereas the green tea and bamboo leaves groups recovered bone density to some extent. The results show that ovariectomy caused an increase in body weight and liver triglycerides, and that green tea was effective for lowering body weight and triglycerides in OVX rats. Ovariectomy induced an increase in Na efflux via Na-K ATPase and a decrease in Na efflux via Na-K cotransport. Furthermore, consumption of green tea and bamboo leaves affected Na efflux channels, controlling electrolyte and body water balance.
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Affiliation(s)
- Sung Hee Ryou
- Department of Foods & Nutrition, Jeju National University, 1 Ara-dong, Jeju-si, Jeju 690-756, Korea
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Ng N, Johnson O, Lindahl B, Norberg M. A reversal of decreasing trends in population cholesterol levels in Västerbotten County, Sweden. Glob Health Action 2012; 5:GHA-5-10367. [PMID: 22468143 PMCID: PMC3313585 DOI: 10.3402/gha.v5i0.10367] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 02/24/2012] [Accepted: 02/28/2012] [Indexed: 11/29/2022] Open
Abstract
Background High cholesterol is identified as a major risk factor for chronic non-communicable diseases, especially cardiovascular and cerebrovascular diseases. Monitoring trends of cholesterol levels and comparing trends across population groups are important to assess population distribution and risks related to cholesterol change over time. Cholesterol surveillance data are lacking, even in high-income countries. Objectives To describe the trends in cholesterol and triglyceride levels in different population groups and to estimate the risk of developing hypercholesterolemia and hypertriglyceridemia in Västerbotten County, Sweden during 1990–2010. Designs and Methods Since 1990, 133,082 individuals living in Västerbotten County, Northern Sweden, invited on their 30th, 40th, 50th and 60th birthdays, participated in the Västerbotten Intervention Program. Ten years after baseline data collection, 34,868 individuals were surveyed for a second time. In addition to a self-administered health questionnaire (that included information on socioeconomic status, demographics, self-reported health and lifestyle behaviours), blood cholesterol and triglyceride were examined. Results The level and prevalence of hypercholesterolemia decreased significantly from 1990 to 2007, but the trends began to increase during 2008–2010 in men, women, and in all educational groups. Men had significantly higher serum triglyceride levels than women and their cholesterol levels were similar to those of the women. This study shows that those with basic education and who live in rural inlands had consistently higher triglyceride level than those who live in the city and have higher educational attainments. People with basic education are also at higher risk of developing hypercholesterolemia and hypertriglyceridemia at 10-year follow-up; the risk is much higher among the older cohorts, particularly women. During 1990–2010, the proportion of participants who reported treatment with lipid-lowering agents increased from 1.1% to 9.6% among men and 0.5% to 5.3% among women. About 60% of those treated achieved treatment goals for cholesterol or triglycerides. Conclusions The increasing trend in cholesterol level in the Västerbotten population during 2008–2010 needs to be closely monitored. Addressing the unequal distribution of cholesterol, as well as other risk factors such as obesity, physical inactivity, high blood glucose, among those with basic education, and particularly among populations in rural areas are important to prevent higher burdens of chronic non-communicable diseases in this population.
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Affiliation(s)
- Nawi Ng
- Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Lee MH, Kim HC, Ahn SV, Hur NW, Choi DP, Park CG, Suh I. Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005. Diabetes Metab J 2012; 36:43-55. [PMID: 22363921 PMCID: PMC3283826 DOI: 10.4093/dmj.2012.36.1.43] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 06/01/2011] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Dyslipidemia is a disorder of lipid metabolism, including elevated total cholesterol, elevated triglyceride, elevated low density lipoprotein cholesterol (LDL-C), and decreased high density lipoprotein cholesterol (HDL-C). The objective of this study was to investigate recent changes in the prevalence of dyslipidemia and also the rates of awareness, treatment, and control of dyslipidemia among Korean adults. METHODS Dyslipidemia is defined according to the National Cholesterol Education Program-Adult Treatment Panel III as total cholesterol ≥240 mg/dL, LDL-C ≥160 mg/dL, HDL-C <40 mg/dL, and triglyceride ≥200 mg/dL. The prevalence of dyslipidemia was estimated for adults aged ≥20 years using the Korea National Health and Nutrition Survey (KNHANES) in 1998 (n=6,923), 2001 (n=4,882), and 2005 (n=5,323). Rates of awareness, treatment and control of dyslipidemia were calculated for adults aged ≥30 years using the KNHANES in 2005 (n=4,654). RESULTS The prevalence of dyslipidemia (aged ≥20 years) increased from 32.4% in 1998 to 42.6% in 2001 and 44.1% in 2005. Compared with the KNHANES in 1998, the prevalence of dyslipidemia was 47% (95% confidence interval [CI], 35% to 59%) higher in 2001 and 61% (95% CI, 49% to 75%) higher in 2005. In 2005, only 9.5% of people with dyslipidemia were aware of the disease, 5.2% used lipid-lowering medication, and 33.2% of patients with treatment reached treatment goals. CONCLUSION The prevalence of dyslipidemia in Korea gradually increased between 1998 and 2005. These findings suggest that more intense efforts for the prevention and treatment of dyslipidemia may lead to further improvement in the management of dyslipidemia.
