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Wang LYT, Thu WPP, Chan YH, Logan S, Kramer MS, Cauley JA, Yong EL. Associations between hypertension with reproductive and menopausal factors: An integrated women's health programme (IWHP) study. PLoS One 2024; 19:e0299840. [PMID: 38527015 PMCID: PMC10962834 DOI: 10.1371/journal.pone.0299840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/18/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Women are less likely to have classic cardiovascular risk factors than men, and events during their reproductive and menopausal years may increase hypertension risk. The aim of this study is to examine woman-specific factors, including menstrual, reproductive and pregnancy complications, in relation to the prevalence of hypertension in mid-life Asian women. METHODS This is a cross-sectional study of 1146 healthy women aged 45-69 years, from a multi-ethnic Asian cohort. The women completed an extensive questionnaire that included their sociodemographic details, medical history, lifestyle and physical activity, and reproductive and menopausal history. They also underwent objectively measured physical performance tests and a dual X-ray absorptiometry scan. Hypertension was defined as a systolic BP ≥140 and/or diastolic BP ≥90mm Hg, past diagnosis by a physician, or use of antihypertensive medications. Multivariable logistic regression was used to assess the independent risk factors for hypertension. RESULTS The average age of the 1146 women analysed was 56.3 (SD 6.2) years, and 55.2 percent of them were hypertensive. The prevalence of gestational diabetes and gestational hypertension was 12.6% and 9.4%, respectively. Besides age, abnormal menstrual cycle length at 25 years of age (OR:2.35, CI:1.34-4.13), preeclampsia (OR:2.46, CI:1.06-5.74), increased visceral adiposity (OR:4.21, CI:2.28-7.79) and reduced physical performance (OR:2.83, CI:1.46-5.47) were independently associated with hypertension in Asian women. CONCLUSIONS Our findings highlight the necessity of including features of menstrual and reproductive history as possible indicators of hypertension risk in cardiovascular disease risk assessment and prevention among Asian women. Reducing visceral adiposity and exercise to improve physical performance may help women avoid developing hypertension.
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Affiliation(s)
- Laureen Yi-Ting Wang
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore, Singapore
- National University Heart Centre, National University Hospital Singapore, Singapore, Singapore
| | - Win P. P. Thu
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, Biostatistics Unit, National University of Singapore, Singapore, Singapore
| | - Susan Logan
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore, Singapore
| | - Michael S. Kramer
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore, Singapore
- Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Jane A. Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Eu-Leong Yong
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore, Singapore
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Carson MY, Thurston RC. Vasomotor symptoms and their links to cardiovascular disease risk. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2023; 30:100448. [PMID: 37214424 PMCID: PMC10198127 DOI: 10.1016/j.coemr.2023.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hot flashes and night sweats, also known as vasomotor symptoms (VMS), are common and bothersome symptoms of the menopause transition. In addition to negatively impacting quality of life, VMS have been associated with multiple indicators of cardiovascular disease (CVD) risk, including an unfavorable CVD risk factor profile, increased subclinical CVD, and elevated risk of CVD events. Several facets of VMS have been associated with CVD risk, including the frequency, timing, duration, and severity of VMS. VMS may signify poor or degrading cardiovascular health among midlife women and indicate women who warrant focused CVD prevention efforts.
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Affiliation(s)
- Mary Y. Carson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca C. Thurston
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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3
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Raman V, Kose V, Somalwar S, Dwidmuthe KS, Rao S. Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review. Cureus 2023; 15:e39069. [PMID: 37323357 PMCID: PMC10267665 DOI: 10.7759/cureus.39069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Complex metabolic dysregulation leads to metabolic syndrome (MetS) causing various symptoms such as type II diabetes, central obesity, cardiovascular diseases (CVD), altered glucose metabolism, hypertension, and dyslipidemia, and is thought to be influenced by a number of factors, including migration from rural to urban areas. socioeconomic changes, and a sedentary lifestyle. Therefore, the primary goal of this scoping review was to determine the prevalence of MetS and its components as well as to understand the association between MetS and menopausal symptoms in post-menopausal women. The search strategy included articles that were published from 2010 onwards in MEDLINE/PubMed, Scopus, and Web of Science databases. The eligibility criteria included population, concept and context (PCC) format and based on it, 10 articles were included in this review. The review concluded that in comparison to pre-menopausal women, MetS is more common in post-menopausal women who are likely to experience somatic complaints and positive correlation of vasomotor symptoms with MetS. Hence, post-menopausal women can be counselled regarding menopausal symptoms related to MetS for which appropriate and adequate treatment or measures should be taken.
