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Wood TWP, Henriques WS, Cullen HB, Romero M, Blengini CS, Sarathy S, Sorkin J, Bekele H, Jin C, Kim S, Chemiakine A, Khondker RC, Isola JVV, Stout MB, Gennarino VA, Mogessie B, Jain D, Schindler K, Suh Y, Wiedenheft B, Berchowitz LE. The retrotransposon - derived capsid genes PNMA1 and PNMA4 maintain reproductive capacity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.11.592987. [PMID: 38798495 PMCID: PMC11118267 DOI: 10.1101/2024.05.11.592987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The human genome contains 24 gag -like capsid genes derived from deactivated retrotransposons conserved among eutherians. Although some of their encoded proteins retain the ability to form capsids and even transfer cargo, their fitness benefit has remained elusive. Here we show that the gag -like genes PNMA1 and PNMA4 support reproductive capacity. Six-week-old mice lacking either Pnma1 or Pnma4 are indistinguishable from wild-type littermates, but by six months the mutant mice become prematurely subfertile, with precipitous drops in sex hormone levels, gonadal atrophy, and abdominal obesity; overall they produce markedly fewer offspring than controls. Analysis of donated human ovaries shows that expression of both genes declines normally with aging, while several PNMA1 and PNMA4 variants identified in genome-wide association studies are causally associated with low testosterone, altered puberty onset, or obesity. These findings expand our understanding of factors that maintain human reproductive health and lend insight into the domestication of retrotransposon-derived genes.
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Liao S, Zhao L, Huang C, Xiong A, Xiong W, He Y, Huang X, Hunter V, Luo B. One-year trajectories of nutritional status in perimenopausal women: a community-based multi-centered prospective study. BMC Public Health 2024; 24:914. [PMID: 38549103 PMCID: PMC10976711 DOI: 10.1186/s12889-024-18405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/20/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Nutritional status is a modifiable factor associated with perimenopausal women's health and quality of life. Assessing body composition indicators helps to comprehensively understand nutritional status compared with using body mass index (BMI) only. However, few published studies measured the trends in body composition among perimenopausal women. OBJECTIVES To assess the one-year trajectory of the nutritional status of perimenopausal women and to explore its influential factors. METHODS A community-based observational study with 3-wave repeated measurements at 6-month intervals was carried out. The nutritional status indicators include weight, body mass index (BMI), and body composition variables. Bioelectrical impedance analysis was used to assess body composition. Repeated measures ANOVA and Chi-square test were used to calculate the changes in nutritional status and generalized estimating equations were performed to explore their influential factors. RESULTS 2760 participants completed the study. Increasing trajectories in weight (from 56.05 ± 7.55 to 57.02 ± 7.60), fat mass (from 17.99 ± 4.80 to 20.49 ± 4.90), and waist-hip ratio (from 0.86 ± 0.04 to 0.91 ± 0.15) were found (P < 0.001). Decreasing trajectories in skeletal muscle (from 20.30 ± 2.38 to 19.19 ± 2.46), protein level (from 7.39 ± 0.79 to 7.06 ± 0.81), and total body water (from 27.87 ± 2.92 to 27.00 ± 3.01) were found (P < 0.001). Being married/unmarried with a partner and without negative life events were associated with higher total body water, skeletal muscle, and protein level, while negatively associated with fat mass and waist-hip ratio. Age was positively associated with fat mass (P < 0.001). Participants with junior high school education were prone to increased fat mass (P = 0.018) compared with those holding primary school education and below. A per capita monthly income of 1500 to 3000 Yuan was associated with higher total body water, skeletal muscle, and protein level (P < 0.001) compared with a per capita monthly income of less than 1500 Yuan. CONCLUSION Worsening nutritional status exists in perimenopausal women, which is characterized by increased weight, fat mass, and waist-hip ratio, and decreased skeletal muscle, total body water, and protein level. For greater efficiency, precision nutritional interventions are needed, and recipients should be classified into different risk levels based on their sociodemographic background.
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Affiliation(s)
- Shujuan Liao
- Department of Nursing, West China Second University Hospital, Sichuan University, No. 20, Section 3, People's South Road, 610041, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chuanya Huang
- Department of Nursing, West China Second University Hospital, Sichuan University, No. 20, Section 3, People's South Road, 610041, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Anqi Xiong
- Department of Nursing, West China Second University Hospital, Sichuan University, No. 20, Section 3, People's South Road, 610041, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Weijun Xiong
- Chengdu Zhongke Zhiyong Information Technology Co., LTD, Chengdu, Sichuan, China
| | - Yirong He
- Department of Nursing, West China Second University Hospital, Sichuan University, No. 20, Section 3, People's South Road, 610041, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | | | | | - Biru Luo
- Department of Nursing, West China Second University Hospital, Sichuan University, No. 20, Section 3, People's South Road, 610041, Chengdu, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China.
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Salinero AE, Venkataganesh H, Abi-Ghanem C, Riccio D, Kelly RD, Gannon OJ, Sura A, Brooks HL, Zuloaga KL. Effects of High Fat Diet on Metabolic Health Vary by Age of Menopause Onset. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.18.576269. [PMID: 38293070 PMCID: PMC10827154 DOI: 10.1101/2024.01.18.576269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Menopause accelerates metabolic dysfunction, including (pre-)diabetes, obesity and visceral adiposity. However, the effects of endocrine vs. chronological aging in this progression are poorly understood. We hypothesize that menopause, especially in the context of middle-age, will exacerbate the metabolic effects of a high fat diet. Using young-adult and middle-aged C57BL/6J female mice, we modeled diet-induce obesity via chronic administration of high fat (HF) diet vs. control diet. We modeled peri-menopause/menopause via injections of 4-vinylcyclohexene diepoxide, which accelerates ovarian failure vs. vehicle. We performed glucose tolerance tests 2.5 and 7 months after diet onset, during the peri-menopausal and menopausal phases, respectively. Peri-menopause increased the severity of glucose intolerance and weight gain in middle-aged, HF-fed mice. Menopause increased weight gain in all mice regardless of age and diet, while chronological aging drove changes in adipose tissue distribution towards more visceral vs. subcutaneous adiposity. These data are in line with clinical data showing that post-menopausal women are more susceptible to metabolic dysfunction and suggest that greater chorological age exacerbates the effects of endocrine aging (menopause). This work highlights the importance of considering both chronological and endocrine aging in studies of metabolic health.
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Liu H, Chang Z, Liu S, Zhu R, Ma J, Lu X, Li L, Zhang Z. MEDAG expression in vitro and paeoniflorin alleviates bone loss by regulating the MEDAG/AMPK/PPARγ signaling pathway in vivo. Heliyon 2024; 10:e24241. [PMID: 38226230 PMCID: PMC10788805 DOI: 10.1016/j.heliyon.2024.e24241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/17/2024] Open
Abstract
Objectives Osteoporosis (OP) is characterized by reduced bone mass and impaired bone microstructure. Paeoniflorin (PF) is isolated from peony root with anti-inflammatory, immunomodulatory, and bone-protective effects. Up to now, the mechanism of anti-OP in PF has not been completely clarified. Methods The expression of MEDAG in osteoclasts, osteoblasts and adipocytes was detected by RT-qPCR. The OVX mouse model was constructed, and oral administration of PF was performed for 15 weeks. Bone microstructure was detected by H&E staining and a micro-CT system, and expression of signaling proteins examined by Western blot and immunohistochemical staining. ELISA and biochemical kits were used to quantify serum metabolite levels. Key findings MEDAG were upregulated in osteoclasts and adipocytes, and downregulated in osteoblasts. PF administration effectively alleviated OVX-induced bone loss, and histological changes in femur tissues. Moreover, PF significantly reduced serum TRAP, CTX-1, P1NP, BALP, and LDL-C levels and increased HDL-C. In addition, PF inhibited the expression of MEDAG, cathepsin K, NFATc1, PPARγ, and C/EBPα and increased p-AMPKα, OPG and Runx2. Conclusions MEDAG is a potential target for bone diseases, and PF might attenuate OVX-induced osteoporosis via MEDAG/AMPK/PPARγ signaling pathway.
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Affiliation(s)
- Haixia Liu
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhiyue Chang
- The 8th Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shuling Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ruyuan Zhu
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiayi Ma
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinyue Lu
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiguo Zhang
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Bodnaruc AM, Duquet M, Prud’homme D, Giroux I. Diet and Depression during Peri- and Post-Menopause: A Scoping Review Protocol. Methods Protoc 2023; 6:91. [PMID: 37888023 PMCID: PMC10609501 DOI: 10.3390/mps6050091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case-control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6.