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Affiliation(s)
- Myung Ha Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Song Vogue Ahn
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Nam Wook Hur
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Phil Choi
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Gyu Park
- Department of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Il Suh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Karakiriou SK, Douda HT, Smilios IG, Volaklis KA, Tokmakidis SP. Effects of vibration and exercise training on bone mineral density and muscle strength in post-menopausal women. Eur J Sport Sci 2012. [DOI: 10.1080/17461391.2010.536581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yoon JH, Park JK, Oh SS, Lee KH, Kim SK, Cho IJ, Kim JK, Kang HT, Ahn SG, Lee JW, Lee SH, Eom A, Kim JY, Ahn SV, Koh SB. The ratio of serum leptin to adiponectin provides adjunctive information to the risk of metabolic syndrome beyond the homeostasis model assessment insulin resistance: The Korean Genomic Rural Cohort Study. Clin Chim Acta 2011; 412:2199-205. [DOI: 10.1016/j.cca.2011.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 08/02/2011] [Accepted: 08/03/2011] [Indexed: 12/15/2022]
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Lipids, menopause, and early atherosclerosis in Study of Women's Health Across the Nation Heart women. Menopause 2011; 18:376-84. [PMID: 21107300 DOI: 10.1097/gme.0b013e3181f6480e] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The risk of cardiovascular disease increases after menopause. Recent evidence suggests that it is possible for high-density lipoprotein (HDL) to become proatherogenic or dysfunctional in certain situations. Our objective was to evaluate whether the relationship of HDL cholesterol (HDL-C) to subclinical cardiovascular disease differed across the menopausal transition, which would provide insight for this increased risk. METHODS Aortic calcification (AC), coronary artery calcification (CAC), carotid plaque, and intima media thickness (IMT) were measured in an ancillary study of the Study of Women's Health Across the Nation. Women not using hormone therapy were stratified into premenopausal or early perimenopausal (Pre/EP, n=316) and late perimenopausal or postmenopausal (LP/Post, n=224). RESULTS The inverse relationship of HDL-C to subclinical atherosclerosis measures among Pre/EP women was weaker or reversed among LP/Post women, adjusted for age, site, race, systolic blood pressure, glucose, body mass index, smoking, menopause status, and low-density lipoprotein cholesterol. Specifically, multivariable modeling demonstrated an inverse association between HDL-C level and AC and IMT among Pre/EP women; however, the protective effect of HDL-C for AC, left main CAC, carotid plaque, and IMT was not seen in LP/Post women. In a small subset (n=53), LP/Post women had more total and small HDL particles, higher triglyceride levels, and more total low-density lipoprotein particles compared with Pre/EP women (P<0.05). CONCLUSIONS These results suggest that the protective effect of HDL may be diminished as women transition in menopause. Future studies should examine whether this may be due to changes in HDL size, functionality, or related changes in other lipids or lipoproteins.
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Lee MH, Ahn SV, Hur NW, Choi DP, Kim HC, Suh I. Gender differences in the association between smoking and dyslipidemia: 2005 Korean National Health and Nutrition Examination Survey. Clin Chim Acta 2011; 412:1600-5. [PMID: 21601564 DOI: 10.1016/j.cca.2011.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 04/19/2011] [Accepted: 05/06/2011] [Indexed: 01/11/2023]
Abstract
BACKGROUND Smoking has been reported to be associated with abnormal lipid metabolism. However, it remains uncertain whether adverse metabolic effects of smoking on dyslipidemia differ with gender. The objective of this study was to investigate the association between smoking and dyslipidemia in men and women. METHODS We analyzed data from 2166 men and 3003 women aged ≥20 years assessed in the Third Korea National Health and Nutrition Examination Survey (2005). Dyslipidemia was defined according to the National Cholesterol Education Program-Adult Treatment Panel III. RESULTS The prevalence of dyslipidemia was higher in men than in women. The odds ratios (95% confidence interval) of dyslipidemia associated with current smoking were 1.35 (0.98-1.85) in men and 1.92 (1.19-3.10) in women (p for interaction with gender <0.001). After stratification by components of dyslipidemia, women smokers showed higher odds ratios of having high triglyceride and low high-density lipoprotein cholesterol than men smokers. The association between current heavy-smoking (≥20 pack-years) and dyslipidemia was stronger in women than in men. CONCLUSIONS The association between smoking and dyslipidemia was significantly different between men and women. Women smokers might be more susceptible to develop dyslipidemia than men smokers.