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Affiliation(s)
- Vishal Raman
- Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Varsha Kose
- Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Savita Somalwar
- Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Kanchan S Dwidmuthe
- Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Shraddha Rao
- Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
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Tijerina A, Barrera Y, Solis-Pérez E, Salas R, Jasso JL, López V, Ramírez E, Pastor R, Tur JA, Bouzas C. Nutritional Risk Factors Associated with Vasomotor Symptoms in Women Aged 40-65 Years. Nutrients 2022; 14:2587. [PMID: 35807766 PMCID: PMC9268510 DOI: 10.3390/nu14132587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 12/10/2022] Open
Abstract
Vasomotor symptoms (VMS) are the most common symptoms among menopausal women; these include hot flashes and night sweats, and palpitations often occur along with hot flashes. Some studies in Mexico reported that around 50% of women presented with VMS mainly in the menopausal transition. It has been proven that VMS are not only triggered by an estrogen deficiency, but also by nutritional risk factors. Evidence of an association between nutritional risk factors and VMS is limited in Mexican women. The aim of this study is to identify nutritional risk factors associated with VMS in women aged 40−65 years. This is a comparative cross-sectional study, undertaken in a retrospective way. A sample group (n = 406 women) was divided into four stages according to STRAW+10 (Stages of Reproductive Aging Workshop): late reproductive, menopausal transition, early postmenopause, and late postmenopause. Hot flashes were present mainly in the early postmenopause stage (38.1%, p ≤ 0.001). Two or more VMS were reported in 23.2% of women in the menopausal transition stage and 29.3% in the early postmenopause stage (p < 0.001). The presence of VMS was associated with different nutritional risk factors (weight, fasting glucose levels, cardiorespiratory fitness, and tobacco use) in women living in the northeast of Mexico.
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Affiliation(s)
- Alexandra Tijerina
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Yamile Barrera
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Elizabeth Solis-Pérez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Rogelio Salas
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - José L. Jasso
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Verónica López
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Erik Ramírez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Rosario Pastor
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (R.P.); (C.B.)
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cristina Bouzas
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (R.P.); (C.B.)
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
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Namgoung S, Chang Y, Woo CY, Kim Y, Kang J, Kwon R, Lim GY, Choi HR, Kim KH, Kim H, Hong YS, Zhao D, Cho J, Guallar E, Park HY, Ryu S. Metabolically healthy and unhealthy obesity and risk of vasomotor symptoms in premenopausal women: cross-sectional and cohort studies. BJOG 2022; 129:1926-1934. [PMID: 35596933 PMCID: PMC9541406 DOI: 10.1111/1471-0528.17224] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/18/2022]
Abstract
Objective To examine the relationship between metabolically healthy and unhealthy obesity phenotypes and risk of vasomotor symptoms (VMS) in premenopausal women. Design Prospective cohort study. Setting Middle‐aged women in a cohort based on regular health screening examinations. Population Premenopausal Korean women aged 42–52 years were recruited and were followed up for a median of 4.2 years. The cross‐sectional and cohort studies comprised 4672 women and 2590 women without VMS at baseline, respectively. Methods Adiposity measures included body mass index (BMI), waist circumference and percentage body fat. Being metabolically healthy was defined as not having any metabolic syndrome components or a homeostasis model assessment of insulin resistance of 2.5 or more. Main outcomes measures VMS (hot flushes and night sweats) assessed using the questionnaire. Results All adiposity measures were positively associated with an increased risk of VMS in both cross‐sectional and longitudinal studies. The multivariable‐adjusted prevalence ratio (95% confidence interval [CI]) for VMS comparing percentage body fat of 35% or more with the reference was 1.47 (95% CI 1.14–1.90) in metabolically healthy women, and the corresponding prevalence ratio was 2.32 (95% CI 1.42–3.78) in metabolically unhealthy women (Pinteraction = 0.334). The multivariable‐adjusted hazard ratio for incident VMS comparing percentage body fat of 35% or more with the reference was 1.34 (95% CI 1.00–1.79) in metabolically healthy women, whereas the corresponding hazard ratio was 3.61 (95% CI 1.81–7.20) in metabolically unhealthy women (Pinteraction = 0.036). The association between BMI, waist circumference and VMS did not significantly differ by metabolic health status. Conclusions Maintaining normal weight and being metabolically healthy may help to prevent VMS in premenopausal women. Tweetable abstract Avoiding obesity and a metabolically unhealthy status may help reduce vasomotor symptoms in premenopausal women. Avoiding obesity and a metabolically unhealthy status may help reduce vasomotor symptoms in premenopausal women.