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Affiliation(s)
- Alexandra M. Bodnaruc
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
| | - Miryam Duquet
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
| | | | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.M.B.); (M.D.)
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Alcantara-Diaz AL, Ruiz-Fernandez JF, Salazar-Alarcon JL, Salinas-Sedo G, Toro-Huamanchumo CJ. Diagnostic Performance of 2D Shear Wave (2D-SWE) for Liver Fibrosis in Adults Undergoing Bariatric Surgery. Obes Surg 2023; 33:3120-3126. [PMID: 37566340 DOI: 10.1007/s11695-023-06766-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Among the most recent methods to diagnose liver fibrosis is 2D shear wave elastography (2D-SWE). However, the evidence in the Latin population is limited, and there is no consensus on the cutoff points for each stage of fibrosis. AIM To evaluate the diagnostic performance of 2D-SWE for liver fibrosis in adults with obesity who underwent bariatric surgery (BS). METHODS We conducted a cross-sectional study on patients with obesity who underwent BS between 2020 and 2021. Liver stiffness measurement was reported as the mean of valid measurements in kilopascals made with the 2D-SWE. The outcome was biopsy-proven liver fibrosis. ROC curves were constructed for significant fibrosis (F≥2) and advanced fibrosis (F≥3), with their respective area under the curve (AUC). To obtain the best cutoff point for each scenario, we used the Youden index. The 95% confidence intervals (95% CI) for each cutoff point were estimated by bootstrap with 1000 replications. RESULTS We analyzed data from 227 patients. The mean age was 37.8 ± 11.1 years and 65.2% were women. Overall, the AUC for significant and advanced fibrosis was 0.54 (95% CI: 0.47-0.62) and 0.73 (95% CI: 0.60-0.87), respectively. For advanced fibrosis, higher AUCs were found among women (AUC: 0.82; 95% CI: 0.59-1.00) and among patients with morbid obesity (AUC: 0.78; 95% CI: 0.61-0.99). CONCLUSION The 2D-SWE appears to be a valuable tool for screening advanced liver fibrosis in candidates for BS, mainly in the female population and in adults with morbid obesity.
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Affiliation(s)
- Ana L Alcantara-Diaz
- School of Medicine, Universidad de San Martín de Porres, Chiclayo, Peru
- SCIEMVE, Sociedad Científica de Estudiantes de Medicina Veritas, Chiclayo, Peru
| | | | | | | | - Carlos J Toro-Huamanchumo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Av. La Fontana 750, 15024, Lima, Peru.
- OBEMET Center for Obesity and Metabolic Health, Lima, Peru.
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Leite MM, de Sousa Neto IV, Dutra MT, Funghetto SS, de Oliveira Silva A, da Silva ICR, Ramos de Lima L, Morato Stival M. Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus. Clin Interv Aging 2023; 18:1535-1546. [PMID: 37727449 PMCID: PMC10506670 DOI: 10.2147/cia.s414620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/03/2023] [Indexed: 09/21/2023] Open
Abstract
Purpose To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care. Patients and Methods The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis. Results The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (β = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001). Conclusion WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.
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Affiliation(s)
- Mateus Medeiros Leite
- Graduate Program in Health Sciences and Technologies, University of Brasilia, Faculty of Ceilândia, Brasilia, Brazil
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | | | - Silvana Schwerz Funghetto
- Graduate Program in Health Sciences and Technologies, University of Brasilia, Faculty of Ceilândia, Brasilia, Brazil
| | | | | | | | - Marina Morato Stival
- Graduate Program in Health Sciences and Technologies, University of Brasilia, Faculty of Ceilândia, Brasilia, Brazil
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Yu EH, Lee HJ, Kim HJ, Kim IH, Joo JK, Na YJ. Correlation of Sarcopenic Obesity on Various Cardiometabolic Risk Factors and Fracture Risk in Mid-Aged Korean Women. J Menopausal Med 2023; 29:58-65. [PMID: 37691313 PMCID: PMC10505515 DOI: 10.6118/jmm.23014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the correlation of sarcopenic obesity with various cardiometabolic risk factors and fracture risk in middle-aged Korean women. METHODS In this cross-sectional study, the medical records of 1,775 women who had visited Pusan National University Hospital for routine health screenings from 2010 to 2016 were reviewed. The patients were divided into four groups as follows: group 1, nonsarcopenic, nonobese (NS-NO); group 2, nonsarcopenic, obese (NS-O); group 3, sarcopenic, nonobese (S-NO); and group 4, sarcopenic, obese (S-O). Each patient was assessed based on self-reported questionnaires and individual interviews with a healthcare provider. The Fracture Risk Assessment Tool (FRAX) was used to assess bone fracture risk. RESULTS Postmenopausal women accounted for 68.5% of the total patient population. The proportion of each group was as follows: NS-NO, 71.2%; NS-O, 17.9%; S-NO, 10.2%; and S-O, 0.7%. Statistical analysis of various parameters associated with metabolic and cardiovascular risks revealed that the S-O group had more patients with hypertension, diabetes, osteopenia, and metabolic syndrome. The FRAX scores were significantly higher in the S-O group than in other groups. CONCLUSIONS Middle-aged women with obesity and reduced muscle mass, known as sarcopenic obesity, are at increased risk of hypertension, diabetes, and metabolic syndrome. Furthermore, sarcopenic obesity, individual cardiometabolic risks, and menopause can increase the bone fracture risk.
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Affiliation(s)
- Eun Hee Yu
- Department of Obstetrics and Gynecology, Biomedical Research Institute Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyun Joo Lee
- Department of Obstetrics and Gynecology, Biomedical Research Institute Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyeon Jin Kim
- Department of Obstetrics and Gynecology, Biomedical Research Institute Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - In Hye Kim
- Department of Obstetrics and Gynecology, Biomedical Research Institute Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jong Kil Joo
- Department of Obstetrics and Gynecology, Biomedical Research Institute Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
| | - Yong Jin Na
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea
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Cowan S, Dordevic A, Sinclair AJ, Truby H, Sood S, Gibson S. Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study. Menopause 2023; 30:738-749. [PMID: 37192829 DOI: 10.1097/gme.0000000000002188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Chronic inflammation is associated with obesity and is an underlying pathophysiology for cardiovascular disease (CVD) development in postmenopausal women. This study aims to determine feasibility and efficacy of an anti-inflammatory dietary intervention to lower levels of C-reactive protein in weight stable postmenopausal women with abdominal obesity. METHODS This mixed-methods pilot study used a single arm pre-post design. Thirteen women followed a 4-week anti-inflammatory, dietary intervention, optimizing consumption of healthy fats, low glycemic index wholegrains, and dietary antioxidants. Quantitative outcomes included change in inflammatory and metabolic markers. Focus groups were undertaken and thematically analyzed to explore participants lived experience of following the diet. RESULTS There was no significant change in plasma high-sensitivity C-reactive, protein. Despite discouraging weight loss, median (Q1-Q3) body weight decreased by -0.7 (-1.3 to 0 kg, P = 0.02). This was accompanied by reductions in plasma insulin (0.90 [-0.05 to 2.20] mmol/L), Homeostatic Model Assessment of Insulin Resistance (0.29 [-0.03 to 0.59]), and low-density lipoprotein:high-density lipoprotein ratio (0.18 [-0.01 to 0.40]) ( P ≤ 0.023 for all). Thematic analysis revealed that postmenopausal women have a desire to improve meaningful markers of health status that do not focus on weight. Women were highly engaged with learning about emerging and innovative nutrition topics, favoring a detailed and comprehensive nutrition education style that challenged their proficient health literacy and cooking skills. CONCLUSIONS Weight-neutral dietary interventions targeting inflammation can improve metabolic markers and may be a viable strategy for CVD risk reduction in postmenopausal women. To determine effects on inflammatory status, a fully powered and longer-term randomized controlled trial is required.
