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Lucà F, Pavan D, Gulizia MM, Manes MT, Abrignani MG, Benedetto FA, Bisceglia I, Brigido S, Caldarola P, Calvanese R, Canale ML, Caretta G, Ceravolo R, Chieffo A, Chimenti C, Cornara S, Cutolo A, Di Fusco SA, Di Matteo I, Di Nora C, Fattirolli F, Favilli S, Francese GM, Gelsomino S, Geraci G, Giubilato S, Ingianni N, Iorio A, Lanni F, Montalto A, Nardi F, Navazio A, Nesti M, Parrini I, Pilleri A, Pozzi A, Rao CM, Riccio C, Rossini R, Scicchitano P, Valente S, Zuccalà G, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists Position Paper 'Gender discrepancy: time to implement gender-based clinical management'. Eur Heart J Suppl 2024; 26:ii264-ii293. [PMID: 38784671 PMCID: PMC11110461 DOI: 10.1093/eurheartjsupp/suae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
It has been well assessed that women have been widely under-represented in cardiovascular clinical trials. Moreover, a significant discrepancy in pharmacological and interventional strategies has been reported. Therefore, poor outcomes and more significant mortality have been shown in many diseases. Pharmacokinetic and pharmacodynamic differences in drug metabolism have also been described so that effectiveness could be different according to sex. However, awareness about the gender gap remains too scarce. Consequently, gender-specific guidelines are lacking, and the need for a sex-specific approach has become more evident in the last few years. This paper aims to evaluate different therapeutic approaches to managing the most common women's diseases.
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Affiliation(s)
- Fabiana Lucà
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Daniela Pavan
- Cardio-Cerebro-Rehabilitation Department, Azienda Sanitaria Friuli Occidentale, (AS FO) Via della Vecchia Ceramica, 1, Pordenone 33170, Italy
| | - Michele Massimo Gulizia
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | - Maria Teresa Manes
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | | | - Francesco Antonio Benedetto
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Irma Bisceglia
- Cardio-Thoraco-Vascular Department, San Camillo Forlanini Hospital, 00152 Roma, Italy
| | - Silvana Brigido
- Cardiology Clinics, ‘F.’ Hospital Jaia’, 70014 Conversano, BA, Italy
| | | | | | | | - Giorgio Caretta
- Cardiology Unit, Sant’Andrea Hospital, 19100 La Spezia, SP, Italy
| | - Roberto Ceravolo
- Cardiology Division, Giovanni Paolo II Hospial, 88046 Lamezia Terme, CZ, Italy
| | - Alaide Chieffo
- Interventional Cardiology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy
| | - Cristina Chimenti
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy
| | - Stefano Cornara
- Levante Cardiology, San Paolo Hospital, Savona, 17100 Savona, SV, Italy
| | - Ada Cutolo
- Cardiolog Unit, Ospedale dell’Angelo, 30172 Mestre, Italy
| | | | - Irene Di Matteo
- Cardiology Unit, Cariovascular Department, ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
| | - Concetta Di Nora
- Cardiac Surgery Unit, Santa Maria della Misericordia Hospital, 33100 Udine, UD, Italy
| | - Francesco Fattirolli
- Department of Experimental and Clinical Medicine, Florence University, 50121 Firenze, Italy
| | - Silvia Favilli
- Pediatric and Transition Cardiology Unit, Meyer University Hospital, 50139 Florence, Italy
| | - Giuseppina Maura Francese
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | - Sandro Gelsomino
- Pediatric and Transition Cardiology Unit, Meyer University Hospital, 50139 Florence, Italy
| | - Giovanna Geraci
- Cardiology Unit, Sant'Antonio Abate di Erice, 91016 Erice, Trapani, Italy
| | | | | | - Annamaria Iorio
- Cardiology Unity 1, Cardiology 1, Cardiovascular Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
| | - Francesca Lanni
- Cardiology Unity, San Giuseppe Moscati Hospital, 83100 Avellino, Italy
| | - Andrea Montalto
- Cardiac Surgery Unit, San Camillo Forlanini Hospital, 00152 Roma, Italy
| | - Federico Nardi
- Dipartimento di Cardiologia, Ospedale Santo Spirito, Casale Monferrato, Italy
| | | | - Martina Nesti
- Cardiology Unity, San Donato Hospital, 52100 Arezzo, Italy
| | - Iris Parrini
- Cardiology Unity, Umberto I Di Torino Hospital, 10128 Torino, Italy
| | - Annarita Pilleri
- Federico Nardi, Cardiology Unit, Casale Monferrato Hospital, 15033 Casale Monferrato (AL), Italy
| | - Andrea Pozzi
- Cardiology Unity 1, Cardiology 1, Cardiovascular Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
| | - Carmelo Massimiliano Rao
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Carmine Riccio
- Post-Acute Patient Follow-up Unit, Cardio-Vascular Department, AORN Sant'Anna and San Sebastiano, Caserta, Italy
| | | | | | - Serafina Valente
- Clinical-Surgical Cardiology, A.O.U. Siena, Santa Maria alle Scotte Hospital, 53100 Siena, Italy
| | - Giuseppe Zuccalà
- Department of Geriatrics, Center for Aging Medicine, Catholic University of the Sacred Heart and IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy
| | - Domenico Gabrielli
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
- Fondazione per il Tuo cuore—Heart Care Foundation, 50121 Firenze, Italy
| | - Massimo Grimaldi
- Cardiology Division, Coronary Intensive Care Unit, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy
| | | | - Fabrizio Oliva
- Cardiology Unit, Cariovascular Department, ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
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Jane L Espartero L, Yamada M, Ford J, Owens G, Prow T, Juhasz A. Health-related toxicity of emerging per- and polyfluoroalkyl substances: Comparison to legacy PFOS and PFOA. ENVIRONMENTAL RESEARCH 2022; 212:113431. [PMID: 35569538 DOI: 10.1016/j.envres.2022.113431] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are highly persistent, manufactured chemicals used in various manufacturing processes and found in numerous commercial products. With over 9000 compounds belonging to this chemical class, there is increasing concern regarding human exposure to these compounds due to their persistent, bioaccumulative, and toxic nature. Human exposure to PFAS may occur from a variety of exposure sources, including, air, food, indoor dust, soil, water, from the transfer of PFAS from non-stick wrappers to food, use of cosmetics, and other personal care products. This critical review presents recent research on the health-related impacts of PFAS exposure, highlighting compounds other than Perfluorooctanoic acid (PFOA) and Perfluoroctane sulfonate (PFOS) that cause adverse health effects, updates the current state of knowledge on PFAS toxicity, and, where possible, elucidates cause-and-effect relationships. Recent reviews identified that exposure to PFAS was associated with adverse health impacts on female and male fertility, metabolism in pregnancy, endocrine function including pancreatic dysfunction and risk of developing Type 2 diabetes, lipid metabolism and risk of childhood adiposity, hepatic and renal function, immune function, cardiovascular health (atherosclerosis), bone health including risk for dental cavities, osteoporosis, and vitamin D deficiency, neurological function, and risk of developing breast cancer. However, while cause-and-effect relationships for many of these outcomes were not able to be clearly elucidated, it was identified that 1) the evidence derived from both animal models and humans suggested that PFAS may exert harmful impacts on both animals and humans, however extrapolating data from animal to human studies was complicated due to differences in exposure/elimination kinetics, 2) PFAS precursor kinetics and toxicity mechanism data are still limited despite ongoing exposures, and 3) studies in humans, which provide contrasting results require further investigation of the long-term-exposed population to better evaluate the biological toxicity of chronic exposure to PFAS.
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Affiliation(s)
- Lore Jane L Espartero
- Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia
| | - Miko Yamada
- Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia
| | - Judith Ford
- University of Sydney, New South Wales, United Kingdom
| | - Gary Owens
- Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia
| | - Tarl Prow
- Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia; Skin Research Centre, York Biomedical Research Institute, Hull York Medical School, University of York, United Kingdom
| | - Albert Juhasz
- Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia.