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Affiliation(s)
- Myung Ha Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Straface E, Lista P, Gambardella L, Franconi F, Malorni W. Gender-specific features of plasmatic and circulating cell alterations as risk factors in cardiovascular disease. Fundam Clin Pharmacol 2010; 24:665-74. [DOI: 10.1111/j.1472-8206.2010.00860.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lombardi M, Mercuro G, Fini M, Rosano GM. Gender-specific aspects of treatment of cardiovascular risk factors in primary and secondary prevention. Fundam Clin Pharmacol 2010; 24:699-705. [DOI: 10.1111/j.1472-8206.2010.00834.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Impact of triglycerides on lipid and lipoprotein biology in women. ACTA ACUST UNITED AC 2010; 7:189-205. [DOI: 10.1016/j.genm.2010.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2010] [Indexed: 11/18/2022]
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Rosano GMC, Vitale C, Fini M. Cardiovascular aspects of menopausal hormone replacement therapy. Climacteric 2009; 12 Suppl 1:41-6. [DOI: 10.1080/13697130903012306] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rosano GMC, Maffei S, Andreassi MG, Vitale C, Vassalle C, Gambacciani M, Stramba-Badiale M, Mercuro G. Hormone replacement therapy and cardioprotection: a new dawn? A statement of the Study Group on Cardiovascular Disease in Women of the Italian Society of Cardiology on hormone replacement therapy in postmenopausal women. J Cardiovasc Med (Hagerstown) 2009; 10:85-92. [PMID: 19145119 DOI: 10.2459/jcm.0b013e328313e979] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cardiovascular disease is the leading cause of death in women in Western countries. Despite preventive strategies, in the past decades the incidence of cardiovascular events has shown a decline in men but a rise in women, matching the growth of the population of postmenopausal women. Several epidemiological findings suggest the causative pathophysiological role of ovarian hormone deficiency in the development of cardiovascular disease in women. Observational and randomized studies have suggested that hormone replacement therapy in early postmenopause could be beneficial from a cardiovascular point of view. Conversely, aging, time since menopause and presence of cardiovascular risk factors or cardiovascular disease may decrease its efficacy and increase the risk of cardiovascular events. It is plausible that the unfavorable effects of the estrogen/progestin combination used in the randomized studies are not related to the hormone preparation per se but rather to the use of hormones in the less receptive group of women, older and with cardiovascular risk factors. Clinical judgment, choice of the right dose and estrogen/progestin combination are of pivotal importance to maximize the beneficial effect of estrogen replacement therapy/hormone replacement therapy, especially if given within a reasonable time after the menopause to women who need the therapy for the relief of menopausal symptoms.
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Affiliation(s)
- Giuseppe M C Rosano
- Centre for Clinical and Basic Research, IRCCS San Raffaele Roma, Via della Pisana 234, 00163 Rome, Italy.
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Factors associated with total cholesterol levels in women around menopause attending menopause clinics in Italy. Climacteric 2009. [DOI: 10.1080/13697130310001651517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Impact of age and menopausal status on the postprandial triacylglycerol response in healthy women. Atherosclerosis 2009; 208:246-52. [PMID: 19640535 DOI: 10.1016/j.atherosclerosis.2009.06.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/02/2009] [Accepted: 06/27/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the impact of age and the natural menopause on the postprandial triacylglycerol (TAG) response in healthy women. METHODS AND RESULTS Thirty-seven premenopausal and sixty-one postmenopausal women underwent a sequential meal postprandial investigation, in which blood samples were taken at regular intervals after a test breakfast and lunch given at 0 and 330 min respectively. Lipids and glucose were measured in the fasting sample, with TAG analysed in the postprandial samples. Postmenopausal women were shown to have higher fasting total cholesterol, low density lipoprotein cholesterol (LDL-C) and glucose (P<0.02). Marked differences in the postprandial TAG response were evident between the groups, with a greater incremental area under the curve (IAUC) and maximum TAG concentration in the postmenopausal women (P<0.04). Multivariate regression analysis revealed both age and fasting TAG to be independently associated with the summary measures of the postprandial TAG response in the premenopausal women only. Interestingly, sub-division of the women into both younger and older pre- and postmenopausal subgroups, showed the most marked difference in TAG-IAUC to be between the younger and the older premenopausal women, whereas differences in fasting LDL-C were most evident between the older premenopausal and the younger postmenopausal women. CONCLUSIONS Our results suggest a divergence in the relationship of age and menopausal status with fasting LDL-C and postprandial TAG which may reflect differences in the metabolic effects of age and the menopause on these lipid risk markers or a greater impact of early oestrogen decline on pathways of TAG rather than LDL metabolism.