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Affiliation(s)
- Stephanie Cowan
- From the Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Aimee Dordevic
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | | | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Surbhi Sood
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
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Chikwati RP, Mahyoodeen NG, Jaff NG, Ramsay M, Micklesfield LK, Wade AN, Agongo G, Asiki G, Choma SSR, Boua PR, George JA, Crowther NJ. Cardiometabolic disease risk factors in pre- and postmenopausal women from four sub-Saharan African countries: A cross-sectional study. Maturitas 2023; 172:60-68. [PMID: 37116348 PMCID: PMC10278059 DOI: 10.1016/j.maturitas.2023.04.005] [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: 12/18/2022] [Revised: 03/17/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To compare the risk factors for cardiometabolic disease between pre- and postmenopausal women from four sub-Saharan African countries. STUDY DESIGN This cross-sectional study included 3609 women (1740 premenopausal and 1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi), and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women, within and across sites using multivariable regression analyses. The sites represent populations at different stages of the health transition, with those in Ghana and Burkina Faso being rural, whilst those in Kenya and South Africa are more urbanised. MAIN OUTCOME MEASURES Anthropometric and cardiometabolic variables. RESULTS The prevalence rates of risk factors for cardiometabolic disease were higher in South (Soweto and Dikgale) and East (Nairobi) Africa than in West Africa (Nanoro and Navrongo), irrespective of menopausal status. Regression models in combined West African populations demonstrated that postmenopausal women had a larger waist circumference (β = 1.28 (95 % CI: 0.58; 1.98) cm), log subcutaneous fat (β =0.15 (0.10; 0.19)), diastolic (β = 3.04 (1.47; 4.62) mm Hg) and log systolic (β = 0.04 (0.02; 0.06)) blood pressure, log carotid intima media thickness (β = 0.03 (0.01; 0.06)), low-density lipoprotein cholesterol (β = 0.14 (0.04; 0.23) mmol/L) and log triglyceride (β= 0.10 (0.04; 0.16)) levels than premenopausal women. No such differences were observed in the South and East African women. CONCLUSIONS Menopause-related differences in risk factors for cardiometabolic disease were prominent in West but not East or South African study sites. These novel findings should inform cardiometabolic disease prevention strategies in midlife women specific to rural and urban and peri-urban locations in sub-Saharan Africa.
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Affiliation(s)
- Raylton P Chikwati
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nasrin Goolam Mahyoodeen
- Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G Jaff
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K Micklesfield
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alisha N Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Department of Biochemistry and Forensic Science, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Science, Navrongo, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Solomon S R Choma
- Department of Pathology and Medical Sciences, DIMAMO HDSS, University of Limpopo, Polokwane, South Africa
| | - Palwende R Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Burkina Faso
| | - Jaya A George
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
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Marsh ML, Oliveira MN, Vieira-Potter VJ. Adipocyte Metabolism and Health after the Menopause: The Role of Exercise. Nutrients 2023; 15:444. [PMID: 36678314 PMCID: PMC9862030 DOI: 10.3390/nu15020444] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
Postmenopausal women represent an important target population in need of preventative cardiometabolic approaches. The loss of estrogen following the menopause eliminates protections against metabolic dysfunction, largely due to its role in the health and function of adipose tissue. In addition, some studies associate the menopause with reduced physical activity, which could potentially exacerbate the deleterious cardiometabolic risk profile accompanying the menopause. Meanwhile, exercise has adipocyte-specific effects that may alleviate the adverse impact of estrogen loss through the menopausal transition period and beyond. Exercise thus remains the best therapeutic agent available to mitigate menopause-associated metabolic dysfunction and represents a vital behavioral strategy to prevent and alleviate health decline in this population.
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12
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Raguindin PF, Cardona I, Muka T, Lambrinoudaki I, Gebhard C, Franco OH, Marques‐Vidal P, Glisic M. Does reproductive stage impact cardiovascular disease risk factors? Results from a population-based cohort in Lausanne (CoLaus study). Clin Endocrinol (Oxf) 2022; 97:568-580. [PMID: 35377481 PMCID: PMC9790265 DOI: 10.1111/cen.14730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/30/2022]
Abstract
CONTEXT Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying ageing trajectories. DESIGN The CoLaus study is a prospective population-based cohort study in Lausanne, Switzerland. PATIENTS We used data from women at baseline and follow-up (mean: 5.6 ± 0.5 years) from 2003 to 2012 who did not use hormone therapy. We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years) and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. MEASUREMENTS We measured fasting lipids, glucose and cardiovascular inflammatory markers. We used repeated measures (linear mixed models) for longitudinal analysis, using premenopausal women as a reference category. We adjusted analyses for age, medications and lifestyle factors. RESULTS We used the data from 1710 women aged 35-75 years. Longitudinal analysis showed that the changes in CVD risk factors were not different in the other three menopausal categories compared to premenopausal women. When age was used as a predictor variable and adjusted for menopause status, most CVD risk factors increased, while interleukin-6 and interleukin-1β decreased with advancing age. CONCLUSION The current study suggests that women have a worsening cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the 5-year changes in cardiovascular risk factors may not depend on the reproductive stage.
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Affiliation(s)
- Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
- Graduate School for Health SciencesUniversity of BernBernSwitzerland
| | - Isabel Cardona
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, Aretaieio HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Catherine Gebhard
- Department of Nuclear MedicineUniversity Hospital ZurichZurichSwitzerland
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Pedro Marques‐Vidal
- Department of Nuclear Medicine, Lausanne University Hospital (CHUV)University of LausanneLausanneSwitzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
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13
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Chen Q, Wang H, Wang G, Zhao J, Chen H, Lu X, Chen W. Lactic Acid Bacteria: A Promising Tool for Menopausal Health Management in Women. Nutrients 2022; 14:4466. [PMID: 36364729 PMCID: PMC9654486 DOI: 10.3390/nu14214466] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 08/10/2023] Open
Abstract
Menopause is a period during which women undergo dramatic hormonal changes. These changes lead to physical and mental discomfort, are greatly afflictive, and critically affect women's lives. However, the current safe and effective management measures for women undergoing menopause are insufficient. Several probiotic functions of lactic acid bacteria (LAB) have been recognized, including alleviation of lactose intolerance, protection of digestive tract health, activation of the immune system, protection against infections, improvement of nutrient uptake, and improvement of the microbiota. In this review, we highlight the currently available knowledge of the potential protective effects of LAB on preventing or mitigating menopausal symptoms, particularly in terms of maintaining balance in the vaginal microbiota, reducing bone loss, and regulating the nervous system and lipid metabolism. Given the increasing number of women entering menopause and the emphasis on the management of menopausal symptoms, LAB are likely to soon become an indispensable part of clinical/daily care for menopausal women. Herein, we do not intend to provide a comprehensive analysis of each menopausal disorder or to specifically judge the reliability and safety of complementary therapies; rather, we aim to highlight the potential roles of LAB in individualized treatment strategies for the clinical management of menopause.
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Affiliation(s)
- Qian Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Haojue Wang
- Department of Obstetrics and Gynecology, Wuxi Xishan People’s Hospital, Wuxi 214105, China
| | - Gang Wang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi 214122, China
- Yangzhou Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, China
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi 214122, China
- Yangzhou Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, China
| | - Haiqin Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi 214122, China
- Yangzhou Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, China
| | - Xianyi Lu
- Department of Obstetrics and Gynecology, Wuxi Xishan People’s Hospital, Wuxi 214105, China
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi 214122, China
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14
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Body fat distribution and insulin resistance among Korean middle-aged women: a Korean National Health and Nutrition Examination Survey. Obstet Gynecol Sci 2022; 65:468-476. [PMID: 35908650 PMCID: PMC9483664 DOI: 10.5468/ogs.22001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 07/14/2022] [Indexed: 11/08/2022] Open
Abstract
Objective To evaluate menopause-related changes in body fat distribution and their relationship with insulin resistance in middle-aged Korean women. Methods We analyzed women aged 40–60 years using data from the National Health and Nutrition Examination Survey conducted from 2008 to 2011. Body fat was measured using dual-energy X-ray absorptiometry. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Results Among 3,468 participants, menopausal women (n=1,489) had a higher body mass index (BMI) and higher trunk, arm, and head fat percentages than premenopausal women (n=1,979). However, no significant difference was found in the leg fat percentage according to menopausal status. Multivariable regression analysis for HOMA-IR showed that trunk fat percentage, BMI, and waist circumference positively correlated with insulin resistance and leg fat percentage negatively correlated after adjusting for several confounding factors, whereas menopausal status was not associated with HOMA-IR. Conclusion Middle-aged women not only have different body weights and BMI but also have different body fat distributions according to menopausal status. Each fat percentage change in the trunk and leg is differently associated with metabolic health, particularly insulin resistance. To evaluate the metabolic health of middle-aged women, BMI is generally noted; however, body fat distribution, which can be easily assessed using dual-energy X-ray absorptiometry, should also be considered.