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Affiliation(s)
- Sunju Namgoung
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of The Environmental Health Centre, Wonju Severance Christian Hospital, Yonsei University School of Medicine, Wonju, Korea
| | - Yoosoo Chang
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chae-Yeon Woo
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yejin Kim
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeonggyu Kang
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ria Kwon
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Ga-Young Lim
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Hye Rin Choi
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynaecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hoon Kim
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Soo Hong
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Di Zhao
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Juhee Cho
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hyun-Young Park
- Department of Precision Medicine, National Institute of Health, Korea Disease Control and Prevention Agency (KDCA), Cheongju, Korea
| | - Seungho Ryu
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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6
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Yu Q, Chae HD, Hsiao SM, Xie J, Blogg M, Sumarsono B, Kim S. Prevalence, severity, and associated factors in women in East Asia with moderate-to-severe vasomotor symptoms associated with menopause. Menopause 2022; 29:553-563. [PMID: 35231007 PMCID: PMC9060817 DOI: 10.1097/gme.0000000000001949] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand prevalence, severity, impact, and treatment of vasomotor symptoms associated with menopause, using cross-sectional survey data. METHODS This online, two-part survey was conducted in East Asia among women 40-65 years recruited from established online panels (Edelman, Beijing; Hankook Research, Seoul; Rakuten Insight, Taipei) using stratified sampling. Part I collected demographics/disease characteristics, including menopausal status and vasomotor symptom severity. Women with moderate-to-severe vasomotor symptoms completed Part II, including clinical characteristics, health-related quality of life, and healthcare-seeking behavior. Primary endpoints included vasomotor symptom prevalence and severity and proportions of women eligible and willing to take hormone therapy. Results are presented for each of the three online panels separately and as a pooled total. All analyses are descriptive with no formal hypothesis testing across groups. RESULTS Numbers of peri- versus postmenopausal women completing Part I were Edelman, 1,588 (55.1% vs 44.9%); Hankook Research, 1,000 (43.6% vs 56.4%); Rakuten Insight, 773 (61.7% vs 38.3%). Vasomotor symptom prevalence was =80% in each region; overall moderate-to-severe vasomotor symptom prevalence was 55%; >50% of women were untreated. Most of those treated used non-prescription treatments. Menopausal hormone therapy use was reported by 11.6% of peri- and 7.2% of postmenopausal women. In peri- and postmenopausal women with moderate-to-severe vasomotor symptoms, 8.6% and 3.4%, respectively, were hormone therapy-willing, 19.3% and 16.8% hormone therapy-contraindicated, 25.4% and 23.0% hormone therapy-cautious, and 10.2% and 8.3% hormone therapy-averse. Women experienced significant burden on health-related quality of life and substantial impairment of work productivity and daily activities. CONCLUSIONS Vasomotor symptoms associated with menopause affected =80% of women aged 40 to 65 years. A substantial proportion of women are unsuitable for, or choose not to take, menopausal hormone therapy, resulting in an unmet need for nonhormonal treatment options.
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Affiliation(s)
- Qi Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Hee-Dong Chae
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital
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7
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Ryu KJ, Park H, Park JS, Lee YW, Kim SY, Kim H, Lee YJ, Kim T. Vasomotor symptoms and carotid artery intima-media thickness among Korean midlife women. Maturitas 2022; 159:1-6. [DOI: 10.1016/j.maturitas.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/15/2022]
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Min SH, Yang Q, Min SW, Ledbetter L, Docherty SL, Im EO, Rushton S. Are there differences in symptoms experienced by midlife climacteric women with and without metabolic syndrome? A scoping review. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221083817. [PMID: 35266423 PMCID: PMC8918770 DOI: 10.1177/17455057221083817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/15/2022] [Accepted: 02/10/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome. METHODS A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria. RESULTS The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters. CONCLUSION Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions.
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Affiliation(s)
- Se Hee Min
- Duke University School of Nursing, Durham, NC, USA
| | - Qing Yang
- Duke University School of Nursing, Durham, NC, USA
| | - Se Won Min
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | | | - Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA, USA
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9
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Min SH, Docherty SL, Im EO, Yang Q. Identification of Symptom Clusters Among Midlife Menopausal Women with Metabolic Syndrome. West J Nurs Res 2021; 44:838-853. [PMID: 34039103 DOI: 10.1177/01939459211018824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to identify and compare symptom clusters in midlife menopausal women with and without metabolic syndrome based on symptom occurrence and severity dimension through secondary data analysis of the Study of Women's Health Across the Nation. Exploratory factor analysis was used to group symptoms that are highly correlated with each other and verified by confirmatory factor analysis. Midlife menopausal women with metabolic syndrome (n = 424) experienced mental health, vasomotor, and somatic cluster across both symptom dimensions. In contrast, midlife menopausal women without metabolic syndrome (n = 1022) experienced mental health/sleep/urinary, vasomotor, and somatic cluster for symptom occurrence dimension and mental health/sleep, vasomotor/genital, and somatic cluster for symptom severity dimension. This is the first study to identify symptom clusters in midlife menopausal women with metabolic syndrome, who are at risk for experiencing complex symptoms associated with menopause transition and metabolic syndrome, and to compare symptom clusters to those without metabolic syndrome.
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Affiliation(s)
- Se Hee Min
- School of Nursing, Duke University, Durham, NC, USA
| | | | - Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
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10
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Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology. Biomolecules 2021; 11:biom11050708. [PMID: 34068722 PMCID: PMC8151888 DOI: 10.3390/biom11050708] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women's brains are more sensitive to factors affecting mental health such as depression and stress than men's brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women's mental health can contribute to preventing cardiovascular disease. Mind-body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women's cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind-body intervention in modulating these factors.