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Zhang S, Zhou J, Li L, Pan X, Lin J, Li C, Leung WT, Wang L. Effect of dehydroepiandrosterone on atherosclerosis in postmenopausal women. Biosci Trends 2021; 15:353-364. [PMID: 34759119 DOI: 10.5582/bst.2021.01320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In China, cardiovascular disease (CVD) has surpassed malignant tumours to become the disease with the highest mortality rate, and atherosclerosis (AS) is an important pathological cause of CVD. Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone in circulating human blood and is a precursor of estrogen and androgen. DHEA is converted into a series of sex hormones in local peripheral tissues where its acts physiologically. DHEA also acts therapeutically, thereby avoiding the adverse systemic reactions to sex hormones. DHEA inhibits AS, thus inhibiting the development of CVD, and it improves the prognosis for CVD. The incidence of CVD in postmenopausal women is substantially higher than that in premenopausal women, and that incidence is believed to be related to a decrease in ovarian function. The current review analyzes the mechanisms of postmenopausal women's susceptibility to AS. They tend to have dyslipidemia, and their vascular smooth muscle cells (VSMCs) proliferate and migrate more. In addition, oxidative stress and the inflammatory response of endothelial cells (ECs) are more serious in postmenopausal women. This review also discusses how DHEA combats AS by countering these mechanisms, which include regulating the blood lipid status, protecting ECs (including coping with oxidative stress and inflammatory reactions of the vascular endothelium, inhibiting apoptosis of ECs, and inducing NO production) and inhibiting the proliferation and migration of VSMCs. As a result, DHEA has great value in preventing AS and inhibiting its progression in postmenopausal women.
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Affiliation(s)
- Siwei Zhang
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Lijuan Li
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Xinyao Pan
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Jing Lin
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Chuyu Li
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Wing Ting Leung
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
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Wong MYZ, Yap J, Huang W, Tan SY, Yeo KK. Impact of Age and Sex on Subclinical Coronary Atherosclerosis in a Healthy Asian Population. JACC: ASIA 2021; 1:93-102. [PMID: 36338370 PMCID: PMC9627875 DOI: 10.1016/j.jacasi.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/17/2022]
Abstract
Background The influence of age and sex on clinical atherosclerotic cardiovascular disease is well reported, but literature remains sparse on whether these extend to the disease in its preclinical stage. Objectives The purpose of this study was to report the prevalence, risk factors, and impact of age and sex on the burden of subclinical coronary atherosclerosis in a healthy Asian population. Methods Healthy subjects age 30 to 69 years, with no history of cardiovascular disease or diabetes were recruited from the general population. Subclinical coronary atherosclerosis was quantified via the coronary artery calcium score (CAC) with CAC of 0 indicating absence of calcified plaque, 1 to 10 minimal plaque, 11 to 100 mild plaque, and >100 moderate to severe plaque. Results A total of 663 individuals (mean age 49.4 ± 9.2 years; 44.8% men) were included. The prevalence of any CAC was 29.3%, with 9% having CAC >100. The prevalence was significantly higher in men than women (43.1% vs 18.0%; P < 0.001). Multivariable analysis revealed significant associations of increasing age, male sex, higher blood pressure, increased glucose levels, and higher low-density lipoprotein cholesterol levels with the presence of any CAC. Low-density lipoprotein cholesterol was more significantly associated with CAC in women compared with men (Pinteraction = 0.022). Conclusions The prevalence of preclinical atherosclerosis increased with age, and was higher in men, with sex-specific differences in associated risk factors. These results will better inform individualized future risk management strategies to prevent the development and progression of coronary artery disease within healthy individuals.
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AlRahimi J, Alattas R, Almansouri H, Alharazi GB, Mufti HN. Assessment of Different Risk Factors Among Adult Cardiac Patients at a Single Cardiac Center in Saudi Arabia. Cureus 2020; 12:e11649. [PMID: 33376660 PMCID: PMC7755695 DOI: 10.7759/cureus.11649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Cardiovascular disease (CVD) has remained the leading cause of death in the last 15 years and is one of the main health problems in Saudi Arabia. Our study aims to assess the prevalence of different CVD risk factors and correlate them among King Faisal Cardiac Center patients in King Abdul-Aziz Medical City in Jeddah, Saudi Arabia. Methods We conducted a cross-sectional study using a convenient sampling technique. Data were collected by interviewing adult patients admitted to King Faisal Cardiac Center and diagnosed with hemodynamically stable cardiac disease. We excluded patients with multiple medical conditions that contribute to acute mental disorders. The sample size was calculated to be 200 patients. Results Overall, 163 patients completed the survey. The majority of the participants (49.1%) were between 46-65 years of age, males, non-smokers, and had more than 11 children. Diabetes was found to be the most common risk factor (66.3%). Most participants had mild to moderate anxiety (63.8%) and depression (66.9%). Most of the patients (51.5%) have a high 10-year risk of developing CVD, followed by moderate and low risk (33.1% and 15.3%, respectively). In our study, a high 10-year risk of CVD was significantly associated with age between 46-80 years with a p-value=0.002, male gender with a p-value=0.007, cigarette smoking with a p-value=0.031, and diabetes with a p-value=0.035. Conclusion The study demonstrated a high prevalence of the following CVD risk factors: age, male gender, immobility, obesity, diabetes, dyslipidemia, and hypertension. In addition, a significant association was found between high 10-year risk of CVD and age, gender, smoking, number of children, and diabetes with a p-value<0.05. No significant association was found in the other risk factors such as obesity, body mass index (BMI), immobility, caregiver, dyslipidemia, depression, and anxiety.
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Affiliation(s)
- Jamilah AlRahimi
- Department of Cardiac Science, Ministry of National Guard Health Affairs, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Rouya Alattas
- Department of Medicine, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Hidaya Almansouri
- Department of Medicine, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Ghadah B Alharazi
- Department of Medicine, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Hani N Mufti
- Department of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.,Department of Cardiac Surgery, King Faisal Cardiac Center, King Abdullah Medical City, Jeddah, SAU.,Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Wang L, Zhang P, Zhang X, Lin W, Tang H, Li J, Wang M, Liu X, Fei Y, Chen H, Peng L, Zhang L, Lai Y, Zeng X, Li X, Xue H, Zhao Y, Zhang F, Zhang W. Sex disparities in clinical characteristics and prognosis of immunoglobulin G4–related disease: a prospective study of 403 patients. Rheumatology (Oxford) 2018; 58:820-830. [PMID: 30561747 DOI: 10.1093/rheumatology/key397] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/08/2018] [Indexed: 12/24/2022] Open
Abstract
Abstract
Objectives
To study the impact of sex on the clinical presentation of IgG4-related disease (IgG4-RD).
Methods
We prospectively enrolled 403 newly diagnosed IgG4-RD patients. We compared the demographic features, clinical manifestations, organ involvement, laboratory tests and treatment outcomes between female and male patients. The organs involved were divided into superficial organs (salivary glands, lacrimal glands, orbit, sinus and skin) and internal organs (all the other organs). The patients treated with glucocorticoids with or without additional immunosuppressants were included in the assessment of treatment outcomes, and potential confounding factors were corrected by propensity score matching or multivariate Cox regression analysis.
Results
Female patients showed younger age at both symptom onset and diagnosis, and a longer interval between symptom onset and diagnosis. Allergy history, Mikulicz’s disease and thyroiditis were more common in female patients, while autoimmune pancreatitis, sclerosing cholangitis and retroperitoneal fibrosis were more common in male patients. In accordance, female patients more frequently presented with superficial organ involvement, while male patients more frequently had internal organ involvement, and the discrepancy was more prominent in the patients with older age. Male sex was associated with higher peripheral eosinophils, CRP and IgG4 levels at baseline. In response to glucocorticoid-based therapies, male sex was associated with a higher IgG4-RD responder index during follow-up as well as a greater risk of relapse (hazard ratio 3.14, P = 0.003).
Conclusion
Our study revealed the sex disparities in clinical characteristics of IgG4-RD, and indicated that male sex was independently associated with worse prognosis in response to glucocorticoid-based therapies.