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15
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Improvement of Peri-Implant Repair in Estrogen-Deficient Rats Fed a Cafeteria Diet and Treated with Risedronate Sodium. BIOLOGY 2022; 11:biology11040578. [PMID: 35453776 PMCID: PMC9025115 DOI: 10.3390/biology11040578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022]
Abstract
Simple Summary Postmenopausal osteoporosis, characterized by an imbalance in the remodeling cycle in which bone resorption exceeds bone formation, affects a large part of the population seeking rehabilitation with osseointegrated implants, making the prognosis of these patients unfavorable. It is estimated that approximately 99 million people over the age of 50 were diagnosed with osteoporosis in the United States in 2010. A range of drugs are used for the treatment of postmenopausal osteoporosis, aiming to prevent skeletal fractures in individuals with this osteometabolic disorder. Bisphosphonates are widely prescribed drugs to increase bone mineral density (BMD) and decrease the risk of skeletal fractures in patients with osteoporosis, with good results in this regard. However, little attention has been paid to the impact that the mechanism of action of this drug generates on the bone repair process, and more scientific evidence is needed to better understand the role of this drug in the peri-implant repair process. Abstract (1) Background: Postmenopausal osteoporosis combined with an unhealthy lifestyle can lead to the development of metabolic syndrome, a common condition in individuals requiring oral rehabilitation. Bisphosphonates are used to increase bone mineral density. However, further studies are needed to evaluate the action of this drug on the bone repair process in the jaws. The aim of this study was to evaluate the peri-implant repair of rats with estrogen deficiency and metabolic syndrome treated with risedronate sodium. (2) Methods: Twenty-four female Wistar rats were divided into three groups: SHAM: sham surgery; OVX/SM: ovariectomy combined with a cafeteria diet; OVX/SM/RIS: ovariectomy associated with a cafeteria diet and treatment with sodium risedronate. After 30 days, the animals underwent extraction of the upper first molars. Thirty days after the extraction, an implant was installed in the same region. Sixty days after the implant was installed, the animals were euthanized for biomechanical analysis and confocal microscopic analysis. After confirming the normal distribution of the sample data, a one-way ANOVA test was performed, followed by Tukey’s post-test, with a 5% significance level. (3) Results: Significant bone preservation was observed in the risedronate-treated group. Higher removal torque values were obtained by the risedronate-treated group. (4) Conclusions: Better biomechanical performance of the implants installed in the animals treated with risedronate sodium was observed.
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16
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Abstract
Menopause nomenclature varies in the scholarly literature making synthesis and interpretation of research findings difficult. Therefore, the present study aimed to review and discuss critical developments in menopause nomenclature; determine the level of heterogeneity amongst menopause definitions and compare them with the Stages of Reproductive Aging Workshop criteria. Definitions/criteria used to characterise premenopausal and postmenopausal status were extracted from 210 studies and 128 of these studies were included in the final analyses. The main findings were that 39.84% of included studies were consistent with STRAW classification of premenopause, whereas 70.31% were consistent with STRAW classification of postmenopause. Surprisingly, major inconsistencies relating to premenopause definition were due to a total lack of reporting of any definitions/criteria for premenopause (39.84% of studies). In contrast, only 20.31% did not report definitions/criteria for postmenopause. The present findings indicate that there is a significant amount of heterogeneity associated with the definition of premenopause, compared with postmenopause. We propose three key suggestions/recommendations, which can be distilled from these findings. Firstly, premenopause should be transparently operationalised and reported. Secondly, as a minimum requirement, regular menstruation should be defined as the number of menstrual cycles in a period of at least 3 months. Finally, the utility of introducing normative age-ranges as supplementary criterion for defining stages of reproductive ageing should be considered. The use of consistent terminology in research will enhance our capacity to compare results from different studies and more effectively investigate issues related to women's health and ageing.
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Affiliation(s)
- Ananthan Ambikairajah
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia.
- Discipline of Psychology, Faculty of Health, University of Canberra, Building 12, 11 Kirinari Street, Canberra, ACT, 2617, Australia.
| | - Erin Walsh
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia
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17
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Ko SH, Jung Y. Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients 2021; 13:nu13124556. [PMID: 34960109 PMCID: PMC8704126 DOI: 10.3390/nu13124556] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
Aging women experience hormonal changes, such as decreased estrogen and increased circulating androgen, due to natural or surgical menopause. These hormonal changes make postmenopausal women vulnerable to body composition changes, muscle loss, and abdominal obesity; with a sedentary lifestyle, these changes affect overall energy expenditure and basal metabolic rate. In addition, fat redistribution due to hormonal changes leads to changes in body shape. In particular, increased bone marrow-derived adipocytes due to estrogen loss contribute to increased visceral fat in postmenopausal women. Enhanced visceral fat lipolysis by adipose tissue lipoprotein lipase triggers the production of excessive free fatty acids, causing insulin resistance and metabolic diseases. Because genes involved in β-oxidation are downregulated by estradiol loss, excess free fatty acids produced by lipolysis of visceral fat cannot be used appropriately as an energy source through β-oxidation. Moreover, aged women show increased adipogenesis due to upregulated expression of genes related to fat accumulation. As a result, the catabolism of ATP production associated with β-oxidation decreases, and metabolism associated with lipid synthesis increases. This review describes the changes in energy metabolism and lipid metabolic abnormalities that are the background of weight gain in postmenopausal women.
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Affiliation(s)
- Seong-Hee Ko
- Department of Microbiology, College of Medicine, Gachon University, Incheon 21999, Korea;
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea
| | - YunJae Jung
- Department of Microbiology, College of Medicine, Gachon University, Incheon 21999, Korea;
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea
- Correspondence: ; Tel.: +82-32-899-6415
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18
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Hyvärinen M, Juppi HK, Taskinen S, Karppinen JE, Karvinen S, Tammelin TH, Kovanen V, Aukee P, Kujala UM, Rantalainen T, Sipilä S, Laakkonen EK. Metabolic health, menopause, and physical activity-a 4-year follow-up study. Int J Obes (Lond) 2021; 46:544-554. [PMID: 34802032 PMCID: PMC8605777 DOI: 10.1038/s41366-021-01022-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/09/2022]
Abstract
Background In women, metabolic health deteriorates after menopause, and the role of physical activity (PA) in mitigating the change is not completely understood. This study investigates the changes in indicators of metabolic health around menopause and evaluates whether PA modulates these changes. Methods Longitudinal data of 298 women aged 48–55 years at baseline participating in the ERMA and EsmiRs studies was used. Mean follow-up time was 3.8 (SD 0.1) years. Studied indicators of metabolic health were total and android fat mass, waist circumference, waist-to-hip ratio (WHR), systolic (SBP) and diastolic (DBP) blood pressure, blood glucose, triglycerides, serum total cholesterol, and high- (HDL-C) and low-density (LDL-C) lipoprotein cholesterol. PA was assessed by accelerometers and questionnaires. The participants were categorized into three menopausal groups: PRE-PRE (pre- or perimenopausal at both timepoints, n = 56), PRE-POST (pre- or perimenopausal at baseline, postmenopausal at follow-up, n = 149), and POST-POST (postmenopausal at both timepoints, n = 93). Analyses were carried out using linear and Poisson mixed-effect models. Results At baseline, PA associated directly with HDL-C and inversely with LDL-C and all body adiposity variables. An increase was observed in total (B = 1.72, 95% CI [0.16, 3.28]) and android fat mass (0.26, [0.06, 0.46]), SBP (9.37, [3.34, 15.39]), and in all blood-based biomarkers in the PRE-POST group during the follow-up. The increase tended to be smaller in the PRE-PRE and POST-POST groups compared to the PRE-POST group, except for SBP. The change in PA associated inversely with the change in SBP (−2.40, [−4.34, −0.46]) and directly with the change in WHR (0.72, [0.05, 1.38]). Conclusions In middle-aged women, menopause may accelerate the changes in multiple indicators of metabolic health. PA associates with healthier blood lipid profile and body composition in middle-aged women but does not seem to modulate the changes in most of the studied metabolic health indicators during the menopausal transition.