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Saú HPF, Schmitt ACB, Cardoso MRA, Aldrighi JM. Prevalence of hot flashes in women of 40 to 65 years of age with metabolic syndrome. Rev Assoc Med Bras (1992) 2020; 66:1628-1632. [DOI: 10.1590/1806-9282.66.12.1628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/22/2022] Open
Abstract
SUMMARY OBJECTIVE: Hot flashes have a negative impact on the quality of life of women during the menopausal transition and thereafter. The progressive reduction in gonadal estrogen levels associated with aging promotes an accumulation of abdominal fat, dyslipidemia, and arterial hypertension, all of which are components of metabolic syndrome (MetS). The objective of the present study was to estimate the prevalence of hot flashes and evaluate their relationship with MetS in women ≥ 40 years of age. METHODS: This was a cross-sectional study involving women aged between 40 and 65 years. We used the Kupperman index to quantify the climacteric symptoms and the National Cholesterol Education Program Adult Treatment Panel III criteria for the diagnosis of MetS. RESULTS: 1,435 women were initially selected, and we obtained information from 647. The mean age at menopause was 45.99 years (SD 6.61 years) and the prevalence of hot flashes and MetS were 55.83% (95% CI: 52.35-59.25%) and 46.29% (95% CI: 44.75-52.53%), respectively. We identified a positive association between MetS and hot flashes (OR 1.16; 95% CI: 1.01-1.33). CONCLUSIONS: In women ≥ 40 years of age, hot flashes are highly prevalent and appear to be associated with MetS.
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Huang Z, Shi J, Liu W, Wei S, Zhang Z. The influence of educational level in peri-menopause syndrome and quality of life among Chinese women. Gynecol Endocrinol 2020; 36:991-996. [PMID: 32573286 DOI: 10.1080/09513590.2020.1781081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: To investigate the influence of education level in the peri-menopausal symptoms and quality of life (QoL) among Chinese women.Methods: We carried out a cross-sectional study of 1632 peri-menopausal women (age 40-60 y) who visited Hangzhou Women's Hospital from November 2018 to November 2019. The menopausal symptoms were evaluated by modified Kupperman index (KI). World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to evaluate the QoL.Result: In total, 1501 women were included in the analysis. The mean age of natural menopause was 49.63 years in China. The five most frequent symptoms in menopausal women were Hot flash (75.53%), sexual problems (72.62%), insomnia (67.29%), fatigue (65.56%), and irritability (61.89%). Natural menopausal age, parity, BMI, bone mineral density, depression, skin formication, total score of KI, and the score of WHOQOL-BREF questionnaire were different in different educational background women (p < .05).Conclusions: The results of the study suggest that education level is associated with the age of natural menopause and menopausal symptoms. A high educational level is correlated with a better score of WHOQOL-BREF in peri-menopause women.
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Affiliation(s)
- Zheren Huang
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Junyu Shi
- Department of Obstetrics and Gynecology, The First People's Hospital of Changzhou, Changzhou, China
| | - Wenhua Liu
- Department of Obstetrics and Gynecology, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Shuangshuang Wei
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Zhifen Zhang
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
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Li J, Liu B, Tang R, Luo M, Li HJ, Peng Y, Wang Y, Liu G, Lin S, Chen R. Relationship between vasomotor symptoms and metabolic syndrome in Chinese middle-aged women. Climacteric 2020; 24:151-156. [PMID: 33103941 DOI: 10.1080/13697137.2020.1789094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to find the associations between vasomotor symptoms (VMS) and metabolic syndrome (MetS) in Chinese middle-aged women in a cross-sectional study. METHODS A total of 675 participants were recruited from an urban Chinese community. MetS was defined by the 2009 criteria of the Joint Interim Statement. VMS including hot flashes and sweats, blood pressure, weight, height, waist circumference (WC), serum glucose, triglycerides, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), estradiol, and follicle-stimulating hormone (FSH) were collected. RESULTS The presence of hot flashes was independently associated with the risk of MetS after adjusting for age, menopausal status, FSHlog, estradiollog, and physical activity (odds ratio: 1.98, 95% confidence interval: 1.21-3.24, p = 0.006). Both hot flashes and sweats were also independently associated with WC (for hot flashes, p = 0.016; and for sweats, p = 0.007) and triglycerides (for hot flashes, p = 0.041; and for sweats, p = 0.014) significantly. However, VMS were not significantly associated with blood pressure, glucose, HDL, and LDL. CONCLUSION Women with hot flashes had a higher risk of MetS. Both hot flashes and sweats were related to a higher amount of central fat indicated by WC and higher triglycerides, but were not related to blood pressure, glucose, and HDL in Chinese women.