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Affiliation(s)
- Liwen Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
- Tsinghua University School of Medicine, Beijing, China
| | - Panpan Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Xia Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Wei Lin
- Department of Rheumatology, Hebei General Hospital, Shijiazhuang
| | - Hanqi Tang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
- Tsinghua University School of Medicine, Beijing, China
| | - Jieqiong Li
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Mu Wang
- Department of Stomatology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xiaowei Liu
- Department of Ophthalmology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yunyun Fei
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Hua Chen
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Linyi Peng
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Li Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Yamin Lai
- Department of Gastroenterology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xuejun Zeng
- Department of General Internal Medicine, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xuemei Li
- Department of Nephrology, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yan Zhao
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Fengchun Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
| | - Wen Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing
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Hirose A, Terauchi M, Osaka Y, Akiyoshi M, Kato K, Miyasaka N. Effect of soy lecithin on fatigue and menopausal symptoms in middle-aged women: a randomized, double-blind, placebo-controlled study. Nutr J 2018; 17:4. [PMID: 29310653 PMCID: PMC5757297 DOI: 10.1186/s12937-018-0314-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/02/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Lecithin is a complex mixture of phospholipids which compose lipid bilayer cell membranes. Lipid replacement therapy, or administration of phospholipids for the purpose of repairing the dmaged cell membranes, had been shown to alleviate fatigue. The present study aimed to investigate the effect of soy lecithin on fatigue in middle-aged women, as well as other menopausal symptoms and various health parameters. METHODS This randomized, double-blind, placebo-controlled study included 96 women aged 40 to 60 years who complained of fatigue. The participants were randomized to receive active tablets containing high-dose (1200 mg/day; n = 32) or low-dose (600 mg/day; n = 32) soy lecithin, or placebo (n = 32), for 8 weeks. The following parameters were evaluated: age, menopausal status, lifestyle factors, physical and psychological symptoms of menopause, subjective symptoms of insomnia and fatigue, body composition, cardiovascular parameters, and physical activities and objective sleep states obtained from actigraphy before and 4 and 8 weeks after treatment. Fatigue was evaluated using the Profile of Mood States (POMS)-brief, Menopausal Health-Related Quality of Life questionnaire, Chalder Fatigue Scale, and Brief Fatigue Inventory. RESULTS Eighty-nine women completed the study. There were no significant differences in the changes in Chalder Fatigue Scale score (placebo vs low-dose vs high-dose groups: -2.9 ± 1.1, -3.2 ± 1.1, and -3.5 ± 1.0; P = 0.79). On the other hand, the improvements were greater in the high-dose group compared with the placebo group concerning vigor scores in the POMS-brief (1.9 ± 0.7 vs 0.2 ± 0.6; P = 0.02), diastolic blood pressure (-4.1 ± 1.8 vs 1.2 ± 1.9; P = 0.05), and cardio-ankle vascular index (-0.4 ± 0.2 vs 0.07 ± 0.1; P = 0.03) after 8 weeks of treatment. CONCLUSIONS High-dose (1200 mg/day) soy lecithin not only increases vigor, but also lowers the diastolic blood pressure and cardio-ankle vascular index in middle-aged women who present with fatigue. TRIAL REGISTRATION UMIN-CTR UMIN000017127 .
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Affiliation(s)
- Asuka Hirose
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
- Department of Women‘s Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
| | - Masakazu Terauchi
- Department of Women‘s Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
| | - Yurika Osaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
| | - Mihoko Akiyoshi
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
| | - Kiyoko Kato
- Department of Women‘s Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
| | - Naoyuki Miyasaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan
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8
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Yang ZQ, Zhao Q, Jiang P, Zheng SB, Xu B. Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study. BMC Geriatr 2017; 17:296. [PMID: 29281978 PMCID: PMC5745978 DOI: 10.1186/s12877-017-0686-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. METHODS A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. RESULTS Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m2). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. CONCLUSIONS The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.
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Affiliation(s)
- Zhi-Qi Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Qi Zhao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Ping Jiang
- Changning District Health and Family Planning Commission, Changning District, Shanghai, China
| | - Song-Bai Zheng
- Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Biao Xu
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, School of Public Health, Fudan University, No.130 Dong-An Road, Shanghai, China
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9
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Effects of tibolone on fibrinogen and antithrombin III: A systematic review and meta-analysis of controlled trials. Pharmacol Res 2017; 124:64-73. [DOI: 10.1016/j.phrs.2017.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 11/21/2022]
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10
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Chung WS, Lin HH. Sex Differences in the Risk of Developing Acute Coronary Syndrome in Patients With Sleep Disorders: A Population-Based Cohort Study. Am J Mens Health 2017; 11:1560-1568. [DOI: 10.1177/1557988316651260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Studies that focus on the relationship between sex and the risk of acute coronary syndrome (ACS) are scant. The current study investigated the effects of sex differences in the risk of developing ACS in patients with sleep disorders (SDs). This longitudinal population-based cohort study evaluated the incidence and risk of ACS development in 40,232 men and 65,519 women newly diagnosed with SDs between 2002 and 2008 from the Longitudinal Health Insurance Database. The follow-up period began from the entry date and ended on the date of an ACS event or December 31, 2010. Univariable and multivariable Cox proportional hazard regression models were conducted to estimate the sex differences in the risk of ACS. Men with SDs exhibited an increased incidence of ACS compared with women with SDs in all age- and comorbidity-specific subgroups. After covariates were adjusted, the men with SDs exhibited a 1.48-fold adjusted hazard ratio (aHR) of ACS compared with the women with SDs (95% confidence interval [CI] = 1.36-1.60). After age group stratification, the men with SDs in the young adult group exhibited the highest risk of subsequent ACS development compared with the women with SDs (aHR = 2.07, 95% CI = 1.69-2.55), followed by those in middle-aged adults (aHR = 1.52, 95% CI = 1.32-1.76) and older adults groups (aHR = 1.24, 95% CI = 1.11-1.39). This study determined that men with SDs, particularly young men, are at a higher risk of subsequent ACS development compared with women with SDs.
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Affiliation(s)
- Wei-Sheng Chung
- Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- China Medical University, Taichung, Taiwan
- Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Hsuan-Hung Lin
- Central Taiwan University of Science and Technology, Taichung, Taiwan
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11
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Einiö E, Moustgaard H, Martikainen P, Leinonen T. Does the risk of hospitalisation for ischaemic heart disease rise alreadybeforewidowhood? J Epidemiol Community Health 2017; 71:599-605. [DOI: 10.1136/jech-2016-207987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 12/15/2016] [Accepted: 02/10/2017] [Indexed: 12/26/2022]
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12
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Chung H, Chou W, Sears DD, Patterson RE, Webster NJG, Ellies LG. Time-restricted feeding improves insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity. Metabolism 2016; 65:1743-1754. [PMID: 27832862 PMCID: PMC5123758 DOI: 10.1016/j.metabol.2016.09.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Menopause is associated with significant hormonal changes that result in increased total body fat and abdominal fat, amplifying the risk for metabolic syndrome and diseases such as diabetes, cardiovascular disease and cancer in postmenopausal women. Intermittent fasting regimens hold significant health benefit promise for obese humans, however, regimens that include extreme daytime calorie restriction or daytime fasting are generally associated with hunger and irritability, hampering long-term compliance and adoption in the clinical setting. Time-restricted feeding (TRF), a regimen allowing eating only during a specific period in the normal circadian feeding cycle, without calorie restriction, may increase compliance and provide a more clinically viable method for reducing the detrimental metabolic consequences associated with obesity. METHODS We tested TRF as an intervention in a mouse model of postmenopausal obesity. Metabolic parameters were measured using Clinical Laboratory Animal Monitoring System (CLAMS) and we carried out glucose tolerance tests. We also stained liver sections with oil red O to examine steatosis and measured gene expression related to gluconeogenesis. RESULTS Preexisting metabolic disease was significantly attenuated during 7 weeks of TRF. Despite having access to the same high fat diet (HFD) as ad libitum fed (ALF) mice, TRF mice experienced rapid weight loss followed by a delayed improvement in insulin resistance and a reduced severity of hepatic steatosis by having access to the HFD for only 8h during their normal nocturnal feeding period. The lower respiratory exchange ratio in the TRF group compared with the ALF group early in the dark phase suggested that fat was the predominant fuel source in the TRF group and correlated with gene expression analyses that suggested a switch from gluconeogenesis to ketogenesis. In addition, TRF mice were more physically active than ALF fed mice. CONCLUSIONS Our data support further analysis of TRF as a clinically viable form of intermittent fasting to improve metabolic health due to obesity.
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Affiliation(s)
- Heekyung Chung
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA
| | - Winjet Chou
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA
| | - Dorothy D Sears
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA; Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA 92093, USA
| | - Ruth E Patterson
- Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA 92093, USA
| | - Nicholas J G Webster
- Department of Medicine, Division of Endocrinology and Metabolism, UC San Diego, La Jolla, CA 92093, USA; Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Lesley G Ellies
- Moores Cancer Center, UC San Diego, La Jolla, CA 92093, USA; Department of Pathology, UC San Diego, La Jolla, CA 92093, USA.