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Affiliation(s)
- Matti Hyvärinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Hanna-Kaarina Juppi
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sara Taskinen
- Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
| | - Jari E Karppinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sira Karvinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Vuokko Kovanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, Pelvic Floor Research and Therapy Unit, Central Finland Health Care District, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Timo Rantalainen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K Laakkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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19
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Roa-Díaz ZM, Raguindin PF, Bano A, Laine JE, Muka T, Glisic M. Menopause and cardiometabolic diseases: What we (don't) know and why it matters. Maturitas 2021; 152:48-56. [PMID: 34674807 DOI: 10.1016/j.maturitas.2021.06.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 01/11/2023]
Abstract
This narrative review discusses the current understanding, knowledge gaps and challenges in expanding our knowledge of the association between menopause and the reproductive aging process and cardiometabolic disease (CMD) in women, with a focus on type 2 diabetes and cardiovascular disease. The physiological changes that occur at different stages of the reproductive life span, as well as type of menopause and timing, are factors widely associated with CMD risk; however, the underlying mechanisms remain either unclear or insufficiently studied. Decreased ovarian estrogen production and relative androgen excess around menopause onset are the most studied factors linking menopause and cardiometabolic health; nevertheless, the evidence is not persuasive and other hypotheses might explain the changes in CMD risk during menopausal transition. In this context, hormone therapy has been widely adopted in the treatment and prevention of CMD, although uncertainty regarding its cardiometabolic effects has raised the need to optimize therapeutic modalities. Mechanisms such as the "iron overload theory" and new "omics" platforms could provide new insights into potential pathways underlying the association between menopause and cardiometabolic health, such as the DNA damage response. Although it has been widely reported that environmental and lifestyle factors affect both menopause and cardiometabolic health, there is little evidence on the role of these exposures in menopause-associated CMD risk.
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Affiliation(s)
- Zayne M Roa-Díaz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
| | - Arjola Bano
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jessica E Laine
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
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20
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Zandoná J, Ferreira CF, de Oliveira PG, Ferreira FV, Vasconcelos AO, Wender MCO. Early decrease in lean mass and bone mass in postmenopausal women: a cross-sectional study. Climacteric 2021; 25:96-102. [PMID: 34608839 DOI: 10.1080/13697137.2021.1978970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The effect of menopause transition in body composition was evaluated in a cross-sectional study. METHOD The study was carried out in an outpatient clinic of Brazil enrolling premenopausal (n = 64) and postmenopausal (n = 42) women aged between 44 and 52 years, with weight stability (±2 kg) for at least 6 months before evaluation. Participants answered a sociodemographic semi-structured questionnaire, the Menopause Rating Scale, the International Physical Activity Questionnaire, 24-h dietary recall and a visual analogue scale of appetite. Blood biochemical, anthropometry and densitometry measurements were used for body composition estimation. RESULTS Most participants were overweight (31.4%) or obese (45.7%) and categorized as 'high active' in physical activity (65.7%). Lean mass and bone mass decreased in the first few years of menopause. A metabolic turn to an increase of lipids was observed, represented by greater total cholesterol and high-density lipoprotein cholesterol levels. Menopause transition did not alter body fat distribution. Total body fat, android fat and gynoid fat were positively related to smoking habit, and android fat was also positively related to waist circumference. CONCLUSION Taken together, early postmenopause can be considered a time window of opportunity for preventing ailments such as atherogenic profile, obesity, increased cardiovascular risk and osteoporosis.
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Affiliation(s)
- J Zandoná
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Grupo de Pesquisa: Climatério e Menopausa, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
| | - C F Ferreira
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Grupo de Pesquisa: Climatério e Menopausa, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
| | - P G de Oliveira
- Grupo de Pesquisa: Climatério e Menopausa, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Programa de Pós-Graduação em Medicina: Ciências Médicas (PPGCM), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
| | - F V Ferreira
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Grupo de Pesquisa: Climatério e Menopausa, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
| | - A O Vasconcelos
- Departamento de Nutrição, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
| | - M C O Wender
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Grupo de Pesquisa: Climatério e Menopausa, Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil.,Programa de Pós-Graduação em Medicina: Ciências Médicas (PPGCM), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
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21
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Dvornyk V, Churnosov M, Deng HW. Polymorphisms of the TNF, LTA, and TNFRSF1B genes are associated with onsets of menarche and menopause in US women of European ancestry. Ann Hum Biol 2021; 48:400-405. [PMID: 34595982 DOI: 10.1080/03014460.2021.1987519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The TNF, LTA and TNFRSF1B genes have been implicated in various traits related to menarche and menopause. AIM To analyse the TNF, LTA and TNFRSF1B genes for their association with ages at menarche (AM) and natural menopause (ANM). SUBJECTS AND METHODS The study sample consisted of 314 unrelated females of European ancestry. Twenty SNPs located in and near the genes were analysed using various statistical methods. In addition, the functional significance of the loci associated with AM and ANM was analysed in silico. RESULTS Locus rs2229094 of the LTA gene was associated with AM according to the additive (β = -0.295, pperm = 0.016) and recessive (β = -0.940, pperm = 0.016) genetic models. Haplotype GG rs1148459-rs590368 of the TNFRSF1B gene was associated with AM (β = 0.307, pperm = 0.023). Haplotype GCA rs2844484-rs2229094-rs1799964 was associated with ANM after adjustment for covariates (β = -1.020, pperm = 0.035). All studied loci were associated with ANM after adjustment for breastfeeding (raw p < 0.05). In addition, eight of the most significant models of interlocus interactions were associated with AM and five with ANM. CONCLUSION The results of the present study suggest that the TNF, LTA and TNFRSF1B genes are associated with AM and ANM.
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Affiliation(s)
- Volodymyr Dvornyk
- Department of Life Sciences, College of Science and General Studies, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Mikhail Churnosov
- Department of Medical Biological Disciplines, Belgorod State University, Belgorod, Russia
| | - Hong-Wen Deng
- Deming Department of Medicine, School of Medicine, Tulane Centre of Biomedical Informatics and Genomics, Tulane University, New Orleans, LA, USA
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22
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Riat A, Suwandi A, Ghashang SK, Buettner M, Eljurnazi L, Grassl GA, Gutenbrunner C, Nugraha B. Ramadan Fasting in Germany (17-18 h/Day): Effect on Cortisol and Brain-Derived Neurotrophic Factor in Association With Mood and Body Composition Parameters. Front Nutr 2021; 8:697920. [PMID: 34458302 PMCID: PMC8387581 DOI: 10.3389/fnut.2021.697920] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/07/2021] [Indexed: 12/22/2022] Open
Abstract
Ramadan fasting (RF) is a type of diurnal intermittent fasting. Previous studies reported the benefits of RF in healthy subjects on mood and health related to quality of life (QoL). Cortisol and brain-derived neurotrophic factor (BDNF) have been shown to play a role in mood, body composition parameters, and health-related QoL. This study aimed at elucidating the mechanism of the benefit of RF, particularly cortisol and BNDF and their association with mood and QoL. Insulin growth factor-1 (IGF-1), interleukin (IL)-8, matrix metalloproteinase (MMP)-9, and myoglobin were determined. Thirty-four healthy men and women were recruited. Serum from peripheral venous blood samples was collected at five time points: 1 week before RF (T1); mid of RF (T2), last days of RF (T3), 1 week after RF (T4), and 1 month after RF (T5). The amounts of biological mediators in the serum samples were determined by enzyme-linked immunosorbent assay (ELISA) and Luminex assays. BDNF and cortisol significantly decreased at T3 (p < 0.05) and T4 (p < 0.001) compared to T1, respectively. It seems the benefits of RF for mood-related symptoms are mediated by different biological mediators, particularly cortisol and BDNF.
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Affiliation(s)
- Amin Riat
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
| | - Abdulhadi Suwandi
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School and German Center for Infection Research (DZIF), Hannover, Germany.,Institute of Cell Biochemistry, Center of Biochemistry, Hannover Medical School, Hannover, Germany
| | - Samaneh Khoshandam Ghashang
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany.,Department of Dermatology, Johannes Wesling Medical Centre, Minden, Germany
| | - Manuela Buettner
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Luqman Eljurnazi
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
| | - Guntram A Grassl
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School and German Center for Infection Research (DZIF), Hannover, Germany
| | | | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
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23
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Yeh JH, Tung YT, Yeh YS, Chien YW. Effects of Dietary Fatty Acid Composition on Lipid Metabolism and Body Fat Accumulation in Ovariectomized Rats. Nutrients 2021; 13:nu13062022. [PMID: 34208400 PMCID: PMC8231186 DOI: 10.3390/nu13062022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Obesity is a state of excess energy storage resulting in body fat accumulation, and postmenopausal obesity is a rising issue. In this study using ovariectomized (OVX) rats, we mimicked low estrogen levels in a postmenopausal state in order to investigate the effects of different amounts and types of dietary fatty acids on body fat accumulation and body lipid metabolism. Methods: At 9 weeks of age, rats (n = 40) were given an ovariectomy, eight of which were sham-operated to serve as a control group (S). We then divided OVX rats into four different intervention groups: diet with 5% soybean oil (C), and diet with 5% (L), 15% (M), and 20% (H) (w/w) experimental oil, containing 60% monounsaturated fatty acids (MUFAs) and with a polyunsaturated/saturated fatty acid (P/S) ratio of 5. Results: After OVX, compared to the S group, the C group showed significantly higher body weight, and insulin and leptin levels. Compared to the C group, the H group had lower hepatic triglyceride level and FAS enzyme activity, and higher hepatic ACO and CPT-1 gene expressions and enzyme activities. Conclusions: An OVX leads to severe weight gain and lipid metabolism abnormalities, while according to previous studies, high fat diet may worsen the situation. However, during our experiment, we discovered that the experimental oil mixture with 60% MUFAs and P/S = 5 may ameliorate these imbalances.