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Affiliation(s)
- J Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - B Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - R Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - M Luo
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - H J Li
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Y Peng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Y Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - G Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - S Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - R Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, People's Republic of China
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Nasr A, Matthews KA, Brooks MM, McConnell DS, Orchard TJ, Billheimer J, Rader DJ, El Khoudary SR. Vasomotor symptoms and lipids/lipoprotein subclass metrics in midlife women: Does level of endogenous estradiol matter? The SWAN HDL Ancillary Study. J Clin Lipidol 2020; 14:685-694.e2. [PMID: 32747311 DOI: 10.1016/j.jacl.2020.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND A greater frequency of vasomotor symptoms (VMSs) has been associated with higher low-density lipoprotein cholesterol (LDL-C), but the association with high-density lipoprotein cholesterol (HDL-C) remains unclear. Endogenous estradiol (E2) levels are associated with both VMS and lipid levels and thus may confound such associations. OBJECTIVES To assess the relationship of VMS frequency with HDL-C, LDL-C, and lipoprotein concentrations (HDL and LDL particles [HDL-P; LDL-P]) and lipoprotein sizes in midlife women and to evaluate whether these associations are explained by E2. METHODS Participants were from the Study of Women's Health Across the Nation (SWAN) HDL ancillary study who had both nuclear magnetic resonance (NMR) spectroscopy lipoprotein subclass metrics and self-reported frequency of VMS measured 2-5 times over the menopause transition. VMS frequency was categorized into none, 1-5 days (infrequent), or ≥6 days (frequent) within the past 2 weeks. RESULTS We evaluated 522 women [at baseline: mean age 50.3 (SD: 2.8) years; infrequent VMS: 29.8%, frequent VMS: 16.5%]. Adjusting for potential confounders except E2, frequent VMS was associated with smaller HDL size [β(SE): -0.06 (0.03); P = .04] and higher concentrations of LDL-C [β(SE): 3.58 (1.77); P = .04] and intermediate LDL-P [β(SE): 0.09 (0.05); P = .04] than no VMS. These associations were largely explained by E2, all P's > .05. CONCLUSIONS Frequent VMSs were associated with smaller HDL size and higher concentrations of LDL-C and intermediate LDL-P. These associations were explained by endogenous E2. Whether treating frequent VMS with exogenous E2 could simultaneously improve lipids/lipoproteins profile should be assessed in future studies.
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Affiliation(s)
- Alexis Nasr
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria M Brooks
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Trevor J Orchard
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey Billheimer
- Department of Geriatrics and Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Geriatrics and Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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The Effect of Whole Blood Lead (Pb-B) Levels on Changes in Peripheral Blood Morphology and Selected Biochemical Parameters, and the Severity of Depression in Peri-Menopausal Women at Risk of Metabolic Syndrome or with Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145033. [PMID: 32668760 PMCID: PMC7400500 DOI: 10.3390/ijerph17145033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
The aim of our study was to assess the impact of whole blood lead (Pb-B) levels on changes in peripheral blood morphology and selected biochemical parameters, and the severity of depression in peri-menopausal women at risk of metabolic syndrome (pre-MetS) or with metabolic syndrome (MetS). The study involved 233 women from the general population of the West Pomeranian Province (Poland) aged 44–65 years. The intensity of menopausal symptoms and the severity of depression was examined using the Blatt–Kupperman Index (KI) and the Beck Depression Inventory (BDI). C-reactive protein (CRP), insulin, glucose, glycated hemoglobin (HbA1C), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglyceride levels (TG), cortisol, morphology of blood cells and homeostasis model assessment for insulin resistance (HOMA-IR) and Pb-B was measured. Women with MetS had higher levels of glucose, HbA1C, HDL, LDL, TG, cortisol, insulin and higher HOMA-IR. No significant differences in Pb-B were observed between pre-MetS and the control group, and between pre-MetS and the MetS group. A significant correlation was noticed between Pb-B vs. the percentage of monocytes in blood, and blood cortisol levels in women with MetS; Pb-B vs. lymphocyte count and HbA1C in the pre-MetS group, as well as in the BDI scores between the MetS and pre-MetS group. We cannot clearly state that exposure to Pb is an environmental factor that can be considered as a risk factor for MetS in this studied group.
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Abstract
OBJECTIVE Vasomotor symptoms (VMS) including hot flashes and night sweats are common during the menopausal transition and may persist. Although VMS pathophysiology is complex, estrogen's efficiency as VMS therapy suggests hormonal environment change may influence this process. As studies of VMS and breast cancer are inconsistent, we examined associations between persistent VMS and breast cancer incidence and mortality. METHODS The analytic sample included 25,499 postmenopausal women aged 50 to 79 in the Women's Health Initiative (WHI) without current/former menopausal hormone therapy use with information on VMS status (never vs persistent). Breast cancers were verified by medical record review. Cause of death attribution was enhanced by serial National Death Index queries. Associations between VMS status and breast cancer incidence and mortality was determined using time dependent Cox regression analyses adjusted for breast cancer risk factors. RESULTS Through 17.9 years (median) follow-up, 1,399 incident breast cancers were seen. Women with persistent VMS (VMS median duration 10+ years) (n = 9,715), compared to women with never VMS (n = 15,784), had a higher breast cancer incidence (hazard ratio [HR] 1.13 95% confidence interval [CI] 1.02-1.27). While breast cancer-specific mortality was higher in women with persistent VMS (HR 1.33 95% CI 0.88-2.02), the difference was not statistically significant. Persistent VMS status had no influence on breast cancer overall survival (HR 1.02 95% CI 0.81-1.29). CONCLUSION Women with persistent VMS are more likely to be diagnosed with breast cancer than women who never experienced VMS, but not more likely to die from breast cancer.