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Vitale C, Miceli M, Rosano GMC. Gender-specific characteristics of atherosclerosis in menopausal women: risk factors, clinical course and strategies for prevention. Climacteric 2009; 10 Suppl 2:16-20. [PMID: 17882667 DOI: 10.1080/13697130701602712] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cardiovascular disease is the leading cause of mortality and morbidity in women after the age of 50 years in most developed countries. Epidemiology, symptoms and progression of cardiovascular disease are different in women than in men. Indeed, women develop cardiovascular disease when they are about 10 years older than men and typically after the menopause. Risk factors have a different impact in determining cardiovascular risk in the two sexes. In men, cholesterol is more important than in women, in whom arterial hypertension, diabetes and their combination has a greater importance in determining cardiovascular risk. Menopause is an important cardiovascular risk factor both for the negative effect of ovarian hormone deprivation on cardiovascular function and for the consequent worsening of cardiovascular risk factors. Marked gender differences also exist in the clinical manifestations of atherosclerosis and in the pattern of symptoms in the two sexes. Angina, the most common manifestation of coronary heart disease, is frequently uncomplicated in women, whereas in men it tends to evolve to an acute coronary syndrome. The clinical presentation of acute ischemic syndromes is also different in men and women and, because of the frequent atypical symptoms, women tend to underestimate the importance of them. Because of the different impact of cardiovascular risk factors in men and women, the strategies for prevention should be different in the two sexes. In women, the control of blood pressure and glucose metabolism should be a priority. Furthermore, hormone replacement therapy may still have a role in the prevention of cardiovascular diseases if given to the right woman and at the right time.
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Affiliation(s)
- C Vitale
- Center for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy
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Kalpakjian C, Quint E. Menopause Research in Women with Spinal Cord Injury: Challenges and Opportunities. Top Spinal Cord Inj Rehabil 2009. [DOI: 10.1310/sci1501-75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Stramba-Badiale M. Postmenopausal hormone therapy and the risk of cardiovascular disease. J Cardiovasc Med (Hagerstown) 2009; 10:303-9. [PMID: 19430340 DOI: 10.2459/jcm.0b013e328324991c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Sex hormones exert significant effects on the cardiovascular system. Ovarian hormone deficiency associated with menopause plays an important role in the development of cardiovascular disease in women. The reduced risk of cardiovascular diseases associated with hormone replacement therapy (HRT), reported in observational studies, has not been subsequently confirmed in randomized clinical trials. Therefore, at the present time, HRT is not recommended for postmenopausal women for the prevention of cardiovascular diseases. However, the possible role and safety of HRT in women who experience menopausal symptoms that significantly affect their quality of life is still under debate. The increased risk of cardiovascular disease in the larger randomized trial was found in the oldest women and in those who started HRT late after menopause began. Further basic and clinical studies are necessary to evaluate the mechanisms underlying the possible detrimental or protective effects of HRT and to assess benefits and risks of different dosages, route of administration, and duration of HRT. In the absence of clear evidence on the safest hormone regimen, the prescription of HRT in order to reduce menopausal symptoms should be limited to younger postmenopausal women at low risk for cardiovascular diseases, starting in the period close to the beginning of menopause. The benefit of HRT in relieving menopausal symptoms and reducing the occurrence of hip fractures should be weighted against the increased risk of cardiovascular disease and breast cancer. For this purpose, it is crucial to identify the presence of cardiovascular risk factors in perimenopausal and postmenopausal women. The cardiovascular effects of sex hormones, the increased risk of cardiovascular disease after menopause, and the effects of HRT on cardiovascular risk are critically reviewed, as well as their impact on the recommendations for clinical practice.