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Affiliation(s)
- Jhih-Han Yeh
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan;
| | - Yu-Tang Tung
- Graduate Institute of Biotechnology, National Chung Hsing University, Taichung 40227, Taiwan;
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Sheng Yeh
- Department of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63112, USA;
| | - Yi-Wen Chien
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan;
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 6556); Fax: +886-2-2737-3112
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24
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Barghandan N, Dolatkhah N, Eslamian F, Ghafarifar N, Hashemian M. Association of depression, anxiety and menopausal-related symptoms with demographic, anthropometric and body composition indices in healthy postmenopausal women. BMC WOMENS HEALTH 2021; 21:192. [PMID: 33962601 PMCID: PMC8105920 DOI: 10.1186/s12905-021-01338-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/29/2021] [Indexed: 11/16/2022]
Abstract
Background The termination of the menstrual cycle is correlated with a number of physiological alterations and symptoms that can negatively impact emotion and mood. We aimed to investigate the association of anxiety, depression, and menopausal related symptoms with demographic, anthropometric, and body composition indices in healthy postmenopausal women. Methods A total of 320 menopausal women were selected randomly from referrals of health centers between January and June 2018 in Tabriz/Iran. All participants completed a demographic questionnaire. Bioelectrical impedance analysis was applied to evaluate body fat mass (BFM), soft lean mass (SLM), and lean body mass (LBM) of participants. The modified Kupperman index, Beck's depression inventory-II, and Spielberger’s state-trait anxiety inventory were applied to measure the severity of menopausal-related symptoms, the frequency, and severity of the symptoms of depression and state (SA) and trait anxiety (TA), respectively. Results Finally, 245 postmenopausal women with age of 55.33 ± 4.48 years and body mass index (BMI) of 27.96 ± 3.22 kg/m2 were studied. Women with the age of 55 years and older (OR 3.928, 95% CI 1.504–10.256) and also women with mild physical activity (OR 10.104, 95% CI 3.785–26.976) had a greater possibility of having mild and moderate depression in comparison with women less than 50 years old and women with moderate and severe physical activity. Moderate and severe physical activity was correlated with a lower possibility of having medium upward, relatively severe and severe TA in comparison with participants with mild physical activity in these women (OR 0.372, 95% CI 0.151–0.917). Women with higher BMI and BFM had and more severe menopause-related symptoms (r = 0.143, p = 0.025 and r = 0.139, p = 0.030, respectively) and more severe TA symptoms (r = 0.198, p = 0.018 and r = 0.151, p = 0.021, respectively). Women with lower LBM (r = − 0.139, p = 0.031) and lower SLM (r = − 0.128, p = 0.047) had more severe depressive symptoms. Conclusion Postmenopausal women with higher age and lower physical activity had a greater possibility of having mild and moderate depression. Lower physical activity was also correlated with a greater possibility of having medium upward to severe TA symptoms. Postmenopausal women with higher BMI and BFM had more severe menopause-related and TA symptoms. Women with lower LBM and SLM had more severe depressive symptoms.
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Affiliation(s)
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Emam Reza Hospital, Tabriz University of Medical Sciences, Golgasht, Azadi Ave., Tabriz, Iran.
| | - Fariba Eslamian
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahal Ghafarifar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Hashemian
- Department of Biology, School of Art and Science, Utica College, Utica, NY, USA
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25
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Freitas ATA, Donovan Giraldo AE, Pravatta Rezende G, Yela DA, Jales RM, Benetti-Pinto CL. Body composition in women with premature ovarian insufficiency using hormone therapy and the relation to cardiovascular risk markers: A case-control study. Clin Endocrinol (Oxf) 2021; 94:111-118. [PMID: 32939768 DOI: 10.1111/cen.14331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare body composition between women with premature ovarian insufficiency (POI) using hormone therapy and controls with normal ovarian function, and to correlate body composition with cardiovascular risk markers in the POI group. PATIENTS AND DESIGN A case-control study of 70 women with POI matched by age and body mass index with 70 controls. MEASUREMENTS All were submitted to whole-body dual-energy X-ray absorptiometry (DXA) to analyse body composition. In the POI group, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides, glucose, insulin, transaminases and C-reactive protein levels were measured, as well as the thickness of the carotid artery intima-media complex. RESULTS Total mass, fat mass, lean mass (total, percentage and index) and the android/gynoid (A/G) ratio were similar in both groups; however, bone mineral content was lower (P < .001) in the POI group. Lean and fat mass indexes were 14.19 ± 1.63 and 11.04 ± 3.58, respectively, and the percentage of gynoid to android fat was higher (51.17 ± 6.71% versus 47.74 ± 9.19%; A/G ratio = 0.93 ± 0.15) in the POI group. In addition, the increase in total mass correlated positively with glucose and ALT levels and negatively with HDL-cholesterol. Increased A/G ratio was the measurement most frequently associated with cardiovascular risk markers. CONCLUSION The body composition of women with POI using hormone therapy is similar to that of women with normal ovarian function with regard to lean and fat mass content and fat distribution. In women with POI, the higher the A/G ratio, the worse the cardiovascular risk markers.
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Affiliation(s)
- Alberto T A Freitas
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Andrea E Donovan Giraldo
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Gabriela Pravatta Rezende
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Daniela A Yela
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Rodrigo M Jales
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Cristina L Benetti-Pinto
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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26
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Sipilä S, Törmäkangas T, Sillanpää E, Aukee P, Kujala UM, Kovanen V, Laakkonen EK. Muscle and bone mass in middle-aged women: role of menopausal status and physical activity. J Cachexia Sarcopenia Muscle 2020; 11:698-709. [PMID: 32017473 PMCID: PMC7296268 DOI: 10.1002/jcsm.12547] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/09/2019] [Accepted: 01/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Women experience drastic hormonal changes during midlife due to the menopausal transition. Menopausal hormonal changes are known to lead to bone loss and potentially also to loss of lean mass. The loss of muscle and bone tissue coincide due to the functional relationship and interaction between these tissues. If and how physical activity counteracts deterioration in muscle and bone during the menopausal transition remains partly unresolved. This study investigated differences between premenopausal, early perimenopausal, late perimenopausal, and postmenopausal women in appendicular lean mass (ALM), appendicular lean mass index (ALMI), femoral neck bone mineral density (BMD) and T score. Furthermore, we investigated the simultaneous associations of ALM and BMD with physical activity in the above-mentioned menopausal groups. METHODS Data from the Estrogen Regulation of Muscle Apoptosis study were utilized. In total, 1393 women aged 47-55 years were assigned to premenopausal, early perimenopausal, late perimenopausal, and postmenopausal groups based on follicle-stimulating hormone concentration and bleeding diaries. Of them, 897 were scanned for ALM and femoral neck BMD by dual-energy X-ray absorptiometry and ALMI (ALM/height2 ) and neck T scores calculated. Current level of leisure-time physical activity was estimated by a validated self-report questionnaire and categorized as sedentary, low, medium, and high. RESULTS Appendicular lean mass, appendicular lean mass index, femoral neck bone mineral density, and and T score showed a significant linear declining trend across all four menopausal groups. Compared with the postmenopausal women, the premenopausal women showed greater ALM (18.2, SD 2.2 vs. 17.8, SD 2.1, P < 0.001), ALMI (6.73, SD 0.64 vs. 6.52, SD 0.62, P < 0.001), neck BMD (0.969, SD 0.117 vs. 0.925, SD 0.108, P < 0.001), and T score (-0.093, SD 0.977 vs -0.459, SD 0.902, P < 0.001). After adjusting for potential confounding pathways, a higher level of physical activity was associated with greater ALM among the premenopausal [β = 0.171; confidence interval (CI) 95% 0.063-0.280], late perimenopausal (β = 0.289; CI 95% 0.174-0.403), and postmenopausal (β=0.278; CI 95% 0.179-0.376) women. The positive association between femoral neck BMD and level of physical activity was significant only among the late perimenopausal women (β = 0.227; CI 95% 0.097-0.356). CONCLUSIONS Skeletal muscle and bone losses were associated with the menopausal transition. A higher level of physical activity during the different menopausal phases was beneficial, especially for skeletal muscle. Menopause-related hormonal changes predispose women to sarcopenia and osteoporosis and further to mobility disability and fall-related fractures in later life. New strategies are needed to promote physical activity among middle-aged women. Longitudinal studies are needed to confirm these results.