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17
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Ryu KJ, Park H, Park JS, Lee YW, Kim SY, Kim H, Jeong Y, Kim YJ, Yi KW, Shin JH, Hur JY, Kim T. Vasomotor Symptoms: More Than Temporary Menopausal Symptoms. J Menopausal Med 2020; 26:147-153. [PMID: 33423402 PMCID: PMC7797223 DOI: 10.6118/jmm.20030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 01/10/2023] Open
Abstract
Vasomotor symptoms (VMS), such as hot flashes and night sweating, are classic menopausal symptoms experienced by a majority of perimenopausal and postmenopausal women. VMS have received a great deal of attention due to their relationship with cardiometabolic risk. Further, accumulating evidence indicates that VMS are associated with an increased risk of several chronic diseases, including metabolic syndrome, type 2 diabetes mellitus, nonalcoholic fatty liver diseases, and osteoporosis in perimenopausal and postmenopausal women. These findings suggest VMS as biomarkers of impaired cardiometabolic conditions rather than just temporary symptoms in menopausal women, warranting further studies to confirm the casual relationship of VMS with these diseases and the exact underlying mechanism in this context.
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Affiliation(s)
- Ki Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
| | | | - Yeon Woo Lee
- Korea University College of Medicine, Seoul, Korea
| | | | - Hayun Kim
- Korea University College of Medicine, Seoul, Korea
| | - Youngmi Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Kyong Wook Yi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jung Ho Shin
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jun Young Hur
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
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Chedraui P, Pérez-López FR. Metabolic syndrome during female midlife: what are the risks? Climacteric 2019; 22:127-132. [DOI: 10.1080/13697137.2018.1561666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- P. Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - F. R. Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano-Blesa University Hospital, Zaragoza, Spain
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Kim HK, Jeon SH, Ryu KJ, Kim T, Park H. Comparison of the Efficacy of Tibolone and Transdermal Estrogen in Treating Menopausal Symptoms in Postmenopausal Women. J Menopausal Med 2019; 25:123-129. [PMID: 32307937 PMCID: PMC6952704 DOI: 10.6118/jmm.19205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/29/2019] [Accepted: 11/07/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives This study aimed to compare the efficacy of tibolone and transdermal estrogen in treating menopausal symptoms in postmenopausal women with an intact uterus. Methods Overall, 26 women consumed tibolone orally and 31 women received transdermal estrogen gel mixed with progestogen. The menopause rating scale (MRS) was used to assess their menopausal symptoms at their first outpatient visit and 6 months later. Results The transdermal estrogen group showed significant improvements in more items of the MRS questionnaire. There was a favorable change in body weight in the transdermal estrogen group compared with that in the tibolone group. Depressive mood, irritability, physical and mental exhaustion, sexual and bladder problems, and joint and muscular discomfort improved only in the transdermal estrogen group, whereas heart discomfort and vaginal dryness improved only in the tibolone group. Nevertheless, the intergroup differences in each item were insignificant after adjusting for body mass index and hypertension, which differed before treatment. Conclusions Both the therapeutic options improved menopausal symptoms within 6 months of use. However, transdermal estrogen appeared to be more effective in preventing weight gain in menopausal women than tibolone.
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Affiliation(s)
- Hyun Kyun Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Sung Hye Jeon
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Ki Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
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20
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Sayan S, Pekin T, Yıldızhan B. Relationship between vasomotor symptoms and metabolic syndrome in postmenopausal women. J Int Med Res 2018; 46:4157-4166. [PMID: 30092678 PMCID: PMC6166330 DOI: 10.1177/0300060518790709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/03/2018] [Indexed: 11/15/2022] Open
Abstract
Objective This study was performed to compare the vasomotor symptoms and bone mineral density of postmenopausal women with and without metabolic syndrome. Methods We performed a cross-sectional study of 200 postmenopausal women attending routine health check-ups at Marmara Faculty of Medicine Pendik Training and Research Hospital from June 2015 to December 2015. The vasomotor symptoms scored were hot flashes and night sweats. Metabolic syndrome was defined using the consensus criteria of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Results Women with vasomotor symptoms had no metabolic syndrome and were younger than those without vasomotor symptoms. There was no significant difference in vasomotor symptoms between patients with osteopenia in the femoral neck, total femur, and spine and patients with normal bone mineral density. The vasomotor symptoms were similar between smokers and nonsmokers. Conclusion The presence of metabolic symptoms is inversely associated with metabolic syndrome in postmenopausal women. Lipid abnormalities and a high body mass index may be important metabolic components associated with these symptoms. No relationship is present between vasomotor symptoms and the bone mineral density of the spine, femoral neck, and total femur.