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Dus-Zuchowska M, Madry E, Krzyzanowska P, Bogdanski P, Walkowiak J. Twelve-week-conjugated linoleic acid supplementation has no effects on the selected markers of atherosclerosis in obese and overweight women. Food Nutr Res 2016; 60:32776. [PMID: 27834186 PMCID: PMC5103664 DOI: 10.3402/fnr.v60.32776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 11/29/2022] Open
Abstract
Background The antiatherogenic effect of conjugated linoleic acid (CLA) has been demonstrated in animal models. Although there are plenty of in vitro studies that suggest the profitable properties of CLA, the results in humans remain inconsistent. Objective In this study, we assessed the impact of CLA supplementation on the levels of atherosclerosis markers – high-sensitivity C-reactive protein (hs-CRP) and asymmetrical dimethylarginine (ADMA). Design Seventy-four adult female subjects with body mass index ≥25 kg/m2 were enrolled in the double-blind, placebo-controlled nutritional intervention. The study participants were randomly assigned to receive 3 g/day CLA or placebo (sunflower oil) for 12 weeks. In all subjects, we measured hs-CRP and ADMA concentrations by using enzyme-linked immunosorbent assay. Results No significant differences were found in hs-CRP and ADMA levels before and after nutritional intervention between both groups. The changes in hs-CRP and ADMA concentration values (Δhs-CRP; ΔADMA median [interquartile range]) did not differ between subjects from the placebo (−0.1 [−0.8 to 0.3]; −0.02 [−0.12 to 0.14]) and CLA (0.2 [−0.7 to 0.9]; 0.04 [−0.14 to 0.13]) groups. The incidence of reduction of hs-CRP or ADMA concentration was not different in subjects of the CLA group compared to those of the placebo group (41.9% vs. 50%, relative risk [RR]=0.8387, 95% confidence interval [CI]=0.4887–1.4493, p=0.5232 and 61.3% vs. 56.2%, RR=1.0896, 95% CI=0.7200–1.6589, p=0.6847, respectively). Conclusion Twelve weeks of CLA supplementation had no effect on selected markers of atherosclerosis in obese and overweight women.
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Affiliation(s)
- Monika Dus-Zuchowska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Edyta Madry
- Department of Physiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Patrycja Krzyzanowska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Bogdanski
- Department of Education and Obesity Treatment and Metabolic Disorders, Poznan University of Medical Sciences, Poznan, Poland
| | - Jaroslaw Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland;
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14
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Ramezani Tehrani F, Montazeri SA, Khalili D, Cheraghi L, Broekmans FJ, Momenan AA, de Kat AC, Azizi F. Age-specific anti-Müllerian hormone and electrocardiographic silent coronary artery disease. Climacteric 2016; 19:344-8. [DOI: 10.1080/13697137.2016.1185778] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- F. Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S. A. Montazeri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - D. Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - L. Cheraghi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F. J. Broekmans
- Department for Reproductive Medicine, Division Female and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A. A. Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A. C. de Kat
- Department for Reproductive Medicine, Division Female and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - F. Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Janković J, Marinković J, Stojisavljević D, Erić M, Vasiljević N, Janković S. Sex inequalities in cardiovascular health: a cross-sectional study. Eur J Public Health 2015; 26:152-8. [PMID: 26370435 DOI: 10.1093/eurpub/ckv161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status. METHODS The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums. RESULTS A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones. CONCLUSIONS Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention.
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Affiliation(s)
- Janko Janković
- 1 Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia
| | - Jelena Marinković
- 2 Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia
| | | | - Miloš Erić
- 4 Faculty of Economics, Finance and Administration, Singidunum University, Belgrade, Serbia
| | - Nadja Vasiljević
- 5 Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Serbia
| | - Slavenka Janković
- 6 Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia
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16
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Lai YJ, Chen HC, Chou P. Gender Difference in the Interaction Effects of Diabetes and Hypertension on Stroke among the Elderly in the Shih-Pai Study, Taiwan. PLoS One 2015; 10:e0136634. [PMID: 26322779 PMCID: PMC4554728 DOI: 10.1371/journal.pone.0136634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/06/2015] [Indexed: 02/06/2023] Open
Abstract
Aims To investigate the interaction effects of diabetes and hypertension on stroke, and also investigate the independent and interaction effects of parental history and environmental factors on diabetes and hypertension in a cross-sectional elderly population. Methods The Shih-Pai Community Medical Service Program was a community-based, fixed cohort study conducted between June 1999 and November 2002. Socio-demographic and clinical data of subjects aged 65 years and older were collected by well-trained interviewers during home visits. Interaction effects were analyzed using Rothman’s synergy index (SI). Results In total, 4,124 subjects were included in the study, with 2,284 males and 1,840 females. The synergistic interaction of diabetes and hypertension on stroke was statistically significant in women (SI = 3.16, 95% CI: 1.35–7.39). The synergistic interaction of parental diabetes and being overweight on diabetes was only statistically significant in men, and not in women (SI = 3.30, 95% CI: 1.00–10.83 in men, and SI = 1.15, 95% CI: 0.30–4.39 in women). Conclusions A synergistic interaction was found for diabetes and hypertension in both sexes when parental history and being overweight were combined. Furthermore, combining diabetes and hypertension in elderly women was significant in terms of the risk of stroke. Strategies to control risk factors in individuals at additional high risk are urgently needed.
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Affiliation(s)
- Yun-Ju Lai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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17
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Chor D, Pinho Ribeiro AL, Sá Carvalho M, Duncan BB, Andrade Lotufo P, Araújo Nobre A, de Aquino EMLL, Schmidt MI, Griep RH, Molina MDCB, Barreto SM, Passos VMDA, Benseñor IJM, Matos SMA, Mill JG. Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study. PLoS One 2015; 10:e0127382. [PMID: 26102079 PMCID: PMC4478044 DOI: 10.1371/journal.pone.0127382] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 04/15/2015] [Indexed: 12/22/2022] Open
Abstract
High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14-1.28), and among Asian (PR = 1.21; 95% CI: 1.12-1.32) and 'Whites (PR = 1.19; 95% CI: 1.12-1.26) compared to Blacks. Socioeconomic and racial inequality-as measured by different indicators-are strongly associated with HBP control, beyond the expected influence of health services access.
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Affiliation(s)
- Dóra Chor
- Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
- * E-mail:
| | | | - Marilia Sá Carvalho
- Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Bruce Bartholow Duncan
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Aline Araújo Nobre
- Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | | | - Maria Inês Schmidt
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | | | - Sandhi Maria Barreto
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES, Brazil
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Huang D, Song X, Cui Q, Tian J, Wang Q, Yang K. Is there an association between aircraft noise exposure and the incidence of hypertension? A meta-analysis of 16784 participants. Noise Health 2015; 17:93-7. [PMID: 25774612 PMCID: PMC4918658 DOI: 10.4103/1463-1741.153400] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
To determine if aircraft noise exposure causes an increased incidence of hypertension among residents near airports. We conducted a meta-analysis of observational studies to evaluate the association between aircraft noise exposure and the incidence of hypertension. PubMed, Embase, Web of Science, the Cochrane Library, and the Chinese Biomedical Literature Database were searched without any restrictions. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted. The pooled ORs were calculated using both the fixed effects model and random effects model. All analyses were performed using STATA version 12.0 software (Stata Corporation, College Station, TX, USA). We examined five studies, comprising a total of 16,784 residents. The overall OR for hypertension in residents with aircraft noise exposure was 1.63 (95% CI, 1.14-2.33), and one of our included studies showed that there was no evidence that aircraft noise is a risk factor for hypertension in women. According to our subgroup analysis, the summary OR for the incidence was 1.31 (95% CI, 0.85-2.02) with I2 of 80.7% in women and 1.36 (95% CI, 1.15-1.60) with moderate heterogeneity in men. The pooled OR for the incidence of hypertension in residents aged over 55 years and under 55 years was 1.66 (95% CI, 1.21-2.27) with no heterogeneity and 1.78 (95% CI, 1.33-2.39) with I2 of 29.4%, respectively. The present meta-analysis suggests that aircraft noise could contribute to the prevalence of hypertension, but the evidence for a relationship between aircraft noise exposure and hypertension is still inconclusive because of limitations in study populations, exposure characterization, and adjustment for important confounders.