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Affiliation(s)
- Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Timo Törmäkangas
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Elina Sillanpää
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, Pelvic Floor Research and Therapy Unit, Central Finland Central Hospital, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Vuokko Kovanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K Laakkonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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27
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Barrea L, Pugliese G, Laudisio D, Colao A, Savastano S, Muscogiuri G. Mediterranean diet as medical prescription in menopausal women with obesity: a practical guide for nutritionists. Crit Rev Food Sci Nutr 2020; 61:1201-1211. [PMID: 32329636 DOI: 10.1080/10408398.2020.1755220] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Menopausal transition is associated with weight gain and increased visceral fat distribution, which acts as an endocrine organ secreting the pro-inflammatory adipocytokines, which leads to metabolic disorders typical of menopause, including type 2 diabetes and cardiovascular diseases. Given the increasing number of aging population, the nutritional strategies to prevent obesity and obesity-related diseases in menopausal women is becoming a growing need and it should be one of the main objective for Nutritionists. The Mediterranean diet is characterized from foods with anti-inflammatory and antioxidant actions, such as extra-virgin olive oil, vegetables, fruits, legumes, nuts, red wine, and whole-grain cereals. Several evidences showed that the Mediterranean diet acts on both weight control and menopause, in addition to the known effects of the Mediterranean diet on cardiovascular and metabolic diseases. The Mediterranean diet is comparable with pharmacological interventions in terms of reducing the risk of obesity and cardiovascular and metabolic events. Considering that there are no specific dietary guidelines to manage weight in menopause, the aim of this review is to provide a nutritional guideline for the management of weight in menopause, particularly focusing on the Mediterranean diet.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile," University Federico II, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
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28
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Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients 2020; 12:nu12010202. [PMID: 31941004 PMCID: PMC7019719 DOI: 10.3390/nu12010202] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals—and their food sources—to aid the management of abnormal lipid metabolism in postmenopausal women.
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29
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Pérez-López FR, Chedraui P, Pilz S. Vitamin D supplementation after the menopause. Ther Adv Endocrinol Metab 2020; 11:2042018820931291. [PMID: 32551035 PMCID: PMC7278294 DOI: 10.1177/2042018820931291] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/10/2020] [Indexed: 12/14/2022] Open
Abstract
The purpose of this review was to assess recent evidence regarding the effects of low vitamin D levels on some highly prevalent clinical conditions of postmenopausal women. We reviewed and selected recent literature regarding menopause-related conditions associated with vitamin D deficiency and interventions to manage them. Low circulating 25-hydroxyvitamin D (25(OH)D) levels related to menopause are linked to diet, lifestyle, changes in body composition, insulin sensitivity, and reduced physical activity. Vitamin D supplementation increases serum 25(OH)D levels while normalizing parathyroid hormone and bone markers, and in women with serum 25(OH)D levels below 10 ng/ml supplementation may improve bone mineral density. Low vitamin D status has been associated with the metabolic syndrome, high triglyceride levels, and low high-density lipoprotein cholesterol levels. When compared with placebo, vitamin D supplementation may lower the risk of the metabolic syndrome, hypertriglyceridemia, and hyperglycemia. There is an inverse relationship between fat mass and serum 25(OH)D levels and, therefore, the dosage of supplementation should be adjusted according to the body mass index. Although vitamin D supplementation may improve glucose metabolism in prediabetic subjects, data regarding muscle strength are conflictive. There is evidence that vitamin D over-treatment, to reach extremely high circulating 25(OH)D levels, does not result in better clinical outcomes. The identification and treatment of vitamin D deficiency in postmenopausal women may improve their general health and health outcomes. Vitamin D supplementation should preferably be based on the use of either cholecalciferol or calcifediol.
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Affiliation(s)
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, and Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción, Asunción, Paraguay
| | - Stefan Pilz
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
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30
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Ambikairajah A, Walsh E, Tabatabaei-Jafari H, Cherbuin N. Fat mass changes during menopause: a metaanalysis. Am J Obstet Gynecol 2019; 221:393-409.e50. [PMID: 31034807 DOI: 10.1016/j.ajog.2019.04.023] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/15/2019] [Accepted: 04/19/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Data: Fat mass has been shown to increase in aging women; however, the extent to which menopausal status mediates these changes remains unclear. The purpose of this review was to determine (1) how fat mass differs in quantity and distribution between premenopausal and postmenopausal women, (2) whether and how age and/or menopausal status moderates any observed differences, and (3) which type of fat mass measure is best suited to the detection of differences in fat mass between groups. STUDY This review with metaanalyses is reported according to Metaanalysis of Observational Studies in Epidemiology guidelines. STUDY APPRAISAL AND SYNTHESIS METHODS Studies (published up to May 2018) were identified via PubMed to provide fat mass measures in premenopausal and postmenopausal women. We included 201 cross-sectional studies in the metaanalysis, which provided a combined sample size of 1,049,919 individuals and consisted of 478,734 premenopausal women and 571,185 postmenopausal women. Eleven longitudinal studies were included in the metaanalyses, which provided a combined sample size of 2472 women who were premenopausal at baseline and postmenopausal at follow up. RESULTS The main findings of this review were that fat mass significantly increased between premenopausal and postmenopausal women across most measures, which included body mass index (1.14 kg/m2; 95% confidence interval, 0.95-1.32 kg/m2), bodyweight (1 kg; 95% confidence interval, 0.44-1.57 kg), body fat percentage (2.88%; 95% confidence interval, 2.13-3.63%), waist circumference (4.63 cm; 95% confidence interval, 3.90-5.35 cm), hip circumference (2.01 cm; 95% confidence interval, 1.36-2.65 cm), waist-hip ratio (0.04; 95% confidence interval, 0.03-0.05), visceral fat (26.90 cm2; 95% confidence interval, 13.12-40.68), and trunk fat percentage (5.49%; 95% confidence interval, 3.91-7.06 cm2). The exception was total leg fat percentage, which significantly decreased (-3.19%; 95% confidence interval, -5.98 to -0.41%). No interactive effects were observed between menopausal status and age across all fat mass measures. CONCLUSION The change in fat mass quantity between premenopausal and postmenopausal women was attributable predominantly to increasing age; menopause had no significant additional influence. However, the decrease in total leg fat percentage and increase in measures of central fat are indicative of a possible change in fat mass distribution after menopause. These changes are likely to, at least in part, be due to hormonal shifts that occur during midlife when women have a higher androgen (ie, testosterone) to estradiol ratio after menopause, which has been linked to enhanced central adiposity deposition. Evidently, these findings suggest attention should be paid to the accumulation of central fat after menopause, whereas increases in total fat mass should be monitored consistently across the lifespan.
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Zhou H, Zhang C, Ni J, Han X. Prevalence of cardiovascular risk factors in non-menopausal and postmenopausal inpatients with type 2 diabetes mellitus in China. BMC Endocr Disord 2019; 19:98. [PMID: 31601203 PMCID: PMC6787985 DOI: 10.1186/s12902-019-0427-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To investigate the prevalence of cardiovascular disease (CVD) risk factors and assess the 10-year risk of CVD in non-menopausal and postmenopausal women with type 2 diabetes mellitus (T2DM). METHODS A total of 569 patients with T2DM at a Chinese tertiary hospital were investigated using the Framingham Risk Score (FRS). We evaluated the 10-year risk of CVD, clinical and menopause characteristics in all subjects. RESULTS Among the 569 diabetic patients, the incidence of smoking, dyslipidemia, hypertension, overweight or obesity, and nonalcoholic fatty liver disease (NAFLD) was 0.7, 36.2, 38.1 56.6 and 58.2%, respectively. The usage rate of hypoglycemic agents, antihypertensive agents, lipid modulators and antithrombotic drugs was 88.6, 78.3, 50.0 and 27.1%, respectively. However, only 1.2% of inpatients achieved the three target goals for the control of blood glucose (HbA1c < 7%), blood pressure (systolic blood pressure < 130 mmHg, diastolic blood pressure < 80 mmHg), and blood lipids (total cholesterol < 174 mg/dL). The 10-year risk of CVD was (1.6 ± 1.5%) and tended to increase along with age (F = 27.726, P < 0.001). For all subjects (n = 569), multiple linear regression analysis showed that menopause (β = 0.275, P < 0.001), low-density lipoprotein cholesterol (LDL-C) (β = 0.212, P < 0.001), fasting plasma glucose (FPG) (β = 0.093, P = 0.018) and waist-to-hip-ratio (β = - 0.078, P = 0.047) were risk factors of 10-year risk of CVD, which may explain the variance of 14.3%. In the postmenopausal group (n = 397), LDL-C (β = 0.227, P < 0.001), FPG (β = 0.139, P = 0.003) and time since menopause (β = 0.230, P < 0.001) were found to be associated with CVD, which may explain the variance of 14.6%. CONCLUSION The incidence of dyslipidmia, hypertension, overweight or obesity and NAFLD is high. The level of control of blood glucose, blood pressure, and blood lipids was found to be extremely low and the treatment status was not ideal. Besides menopause, LDL-C, FPG and time since menopause were found to be independent risk factors for the 10-year risk of CVD. Therefore, it is necessary to focus on comprehensive control of multiple risk factors, such as plasma glucose, blood pressure and serum lipid.