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Affiliation(s)
- Sena Sayan
- Ministry of Health of the Republic of Turkey, University of
Health Sciences, Van Training and Research Hospital, Obstetrics and Gynecology
Clinic, Van, Turkey
| | - Tanju Pekin
- Marmara University, Department of Obstetrics and Gynecology,
Medical Faculty, Istanbul, Turkey
| | - Begüm Yıldızhan
- Marmara University, Department of Obstetrics and Gynecology,
Medical Faculty, Istanbul, Turkey
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Ryu KJ, Park H, Kim YJ, Yi KW, Shin JH, Hur JY, Kim T. Moderate to severe vasomotor symptoms are risk factors for non-alcoholic fatty liver disease in postmenopausal women. Maturitas 2018; 117:22-28. [PMID: 30314557 DOI: 10.1016/j.maturitas.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 06/22/2018] [Accepted: 08/30/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the association between vasomotor symptoms (VMS) and non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. METHODS This cross-sectional study included 1793 Korean postmenopausal women aged 45-65 years who attended a routine health check at a Korean institution from January 2010 to December 2012. Their scores on the Menopause Rating Scale were used to assess VMS. Moderate to severe VMS included ratings of moderate, severe, and very severe. NAFLD was diagnosed by abdominal ultrasound among those who indicated that their ethanol intake was less than 70 g/week. RESULTS The mean age of these participants was 54.51 ± 4.74 years and the mean duration of menopause was 5.36 ± 4.41 years. A total of 602 (33.6%) women reported mild VMS while 435 (24.3%) reported moderate to severe VMS. The prevalence of NAFLD differed significantly according to the severity of VMS (none, 31.7%; mild, 34.9%; moderate to severe, 39.1%; p = 0.037). Levels of the liver enzymes alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase were significantly higher in women with moderate to severe VMS than in those without VMS. Logistic regression analysis revealed that moderate to severe VMS were significantly associated with the risk of NAFLD (OR: 1.50, 95% CI: 1.10-2.03) after adjusting for age, years since menopause, central obesity, alcohol use, smoking, exercise, and insulin resistance. CONCLUSIONS Moderate to severe VMS are associated with NAFLD and worse liver function profiles in otherwise healthy postmenopausal women. Further longitudinal studies are needed to investigate casual relationships and underlying mechanisms.
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Affiliation(s)
- Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea.
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
| | - Kyong Wook Yi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
| | - Jung Ho Shin
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
| | - Jun Young Hur
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, South Korea
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Miragem AA, Homem de Bittencourt PI. Nitric oxide-heat shock protein axis in menopausal hot flushes: neglected metabolic issues of chronic inflammatory diseases associated with deranged heat shock response. Hum Reprod Update 2018; 23:600-628. [PMID: 28903474 DOI: 10.1093/humupd/dmx020] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/28/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although some unequivocal underlying mechanisms of menopausal hot flushes have been demonstrated in animal models, the paucity of similar approaches in humans impedes further mechanistic outcomes. Human studies might show some as yet unexpected physiological mechanisms of metabolic adaptation that permeate the phase of decreased oestrogen levels in both symptomatic and asymptomatic women. This is particularly relevant because both the severity and time span of hot flushes are associated with increased risk of chronic inflammatory disease. On the other hand, oestrogen induces the expression of heat shock proteins of the 70 kDa family (HSP70), which are anti-inflammatory and cytoprotective protein chaperones, whose expression is modulated by different types of physiologically stressful situations, including heat stress and exercise. Therefore, lower HSP70 expression secondary to oestrogen deficiency increases cardiovascular risk and predisposes the patient to senescence-associated secretory phenotype (SASP) that culminates in chronic inflammatory diseases, such as obesities, type 2 diabetes, neuromuscular and neurodegenerative diseases. OBJECTIVE AND RATIONALE This review focuses on HSP70 and its accompanying heat shock response (HSR), which is an anti-inflammatory and antisenescent pathway whose intracellular triggering is also oestrogen-dependent via nitric oxide (NO) production. The main goal of the manuscript was to show that the vasomotor symptoms that accompany hot flushes may be a disguised clue for important neuroendocrine alterations linking oestrogen deficiency to the anti-inflammatory HSR. SEARCH METHODS Results from our own group and recent evidence on hypothalamic control of central temperature guided a search on PubMed and Google Scholar websites. OUTCOMES Oestrogen elicits rapid production of the vasodilatory gas NO, a powerful activator of HSP70 expression. Whence, part of the protective effects of oestrogen over cardiovascular and neuroendocrine systems is tied to its capacity of inducing the NO-elicited HSR. The hypothalamic areas involved in thermoregulation (infundibular nucleus in humans and arcuate nucleus in other mammals) and whose neurons are known to have their function altered after long-term oestrogen ablation, particularly kisspeptin-neurokinin B-dynorphin neurons, (KNDy) are the same that drive neuroprotective expression of HSP70 and, in many cases, this response is via NO even in the absence of oestrogen. From thence, it is not illogical that hot flushes might be related to an evolutionary adaptation to re-equip the NO-HSP70 axis during the downfall of circulating oestrogen. WIDER IMPLICATIONS Understanding of HSR could shed light on yet uncovered mechanisms of menopause-associated diseases as well as on possible manipulation of HSR in menopausal women through physiological, pharmacological, nutraceutical and prebiotic interventions. Moreover, decreased HSR indices (that can be clinically determined with ease) in perimenopause could be of prognostic value in predicting the moment and appropriateness of starting a HRT.