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Affiliation(s)
| | | | | | | | | | - Kehu Yang
- School of Public Health; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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Kadda O, Manginas A, Stavridis G, Balanos D, Kotiou M, Panagiotakos DB. Gender Analysis in the Outcomes of a Lifestyle Intervention Among Patients Who Had an Open Heart Surgery. Angiology 2015; 67:66-74. [PMID: 25818103 DOI: 10.1177/0003319715577293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The aim of this study was to evaluate the gender-oriented differences in the outcomes of a lifestyle intervention trial (diet, smoking cessation, and exercise) among patients who had open heart surgery. A randomized, nonblind intervention study was performed on 500 patients who had open heart surgery. Immediately after hospital discharge, 250 patients were randomly allocated lifestyle intervention by receiving oral and written information in the form of a booklet with specific educational information for postoperative rehabilitation. The remaining 250 patients received the regular oral instructions. The applied lifestyle intervention proved to be beneficial only in men as far as quitting smoking (relative risk [RR]: 0.36, confidence interval [CI]: 0.16-0.80; P = .01) and returning to work (RR: 0.35, CI: 0.13-0.92; P = .03) are concerned. For both genders, no significant associations between dietary and physical activity recommendations were observed. CONCLUSION Lifestyle nursing intervention immediately after open heart surgery had a beneficial effect on men 1 year after the surgery but not on women. Thus, there is a need for gender-specific studies among women.
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Affiliation(s)
- Olga Kadda
- Department of Critical Care, School of Medicine, University of Athens, Athens, Greece
| | | | - George Stavridis
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitris Balanos
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Maria Kotiou
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Ghoorah K, Campbell P, Kent A, Maznyczka A, Kunadian V. Obesity and cardiovascular outcomes: a review. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2014; 5:77-85. [PMID: 24526749 DOI: 10.1177/2048872614523349] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 01/08/2014] [Indexed: 11/16/2022]
Abstract
The prevalence of obesity is increasing at an epidemic rate globally with more than 1 billion adults overweight and at least 300 million of them clinically obese. This is expected to rise further in the next 20 to 30 years. Obesity is known to be an independent risk factor for serious health conditions, including hypertension, type 2 diabetes, and cardiovascular diseases. Given the association of obesity with cardiovascular disease, it could be speculated that obese individuals would have adverse outcomes after a cardiovascular event compared to those with normal body mass index (BMI). However, various studies have reported a paradoxical U-shaped relationship between obesity and mortality from various diseases, including myocardial infarction and heart failure, suggesting that patients with higher BMI have similar or lower short- and long-term mortality rates. This phenomenon has been termed the 'obesity paradox' or 'reverse epidemiology'. The goal of this review is to evaluate the potential mechanisms behind the obesity paradox and its implications.
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Affiliation(s)
- Kuldeepa Ghoorah
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Alexandra Kent
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Vijay Kunadian
- Newcastle University, Newcastle, UK Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
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21
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Wan R, Jin L, Zhu C, Liu Y, Li L, Guo R, Li S. Sex difference in urocortin production is contributory to the gender disparity in a rat model of vasculitis induced by sodium laurate. Endocrinology 2013; 154:4663-74. [PMID: 24064363 DOI: 10.1210/en.2013-1572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular diseases, the most common leading death diseases, occur more in men than women of the same ages. Increasing evidence shows that urocortin (Ucn1), an autocrine or paracrine pro-inflammatory factor, can be regulated by sex hormones. The purpose of the study is to investigate the role of Ucn1 in gender disparity in a sodium laurate-induced vasculitis model. Rats exhibited visible signs of vasculitis on the 14th day after sodium laurate injection. Inflammatory states of the rat femoral artery were observed by histological examination. Significant gender disparity, with the symptoms much grosser in males than females, was seen. In males, the serum levels of Ucn1, prostaglandin estradiol, and soluble intercellular adhesion molecule-1 and the expressions of Ucn1, cyclooxygenase-2, and intercellular adhesion molecule-1 in femoral artery were higher than those in females. Orchidectomy significantly ameliorated the symptoms of vasculitis accompanied with a decrease in the plasma Ucn1 level. However, estradiol supplement after orchidectomy failed to improve the inflammatory states further. In females, ovariectomy and/or dihydrotestosterone supplement significantly increased Ucn1 level and exacerbated symptoms of vasculitis. Furthermore, ip administration of rabbit antiserum to Ucn1 almost abolished the gender differences in vasculitis. These results demonstrated that vasculitis of this model is androgen-responsive and hormonal manipulation by surgical orchidectomy could substantially attenuate the symptoms of vasculitis. Moreover, Ucn1 is a contributory factor to the gender disparity in vasculitis and dihydrotestosterone-promoted Ucn1 secretion exacerbated the development of vasculitis.
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Affiliation(s)
- Rong Wan
- Department of Pharmacology, Nanjing Medical University-Jiangsu Provincial Key Lab of Cardiovascular Diseases and Molecular Intervention, Nanjing, China.
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Stumpf A, Burgmer M, Schneider G, Heuft G, Schmelz M, Phan NQ, Ständer S, Pfleiderer B. Sex differences in itch perception and modulation by distraction--an FMRI pilot study in healthy volunteers. PLoS One 2013; 8:e79123. [PMID: 24260163 PMCID: PMC3832610 DOI: 10.1371/journal.pone.0079123] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 09/18/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Even though itch is a common syndrome of many diseases there is only little knowledge about sex and gender differences in pruritus, especially in central itch perception and modulation. To our knowledge, this is the first fMRI study examining sex differences in perception and its modulation by distraction. METHODS Experimental itch was induced by application of histamine (0.1 mM) via microdialysis fibers twice at the left forearm and twice at the left lower leg in 33 healthy volunteers (17 females, 16 males). The brain activation patterns were assessed by fMRI during itch without and with distraction (Stroop task). Between the various conditions, subjects were asked to rate itch intensity, desire to scratch and pain intensity. In a second experiment in 10 of the 33 volunteers histamine was replaced by saline solution to serve as control for the 'Stroop' condition. RESULTS Women generally presented higher itch intensities compared to men during itch over the course of the experiment. A more specific analysis revealed higher itch intensities and desire to scratch in women during experimental induced itch that can be reduced by distraction at the lower legs when itch is followed by 'Stroop'. In contrast, men depicted significant reduction of 'itch' by 'Stroop' at the forearms. Women depicted higher brain activation of structures responsible for integration of sensory, affective information and motor integration/planning during 'itch' and 'Stroop' condition when compared to men. No sex differences were seen in the saline control condition. CONCLUSION Women and men exhibited localisation dependent differences in their itch perception with women presenting higher itch intensities and desire to scratch. Our findings parallel clinical observations of women reporting higher itch intensities depending on itch localisation and suffering more from itch as compared to men.
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Affiliation(s)
- Astrid Stumpf
- Department of Psychosomatics and Psychotherapy, University of Muenster, Muenster, Germany
- * E-mail:
| | - Markus Burgmer
- Department of Psychosomatics and Psychotherapy, University of Muenster, Muenster, Germany
| | - Gudrun Schneider
- Department of Psychosomatics and Psychotherapy, University of Muenster, Muenster, Germany
| | - Gereon Heuft
- Department of Psychosomatics and Psychotherapy, University of Muenster, Muenster, Germany
| | - Martin Schmelz
- Department of Anesthesiology and Intensive care Medicine, Karl Feuerstein Professorship, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ngoc Quan Phan
- Competence Center Chronic Pruritus, Department of Dermatology, University of Muenster, Muenster, Germany
| | - Sonja Ständer
- Competence Center Chronic Pruritus, Department of Dermatology, University of Muenster, Muenster, Germany
| | - Bettina Pfleiderer
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
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Wan R, Zhu C, Guo R, Jin L, Liu Y, Li L, Zhang H, Li S. Dihydrotestosterone alters urocortin levels in human umbilical vein endothelial cells. J Endocrinol 2013; 218:321-30. [PMID: 23801677 DOI: 10.1530/joe-13-0138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Urocortin (UCN1) is a member of corticotrophin-releasing factor (CRF) family, which has been proven to participate in inflammation. Previous work showed that dihydrotestosterone (DHT) could promote the inflammatory process. Little is known about the effect of DHT on UCN1 expression. The aim of our study is to investigate the effects and underlying mechanisms of DHT on endothelial UCN1 expression in the absence and presence of induced inflammation. Therefore, we tested the alterations of endothelial UCN1 expression treated with DHT in the presence or absence of lipopolysaccharide (LPS). Our data showed that DHT alone decreased UCN1 levels, which were attenuated in the presence of the androgen receptor (AR) antagonist flutamide. Conversely, in the presence of LPS, DHT augmented the LPS-induced increase in UCN1 expression, which was, interestingly, not affected by flutamide. When cells were treated with DHT alone, AR was upregulated and translocated into the nuclei, which might repress UCN1 expression via a potential androgen-responsive element found in human CRF family promoter. In the presence of LPS, DHT did not influence AR expression and location while it increased toll-like receptor 4 expression and activation, which was not altered by flutamide. DHT enhanced LPS-induced p38MAPK, ERK1/2, and nuclear factor κB pathway activation, which may contribute to the elevated expression of UCN1. These data suggest that DHT differentially influences UCN1 levels under normal and inflammatory conditions in human umbilical vein endothelial cells, which involves AR-dependent and -independent mechanisms respectively.