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Affiliation(s)
- Marco Stramba-Badiale
- Department of Rehabilitation Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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Villa P, Costantini B, Suriano R, Perri C, Macrì F, Ricciardi L, Panunzi S, Lanzone A. The differential effect of the phytoestrogen genistein on cardiovascular risk factors in postmenopausal women: relationship with the metabolic status. J Clin Endocrinol Metab 2009; 94:552-8. [PMID: 19017760 DOI: 10.1210/jc.2008-0735] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The wide family of the phytoestrogens has become an alternative to the classical hormonal therapy in menopause; nevertheless, some findings are still conflicting. OBJECTIVE To examine the effect of genistein administration on metabolic parameters and vascular reactivity considering the basal endocrine status of the patients. DESIGN AND SETTING A randomized placebo controlled study was conducted at a university hospital. PARTICIPANTS Fifty postmenopausal women participated. INTERVENTIONS Thirty subjects (group A) were randomized to receive 54 mg/d genistein while 20 subjects (group B) were treated with the placebo for 24 wk. In group A, we distinguish two subgroups: 14 normoinsulinemic and 12 hyperinsulinemic patients. MAIN OUTCOME MEASURES Anthropometric measures, hormonal and lipid assays, oral glucose tolerance test with glycemic, insulin, and C-peptide evaluation, indexes of insulin sensitivity and endothelial function, and euglycemic-hyperinsulinemic clamps were performed. RESULTS The insulin basal values significantly decreased in group A, whereas the homeostasis model index of insulin sensitivity and the fasting glucose levels significantly improved compared with placebo group. The genistein administration decreased fasting glucose and area under the curve glucose levels in the normoinsulinemic patients after treatment. In the hyperinsulinemic patients, a significant reduction in fasting insulin, fasting C-peptide, and area under the curve insulin levels as well as an increase in fractional hepatic insulin extraction was shown. In these patients, high-density lipoprotein cholesterol levels were significantly improved. The endothelium-dependent and -independent dilatation improved in the treated group. Normoinsulinemic patients showed both a significantly enhanced flow-mediated and nitrate-mediated dilatation, whereas no significant changes were found in the hyperinsulinemic group. CONCLUSIONS The glycoinsulinemic metabolism and the endothelial function were significantly influenced by genistein. In particular, normoinsulinemic patients showed an improvement in glycemic and vascular reactivity indexes. Conversely, an improvement in the insulin sensitivity indexes was noted in hyperinsulinemic patients.
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Affiliation(s)
- Paola Villa
- Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy.
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Lee HJ, Seo YW, Yun KE, Park HS. Determinants of Responsiveness of LDL-cholesterol Lowering to Lifestyle Modification in Hypercholesterolemic Patients. Korean J Fam Med 2009. [DOI: 10.4082/kjfm.2009.30.5.369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Hea-Jin Lee
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Won Seo
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Eun Yun
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye-Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Janssen I, Powell LH, Crawford S, Lasley B, Sutton-Tyrrell K. Menopause and the metabolic syndrome: the Study of Women's Health Across the Nation. ACTA ACUST UNITED AC 2008; 168:1568-75. [PMID: 18663170 DOI: 10.1001/archinte.168.14.1568] [Citation(s) in RCA: 337] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Cross-sectional studies suggest that prevalence of the metabolic syndrome (MetS) increases from premenopause to postmenopause in women, independent of age. Little is known about why. We hypothesized that the incidence of the MetS increases with progression through menopause and that this increase is explained by the progressive androgenicity of the hormonal milieu. METHODS This longitudinal, 9-year study of 949 participants in the Study of Women's Health Across the Nation investigates the natural history of the menopausal transition. Participants of 5 ethnicities at 7 geographic sites were recruited when they were premenopausal or early perimenopausal and were eligible for this study if they (1) reached menopause during the study; (2) had never taken hormone therapy, and (3) did not have diabetes mellitus or the MetS at baseline. The primary outcome was the presence of MetS using National Cholesterol Education Program Adult Treatment Panel III criteria. Secondary outcomes were the components of the MetS. RESULTS By the final menstrual period, 13.7% of the women had new-onset MetS. Longitudinal analyses, centered at the final menstrual period, were adjusted for age at menopause, ethnicity, study site, marital status, education, body mass index, smoking, and aging. Odds of developing the MetS per year in perimenopause were 1.45 (95% confidence interval, 1.35-1.56); after menopause, 1.24 (95% confidence interval, 1.18-1.30). These odds were significantly different (P < .001). An increase in bioavailable testosterone or a decrease in sex hormone-binding globulin levels increased the odds. CONCLUSIONS As testosterone progressively dominates the hormonal milieu during the menopausal transition, the prevalence of MetS increases, independent of aging and other important covariates. This may be a pathway by which cardiovascular disease increases during menopause.
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Affiliation(s)
- Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren, Ste 470, Chicago, IL 60612, USA.
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