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Affiliation(s)
- Antônio Azambuja Miragem
- Laboratory of Cellular Physiology, Department of Physiology, Federal University of Rio Grande do Sul, Rua Sarmento Leite 500, ICBS, 2nd Floor, Suite 350, Porto Alegre, RS 90050-170, Brazil.,Federal Institute of Education, Science and Technology 'Farroupilha', Rua Uruguai 1675, Santa Rosa, RS 98900-000, Brazil
| | - Paulo Ivo Homem de Bittencourt
- Laboratory of Cellular Physiology, Department of Physiology, Federal University of Rio Grande do Sul, Rua Sarmento Leite 500, ICBS, 2nd Floor, Suite 350, Porto Alegre, RS 90050-170, Brazil
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Vasomotor symptoms in women in Asia appear comparable with women in Western countries: a systematic review. Menopause 2017. [DOI: 10.1097/gme.0000000000000896] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Tuomikoski P, Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas 2017; 97:61-65. [PMID: 28159064 DOI: 10.1016/j.maturitas.2016.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 12/16/2016] [Indexed: 12/28/2022]
Abstract
A vast majority of menopausal women suffer from vasomotor symptoms, such as hot flushes and night sweats, the mean duration of which may be up to 7-10 years. In addition to a decreased quality of life, vasomotor symptoms may have an impact on overall health. Vasomotor symptoms are associated with overactivity of the sympathetic nervous system, and sympathetic overdrive in turn is associated with metabolic syndrome, which is a known risk factor for cardiovascular disease. Menopausal hot flushes have a complex relationship to different features of the metabolic syndrome and not all data point towards an association between vasomotor symptoms and metabolic syndrome. Thus, it is still unclear whether vasomotor symptoms are an independent risk factor for metabolic syndrome. Research in this area is constantly evolving and we present here the most recent data on the possible association between menopausal vasomotor symptoms and the metabolic syndrome.
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Affiliation(s)
| | - Hanna Savolainen-Peltonen
- University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Department of Obstetrics and Gynecology, 00029 Helsinki, Finland
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25
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Vasomotor symptoms and osteoporosis in Korean postmenopausal women. Maturitas 2016; 87:27-32. [PMID: 27013285 DOI: 10.1016/j.maturitas.2016.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/05/2016] [Accepted: 02/10/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study examined the relationships between vasomotor symptoms (VMS), bone mineral density (BMD) and osteoporosis in postmenopausal women. STUDY DESIGN A cross-sectional study was conducted of 1390 postmenopausal Korean women aged 45-65 years who attended a routine health check-up at a single institution. Their results on the Menopause Rating Scale were used to assess VMS, and moderate, severe, and very severe VMS were combined into moderate-to-severe VMS. MAIN OUTCOME MEASURES The relationships of VMS with BMD and osteoporosis in the lumbar spine and femoral neck bone were analyzed by multivariate regression analyses. RESULTS The mean age of all participants was 54.63 ± 4.78 years. Four hundred seventy-one (33.9%) women reported mild VMS and 344 (24.7%) reported moderate-to-severe VMS. Osteoporosis was newly diagnosed in 156 (11.2%) women. BMD levels were not significantly different among the no/mild/moderate-to-severe VMS groups, despite the significant differences in the prevalence of osteoporosis in the femoral neck bone. Women with mild VMS and those with moderate-to-severe VMS had a lower BMD than women without VMS after adjustment for age, years since menopause, years of reproductive age, BMI, insulin resistance, smoking, alcohol, steroids use, exercise, previous fracture and parental history of hip fracture. And moderate-to-severe VMS was significantly associated with the risk of osteoporosis in the femoral neck bone (OR = 2.97, 95% CI = 1.41-6.26) and in the lumbar spine (OR = 1.93, 95% CI = 1.09-3.40). CONCLUSIONS VMS are associated with decreased BMD, and moderate-to-severe VMS in particular are independently associated with the risk of osteoporosis in otherwise healthy postmenopausal Korean women.
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Vasomotor symptoms and the homeostatic model assessment of insulin-resistance in Korean postmenopausal women. Obstet Gynecol Sci 2016; 59:45-9. [PMID: 26866035 PMCID: PMC4742475 DOI: 10.5468/ogs.2016.59.1.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/29/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022] Open
Abstract
The aim of this cross-sectional study was to evaluate the association between vasomotor symptoms (VMS) and insulin resistance, which can be postulated by the homeostatic model assessment (HOMA) index. This study involved 1,547 Korean postmenopausal women (age, 45 to 65 years) attending a routine health check-up at a single institution in Korea from January 2010 to December 2012. A menopause rating scale questionnaire was used to assess the severity of VMS. The mean age of participants was 55.22±4.8 years and 885 (57.2%) reported VMS in some degree. The mean HOMA index was 1.79±0.96, and the HOMA index increased with an increase in severity of VMS (none, mild, moderate and severe) in logistic regression analysis (β=0.068, t=2.665, P =0.008). Insulin resistance needs to be considered to understand the linkage between VMS and cardiometabolic disorders.
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