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Affiliation(s)
- Rong Wan
- Jiangsu Provincial Key Lab of Cardiovascular Diseases and Molecular Intervention, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, People's Republic of China
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Ständer S, Stumpf A, Osada N, Wilp S, Chatzigeorgakidis E, Pfleiderer B. Gender differences in chronic pruritus: women present different morbidity, more scratch lesions and higher burden. Br J Dermatol 2013; 168:1273-80. [DOI: 10.1111/bjd.12267] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 12/20/2022]
Affiliation(s)
- S. Ständer
- Competence Centre Chronic Pruritus; Department of Dermatology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - A. Stumpf
- Department of Psychosomatics and Psychotherapy; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - N. Osada
- Department of Medical Informatics and Biomathematics; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - S. Wilp
- Department of Clinical Radiology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - E. Chatzigeorgakidis
- Competence Centre Chronic Pruritus; Department of Dermatology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - B. Pfleiderer
- Department of Clinical Radiology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
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Seo SK, Jung I, Lee SM, Cho S, Choi YS, Chung TS, Lee BS. Relationship between leukoaraiosis and menopause in healthy middle-aged women. Fertil Steril 2013; 100:500-4. [PMID: 23622889 DOI: 10.1016/j.fertnstert.2013.03.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/26/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the relationship between leukoaraiosis (LA) and menopause in healthy middle-aged women. DESIGN A retrospective cohort study. SETTING Health promotion center of a university hospital. PATIENT(S) We studied 262 healthy pre- and postmenopausal women ages 41-60 years who visited the health promotion center for a routine health checkup. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) LA is defined as diffuse white matter abnormalities on computed tomography or magnetic resonance imaging (MRI). LA was assessed by examining MRIs and using the rating scale of the Atherosclerosis Risk in Communities Study. Logistic regression analysis was performed to examine associations between LA and menopause. RESULT(S) Women with LA had a significantly higher age than women without LA. Elevated blood pressure (≥ 130/85 mm Hg) and low high-density lipoprotein cholesterol (<50 mg/dL) were frequent abnormal findings in women with LA. The proportion of menopause was significantly higher in women with LA than in those without LA. Menopause was independently associated with the presence of LA (adjusted odds ratio, 2.24; 95% confidence interval, 1.10, 4.60) after adjusting for confounding variables. CONCLUSION(S) Menopause was significantly associated with LA. Loss of estrogen may play an important role in the development of LA.
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Affiliation(s)
- Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Nemeth CL, Harrell CS, Beck KD, Neigh GN. Not all depression is created equal: sex interacts with disease to precipitate depression. Biol Sex Differ 2013; 4:8. [PMID: 23594674 PMCID: PMC3639119 DOI: 10.1186/2042-6410-4-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/22/2013] [Indexed: 12/28/2022] Open
Abstract
Depression is a common mental disorder that co-occurs in other neurological and somatic diseases. Further, sex differences exist in the prevalence rates of many of these diseases, as well as within non-disease associated depression. In this review, the case is made for needing a better recognition of the source of the symptoms of depression with respect to the sex of the individual; in that, some disease states, which includes the neuroendocrine and immune reactions to the underlying pathophysiology of the disease, may initiate depressive symptoms more often in one sex over the other. The diseases specifically addressed to make this argument are: epilepsy, Alzheimer’s disease, cancer, and cardiovascular disease. For each of these conditions, a review of the following are presented: prevalence rates of the conditions within each sex, prevalence rates of depressive symptoms within the conditions, identified relationships to gonadal hormones, and possible interactions between gonadal hormones, adrenal hormones, and immune signaling. Conclusions are drawn suggesting that an evaluation of the root causes for depressive symptoms in patients with these conditions is necessary, as the underlying mechanisms for eliciting the depressive symptoms may be qualitatively different across the four diseases discussed. This review attempts to identify and understand the mechanisms of depression associated with these diseases, in the context of the known sex differences in the disease prevalence and its age of onset. Hence, more extensive, sex-specific model systems are warranted that utilize these disease states to elicit depressive symptoms in order to create more focused, efficient, and sex-specific treatments for patients suffering from these diseases and concurrent depressive symptoms.
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Kuba VM, Teixeira MAM, Meirelles RMR, Assumpção CRL, Costa OS. Dydrogesterone does not reverse the cardiovascular benefits of percutaneous estradiol. Climacteric 2012; 16:54-61. [PMID: 22640483 DOI: 10.3109/13697137.2012.672843] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the influence of dydrogesterone on estimated cardiovascular risk of users of hormone replacement therapy (HRT) (with percutaneous 17β-estradiol in monotherapy and in combination with dydrogesterone) and HRT non-users through the Framingham score tool for a period of 2 years. METHODS Framingham scores were calculated from the medical records of patients treated for at least 2 years with 17β-estradiol alone or in combination with dydrogesterone, along with HRT non-users, through the analysis of patient medical records, followed for at least 2 years at Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione. RESULTS Improvements in lipid profile, glucose and blood pressure levels, which reduced the estimated cardiovascular risk, were observed in the 17β-estradiol group. Similar changes were observed in the users of 17β-estradiol + dydrogesterone, suggesting that this progestogen does not attenuate the effects caused by 17β-estradiol. CONCLUSIONS Both HRT groups showed a reduction in their Framingham score. In contrast to data from other HRT investigations on cardiovascular risk, these formulations proved to be safe, even in the first year of use.
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Affiliation(s)
- V M Kuba
- Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione - IEDE, Rio de Janeiro, Brazil
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Baron YM, Brincat M, Galea R. Iliac vessel wall thickness in menstrual and hormone treated and untreated postmenopausal women. Gynecol Endocrinol 2012; 28:409-12. [PMID: 22103925 DOI: 10.3109/09513590.2011.632790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess iliac vessel wall thickness in different groups of women. METHOD Three groups of women were menopausal and were classified by hormone replacement therapy (HRT) (n = 32), atherosclerotic risk factors (n = 14) and an untreated group of postmenopausal women (n = 29), two groups of menstrual women, above 35 years (N = 35) and below 35 years (n = 16). In these groups of women, a 3.5 MHz ultrasound was used to assess the combined vessel wall thickness of the right iliac artery inner wall and vein outer wall. RESULTS The iliac vessel wall thickness was found significantly high in the menopausal group of women possessing high risk factors for atherosclerosis (4.3 ± 0.08 mm) and the untreated menopausal group of women (3.9 ± 0.08 mm) compared to the other three groups (p < 0.0001) (Mann-Whitney U test). The vessel wall thickness of the HRT group was 2.96 ± 0.09 mm, the older menstrual group 2.61 ± 0.07 mm, and 2.0 ± 0.06 mm in the young menstrual group. The HRT group had a significantly thicker iliac vessel wall compared to the young menstrual group (p < 0.001). CONCLUSION These results confirm the significant impact of high risk factors, such as smoking, hyperlipidaemia and diabetes, on the vessel wall thickness due to accelerated atherosclerosis. This study also suggests that the oestrogenaemic state of a woman may affect the health of the vessel wall.
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Affiliation(s)
- Yves Muscat Baron
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Msida, Malta.
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Creatsa M, Armeni E, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Alexandrou A, Dendrinos S, Augoulea A, Papamichael C, Lambrinoudaki I. Circulating androgen levels are associated with subclinical atherosclerosis and arterial stiffness in healthy recently menopausal women. Metabolism 2012; 61:193-201. [PMID: 21820132 DOI: 10.1016/j.metabol.2011.06.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 06/03/2011] [Accepted: 06/05/2011] [Indexed: 01/09/2023]
Abstract
Although increasing evidence supports an association between endogenous sex hormones and cardiovascular disease, the results still remain controversial. This study aims to examine the association between endogenous sex hormones and indices of vascular function and structure. Serum follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate (DHEAS), and Δ4-androstenedione were measured in 120 healthy postmenopausal women aged 41 to 60 years. Possible associations with surrogate markers of subclinical atherosclerosis, arterial stiffness, and endothelial function were investigated. Indices of arterial structure included carotid and femoral intima-media thickness and atheromatous plaques presence. Indices of arterial function included flow-mediated dilation of the brachial artery, carotid-femoral pulse wave velocity (PWV), and augmentation index. Total testosterone and free androgen index (FAI) were the most important predictors of common carotid artery intima-media thickness (β = 0.376 and β = 0.236, P < .001 and P = .014, respectively). Similarly, FAI was the only significant independent predictor of PWV (β = 0.254, P = .027) after adjusting for age, smoking, body mass index, homeostasis model assessment of insulin resistance, and blood lipids. Free estrogen index showed a positive association with PWV, independently of age, smoking, and body mass index, but not of homeostasis model assessment of insulin resistance and blood lipids. Age-adjusted levels of DHEAS exhibited a significant independent negative association with measures of augmentation index. Follicle-stimulating hormone, luteinizing hormone, estradiol, sex hormone-binding globulin, and Δ4-androstenedione were not associated with any of the vascular parameters independently of traditional cardiovascular risk factors. Higher serum testosterone and FAI are associated with subclinical atherosclerosis in healthy recently menopausal women. This association is independent of traditional cardiovascular risk factors or insulin resistance. On the contrary, serum DHEAS exhibits a negative association with arterial stiffness.
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Affiliation(s)
- Maria Creatsa
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GR-11528, Athens, Greece
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Hayashi T, Kawashima S, Nomura H, Itoh H, Watanabe H, Ohrui T, Yokote K, Sone H, Hattori Y, Yoshizumi M, Ina K, Kubota K. Age, gender, insulin and blood glucose control status alter the risk of ischemic heart disease and stroke among elderly diabetic patients. Cardiovasc Diabetol 2011; 10:86. [PMID: 21978180 PMCID: PMC3200162 DOI: 10.1186/1475-2840-10-86] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 10/06/2011] [Indexed: 11/30/2022] Open
Abstract
Background We analyzed the effects of insulin therapy, age and gender on the risk of ischemic heart disease (IHD) and cerebrovascular accident (CVA) according to glycemic control. Methods and Results We performed a prospective cohort study (Japan Cholesterol and Diabetes Mellitus Study) of type 2 diabetes patients (n = 4014) for 2 years. The primary endpoint was the onset of fatal/non-fatal IHD and/or CVA, which occurred at rates of 7.9 and 7.2 per 1000 person-years, respectively. We divided diabetic patients into four groups based on age (≤ 70 and > 70) and hemoglobin A1C levels (≤ 7.0 and > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure and low HDL-C in patients under 70 years of age with fair glycemic control and was associated with low diastolic blood pressure in the older/fair group. Interestingly, insulin use was associated with IHD in the older/poor group (OR = 2.27, 95% CI = 1.11-5.89; p = 0.026) and was associated with CVA in the older/fair group (OR = 2.09, 95% CI = 1.06-4.25; p = 0.028). CVA was associated with lower HDL-C and longer duration of diabetes in younger/poor glycemic control group. Results by stepwise analysis were similar. Next, patients were divided into four groups based on gender and diabetic control(hemoglobinA1C < or > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure in male/fair glycemic control group, age in male/poor control group, and short duration of diabetic history in females in both glycemic control groups. Interestingly, insulin use was associated with IHD in the male/poor group(OR = 4.11, 95% CI = 1.22-8.12; p = 0.018) and with CVA in the female/poor group(OR = 3.26, 95% CI = 1.12-6.24; p = 0.02). CVA was associated with short duration of diabetes in both female groups. Conclusions IHD and CVA risks are affected by specific factors in diabetics, such as treatment, gender and age. Specifically, insulin use has a potential role in preventing IHD but may also be a risk factor for CVA among the diabetic elderly, thus revealing a need to develop improved treatment strategies for diabetes in elderly patients. The Japan Cholesterol and Diabetes Mellitus Study was formulated to evaluate them(Umin Clinical Trials Registry, clinical trial reg. no. UMIN00000516; http://www.umin.ac.jp/ctr/index.htm).
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Affiliation(s)
- Toshio Hayashi
- Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Lambrinoudaki I, Armeni E, Georgiopoulos G, Kazani M, Kouskouni E, Creatsa M, Alexandrou A, Fotiou S, Papamichael C, Stamatelopoulos K. Subclinical atherosclerosis in menopausal women with low to medium calculated cardiovascular risk. Int J Cardiol 2011; 164:70-6. [PMID: 21737156 DOI: 10.1016/j.ijcard.2011.06.063] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/08/2011] [Accepted: 06/10/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The menopausal status is closely related with cardiovascular disease (CVD). Nevertheless, it is still not included in risk stratification by total cardiovascular risk estimation systems. The present study aimed to evaluate the extent of subclinical vascular disorders in young healthy postmenopausal women. METHODS This cross-sectional study consecutively recruited 120 healthy postmenopausal women without clinically overt CVD or diabetes, aged 41-60 years and classified as not high-risk by the Heartscore (<5%). In addition to risk factors used for Heartscore calculations, years since menopause and associated risk factors (triglycerides (range 37-278 mg/dl), waist circumference (62-114 cm), fasting blood glucose (69-114 mg/dl) and HOMA-IR (0.44-5)) were also assessed. Carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness in the abnormal range as well as atheromatous plaques both in carotid and femoral arteries were used to define the presence of subclinical atherosclerosis. RESULTS Subclinical atherosclerosis and the presence of at least one plaque were identified in 55% and 28% of women, respectively. Subjects with subclinical atherosclerosis had higher age, years since menopause, HOMA-IR and blood pressure. By multivariate analysis years since menopause and systolic blood pressure independently determined subclinical atherosclerosis while 79% of intermediate-risk women (Heartscore 2-4.9%) being in menopause for at least 4 years would be reclassified to a higher risk for the presence of atherosclerosis. CONCLUSION Subclinical atherosclerosis was highly prevalent in postmenopausal women with low to medium Heartscore. Thus our data suggest that menopausal status and associated risk factors should be additionally weighted in risk calculations, regarding primary prevention strategies in this population.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, 76 Vas. Sofias Ave., University of Athens, Aretaieio Hospital, Athens, Greece
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Matziolis D, Drewke M, Matziolis G, Perka C. Treated Hypertension has No Influence on the Efficacy of Alendronate in the Therapy of Postmenopausal Osteoporosis: A Non-Randomized, Non-Blind, Controlled Prospective Study. Open Orthop J 2011; 5:27-31. [PMID: 21270954 PMCID: PMC3027189 DOI: 10.2174/1874325001105010027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 07/12/2010] [Accepted: 11/25/2010] [Indexed: 11/22/2022] Open
Abstract
Changes in hormone metabolism during menopause are involved in the development of osteoporosis and arterial hypertension. A mutual influence of these two clinical pictures is evident on the basis of pathophysiological factors.In this study, we investigated whether a drug therapy of hypertension influences the efficacy of a bisphosphonate (alendronate) in the treatment of postmenopausal osteoporosis. For this purpose, 60 female patients were enrolled in the study, 30 of them on drug treatment for hypertension in addition to requiring treatment for osteoporosis, while the control group was only suffering from osteoporosis.Bone density was measured at the start of the study and 6 months after therapy (QCT).A significant increase in bone density was demonstrated in both groups, while a difference between the groups could not be seen.Treated arterial hypertension does not have a negative influence on the treatment of postmenopausal osteoporosis with alendronate. Rather, the concomitant treatment of these two clinical pictures would appear to make sense, in order to reduce morbidity and mortality.
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Affiliation(s)
- Doerte Matziolis
- Orthopaedic Department, Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Charitéplatz 1, D-10117 Berlin, Germany
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Rosano GM, Collins P. Gender differences in treatment of cardiovascular disease: a task force on gender of the ESC proposal on gender specific studies in cardiovascular pharmacology. Fundam Clin Pharmacol 2010; 24:662-3. [DOI: 10.1111/j.1472-8206.2010.00895_2.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Eriksson C, Bluhm G, Hilding A, Ostenson CG, Pershagen G. Aircraft noise and incidence of hypertension--gender specific effects. ENVIRONMENTAL RESEARCH 2010; 110:764-72. [PMID: 20880521 DOI: 10.1016/j.envres.2010.09.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 09/01/2010] [Accepted: 09/04/2010] [Indexed: 05/21/2023]
Abstract
Recent studies show associations between aircraft noise and cardiovascular outcomes such as hypertension. However, these studies were mostly cross-sectional and there are uncertainties regarding potential gender differences as well as sensitive subgroups. In this study, we investigated the cumulative incidence of hypertension in relation to aircraft noise exposure among Swedish men and women living in Stockholm County. A total of 4721 subjects, aged 35-56 at baseline, were followed for 8-10 years. The population was selected according to family history of diabetes, which was present for half of the subjects. The exposure assessment was performed by geographical information systems and based on residential history during the period of follow-up. Blood pressure was measured at baseline and at the end of follow-up. Additional information regarding diagnosis and treatment of hypertension as well as various lifestyle factors was provided by questionnaires. In the overall population, no increased risk for hypertension was found among subjects exposed to aircraft noise ≥ 50 dB(A) L(den); relative risk (RR) 1.02 (95% CI 0.90-1.15). When restricting the cohort to those not using tobacco at the blood pressure measurements, a significant risk increase per 5 dB(A) of aircraft noise exposure was found in men; RR 1.21 (1.05-1.39), but not in women; RR 0.97 (0.83-1.13). In both sexes combined, an increased risk of hypertension related to aircraft noise exposure was indicated primarily among those reporting annoyance to aircraft noise; RR 1.42 (1.11-1.82). No consistent effect modification was detected for any of the cardiovascular risk factors under investigation although a family history of diabetes appeared to modify the risk in women. In conclusion, the results suggest an increased risk of hypertension following long-term aircraft noise exposure in men, and that subjects annoyed by aircraft noise may be particularly sensitive to noise related hypertension.
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Affiliation(s)
- Charlotta Eriksson
- Institute of Environmental Medicine, Unit of Environmental Epidemiology, Karolinska Institutet, Nobels väg 13, SE-17177 Stockholm, Sweden.
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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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Duzenli MA, Ozdemir K, Sokmen A, Gezginc K, Soylu A, Celik C, Altunkeser BB, Tokac M. The effects of hormone replacement therapy on myocardial performance in early postmenopausal women. Climacteric 2010; 13:157-70. [PMID: 19672733 DOI: 10.3109/13697130902929567] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The results of the studies in which the effect of hormone replacement therapy (HRT) on cardiac function have been evaluated are rather disputable. In these studies, cardiac function was evaluated with conventional echocardiographic methods. This study was planned in order to investigate the effects of HRT on myocardial velocities and myocardial performance index (MPI) in healthy early postmenopausal women. METHOD In a prospective, controlled study, 60 healthy postmenopausal women were assigned to two groups (32 in the HRT group and 28 in the control group). After conventional echocardiographic parameters were measured, tissue Doppler echocardiography recordings were obtained from the mitral and tricuspid annulus. Systolic myocardial velocity (Sm), early and late diastolic myocardial velocities (Em and Am) and time intervals were measured and MPI was calculated. Then the symptom-limited exercise stress test using the Bruce protocol was performed. After 3 and 6 months of HRT (oral 0.625 mg conjugated estrogen + 2.5 mg medroxyprogesterone acetate/day), the same examinations were repeated. The effects of HRT on myocardial velocities, MPI and exercise time were evaluated at the 3rd and 6th months. RESULTS The parameters of the control group remained statistically unchanged during the study. HRT did not have any effect on segmental and mean left ventricular (LV) Sm or right ventricular (RV) Sm. However, LV Em/Am and RV Em/Am ratios significantly increased at the 6th month of HRT, and LV and RV MPI values were observed to decrease significantly as compared to basal values. Additionally, a significant increase was observed in exercise duration and metabolic equivalent values after 3 months of HRT, and this increase continued at the 6th month as well. The favorable changes in all parameters in the HRT group were significantly different from those of the control group. CONCLUSION Data obtained in this study suggest that HRT is not only effective for treating menopausal complaints but also increases cardiovascular performance by improving especially diastolic functions in early postmenopausal women.
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Affiliation(s)
- M A Duzenli
- Department of Cardiology, Selcuk University, Konya, Turkey
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Pelliccia F, Pasceri V, Cianfrocca C, Vitale C, Meoni G, Pristipino C, Speciale G, Mercuro G, Rosano G. Circulating endothelial progenitor cells in postmenopausal women with and without coronary artery disease. Climacteric 2009; 12:259-65. [DOI: 10.1080/13697130802696191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Bibliography. Current world literature. Atherosclerosis: cell biology and lipoproteins. Curr Opin Lipidol 2008; 19:525-35. [PMID: 18769235 DOI: 10.1097/mol.0b013e328312bffc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Walker ML, Herndon JG. Menopause in nonhuman primates? Biol Reprod 2008; 79:398-406. [PMID: 18495681 PMCID: PMC2553520 DOI: 10.1095/biolreprod.108.068536] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 04/06/2008] [Accepted: 05/02/2008] [Indexed: 11/01/2022] Open
Abstract
A gradual alteration in the mechanisms underlying reproduction and fertility characterizes the aging process in human females. These changes culminate in menopause, conventionally defined as a cessation of menstrual cycles that marks the end of reproductive capacity. In fact, a central and defining event in menopause is the discontinuation of ovulation, which is correlated with a number of structural and functional changes in the reproductive axis. Despite several decades of research, a degree of uncertainty remains as to whether nonhuman primates undergo menopause, and whether they are suitable models of human reproductive senescence. We review some of the controversies that have clouded our understanding of reproductive aging in nonhuman primates, including issues of definition, timing, comparability of data from wild versus captive populations, and cross-species comparisons. The existing data support the view that menopause occurs in a number of primate species and is not unique to humans.
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Affiliation(s)
- Margaret L. Walker
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia 30322
| | - James G. Herndon
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia 30322
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Rodríguez-García M, Gómez-Alonso C, Naves-Díaz M, Diaz-Lopez JB, Diaz-Corte C, Cannata-Andía JB. Vascular calcifications, vertebral fractures and mortality in haemodialysis patients. Nephrol Dial Transplant 2008; 24:239-46. [PMID: 18725376 PMCID: PMC2639312 DOI: 10.1093/ndt/gfn466] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Vascular calcifications and the bone fractures caused by abnormal bone fragility, also called osteoporotic fractures, are frequent complications associated with chronic kidney diseases (CKD). The aim of this study was to investigate the association between vascular calcifications, osteoporotic bone fractures and survival in haemodialysis (HD) patients. METHODS A total of 193 HD patients were followed up to 2 years. Vascular calcifications and osteoporotic vertebral fractures (quoted just as vertebral fractures in the text) were assessed by thoracic, lumbar spine, pelvic and hand X-rays and graded according to their severity. Clinical, biochemical and therapeutic data gathered during the total time spent on HD were collected. RESULTS The prevalence of aortic calcifications was higher in HD patients than in a random-based general population (79% versus 37.5%, P < 0.001). Total time on any renal replacement therapy (RRT) and diabetes were positively associated with a higher prevalence of vascular calcifications. In addition to these factors, time on HD was also positively associated with the severity of vascular calcifications, and higher haemoglobin levels were associated with a lower prevalence of severe vascular calcifications in large and medium calibre arteries. The prevalence of vertebral fractures in HD patients was similar to that of the general population (26.5% versus 24.1%). Age and time on HD showed a positive and statistically significant association with the prevalence of vertebral fractures. Vascular calcifications in the medium calibre arteries were associated with a higher rate of prevalent vertebral fractures. In women, severe vascular calcifications and vertebral fractures were positively associated with mortality [RR = 3.2 (1.0-10.0) and RR = 4.8 (1.7-13.4), respectively]. CONCLUSIONS Positive associations between vascular calcifications, vertebral fractures and mortality have been found in patients on HD.
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Affiliation(s)
| | | | | | | | - Carmen Diaz-Corte
- Nephrology Unit, Instituto Reina Sofia de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Cheifitz R. Lipids, statins and cardiovascular disease. Climacteric 2008; 11:347-8; author reply 348-50. [PMID: 18645702 DOI: 10.1080/13697130802242632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mittendorfer B, Peterson LR. Cardiovascular Consequences of Obesity and Targets for Treatment. DRUG DISCOVERY TODAY. THERAPEUTIC STRATEGIES 2008; 5:53-61. [PMID: 19343099 PMCID: PMC2630250 DOI: 10.1016/j.ddstr.2008.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Obesity is a risk factor for cardiovascular disease, including coronary artery disease and heart failure, but the mechanisms by which it may cause them are not completely clear. Currently, therapies aimed at obesity-related cardiovascular disease include weight loss strategies and reduction of the other risk factors that are associated with obesity and cardiovascular disease. Other pathways with for potential drug development for obesity-related CVD are also discussed.
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Affiliation(s)
- Bettina Mittendorfer
- Department of Medicine, divisions of geriatrics and nutritional sciences, Washington University School of Medicine, St. Louis, MO, USA
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Rosano GM, Vitale C, Fini M. Lipids, statins and cardiovascular disease. Climacteric 2008. [DOI: 10.1080/13697130802242640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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