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Affiliation(s)
- Huanhuan Zhou
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Chenghuan Zhang
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Jingyu Ni
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China
| | - Xiaoyun Han
- The First People's Hospital of Changzhou, 185# Juqian Road, Changzhou, 213000, Jiangsu Province, China.
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Savukoski S, Mäkelä H, Auvinen J, Jokelainen J, Puukka K, Ebeling T, Suvanto E, Niinimäki M. Climacteric Status at the Age of 46: Impact on Metabolic Outcomes in Population-Based Study. J Clin Endocrinol Metab 2019; 104:2701-2711. [PMID: 30753521 DOI: 10.1210/jc.2018-02025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/05/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT Menopausal transition is associated with increased cardiovascular risks. Available data on the effect of earlier climacterium on these risks are limited. OBJECTIVE To compare cardiovascular risk-associated parameters at the ages of 14, 31, and 46 in relation to climacteric status at the age of 46. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study including 2685 women from the Northern Finland Birth Cohort 1966. MAIN OUTCOME MEASURES Follicle-stimulating hormone, body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), blood pressure (BP), body composition, cholesterol levels, testosterone (T) levels, free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and liver enzymes. RESULTS Women who were climacteric at the age of 46 had lower BMIs (P = 0.029), T levels (P = 0.018), and FAIs (P = 0.009) at the age of 31. At the age of 46, they had less skeletal muscle (P < 0.001), a higher fat percentage (P = 0.016), higher cholesterol levels [total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), high-density lipoprotein cholesterol (HDL-C; P = 0.022), and triglycerides (P = 0.008)], and higher alanine aminotransferase (P = 0.023) and γ-glutamyltransferase (P < 0.001) levels compared with preclimacteric women. Waist circumference, WHR, BP, and hs-CRP levels did not differ between the groups. Of the climacteric women, 111/381 were using hormone-replacement therapy (HRT). In subanalysis that excluded the HRT users, triglycerides, HDL-C, and body fat percentage did not differ among the groups. CONCLUSIONS Earlier climacterium is associated with mainly unfavorable metabolic changes.
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Affiliation(s)
- Susanna Savukoski
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hannele Mäkelä
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Oulunkaari Health Centre, Ii, Finland
| | - Jari Jokelainen
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
- Centre for Life Course Epidemiology and Systems Medicine, University of Oulu, Oulu, Finland
| | - Katri Puukka
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- NordLab Oulu, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Tapani Ebeling
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Internal Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eila Suvanto
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maarit Niinimäki
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Mattina GF, Van Lieshout RJ, Steiner M. Inflammation, depression and cardiovascular disease in women: the role of the immune system across critical reproductive events. Ther Adv Cardiovasc Dis 2019; 13:1753944719851950. [PMID: 31144599 PMCID: PMC6545651 DOI: 10.1177/1753944719851950] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Women are at increased risk for developing depression and cardiovascular disease (CVD) across the lifespan and their comorbidity is associated with adverse outcomes that contribute significantly to rates of morbidity and mortality in women worldwide. Immune-system activity has been implicated in the etiology of both depression and CVD, but it is unclear how inflammation contributes to sex differences in this comorbidity. This narrative review provides an updated synthesis of research examining the association of inflammation with depression and CVD, and their comorbidity in women. Recent research provides evidence of pro-inflammatory states and sex differences associated with alterations in the hypothalamic–pituitary–adrenal axis, the renin–angiotensin–aldosterone system and the serotonin/kynurenine pathway, that likely contribute to the development of depression and CVD. Changes to inflammatory cytokines in relation to reproductive periods of hormonal fluctuation (i.e. the menstrual cycle, perinatal period and menopause) are highlighted and provide a greater understanding of the unique vulnerability women experience in developing both depressed mood and adverse cardiovascular events. Inflammatory biomarkers hold substantial promise when combined with a patient’s reproductive and mental health history to aid in the prediction, identification and treatment of the women most at risk for CVD and depression. However, more research is needed to improve our understanding of the mechanisms underlying inflammation in relation to their comorbidity, and how these findings can be translated to improve women’s health.
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Affiliation(s)
- Gabriella F Mattina
- Neuroscience Graduate Program, McMaster University, 1280 Main Street West, ON L8S 4L8, Canada
| | - Ryan J Van Lieshout
- Neuroscience Graduate Program, McMaster University, ON, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Meir Steiner
- Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
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Greendale GA, Sternfeld B, Huang M, Han W, Karvonen-Gutierrez C, Ruppert K, Cauley JA, Finkelstein JS, Jiang SF, Karlamangla AS. Changes in body composition and weight during the menopause transition. JCI Insight 2019; 4:124865. [PMID: 30843880 DOI: 10.1172/jci.insight.124865] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/25/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The relation between the menopause transition (MT) and changes in body composition or weight remains uncertain. We hypothesized that, independent of chronological aging, the MT would have a detrimental influence on body composition. METHODS Participants were from the longitudinal Study of Women's Health Across the Nation (SWAN) cohort. We assessed body composition by dual energy x-ray absorptiometry. Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of outcomes as a function of time before or after the final menstrual period (FMP). Covariates were age at FMP, race, study site, and hormone therapy. RESULTS Fat and lean mass increased prior to the MT. At the start of the MT, rate of fat gain doubled, and lean mass declined; gains and losses continued until 2 years after the FMP. After that, the trajectories of fat and lean mass decelerated to zero slope. Weight climbed linearly during premenopause without acceleration at the MT. Its trajectory became flat after the MT. CONCLUSION Accelerated gains in fat mass and losses of lean mass are MT-related phenomena. The rate of increase in the sum of fat mass and lean mass does not differ between premenopause and the MT; thus, there is no discernable change in rate of weight gain at the start of the MT. FUNDING NIH, Department of Health and Human Services (DHHS), through the National Institute on Aging, National Institute of Nursing Research, and NIH Office of Research on Women's Health (U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, and U01AG012495).
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Affiliation(s)
- Gail A Greendale
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, California, USA
| | | | - MeiHua Huang
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, California, USA
| | - Weijuan Han
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, California, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristine Ruppert
- Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joel S Finkelstein
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sheng-Fang Jiang
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Arun S Karlamangla
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, California, USA
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Karvinen S, Jergenson MJ, Hyvärinen M, Aukee P, Tammelin T, Sipilä S, Kovanen V, Kujala UM, Laakkonen EK. Menopausal Status and Physical Activity Are Independently Associated With Cardiovascular Risk Factors of Healthy Middle-Aged Women: Cross-Sectional and Longitudinal Evidence. Front Endocrinol (Lausanne) 2019; 10:589. [PMID: 31543865 PMCID: PMC6729112 DOI: 10.3389/fendo.2019.00589] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/12/2019] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease (CVD) is the primary cause of mortality in women in developed countries. CVD risk rises with age, yet for women there is a rapid increase in CVD risk that occurs after the onset of menopause. This observation suggests the presence of factors in the middle-aged women that accelerate the progression of CVD independent of chronological aging. Leisure time physical activity (LTPA) is a well-established protective factor against CVD. However, its role in attenuating atherogenic lipid profile changes and CVD risk in post-menopausal women has not been well-established. The present study is part of the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, a population-based cohort study in which middle-aged Caucasian women (47-55) were classified into pre-menopausal, peri-menopausal, and post-menopausal groups based on follicle stimulating hormone levels and bleeding patterns. Comprehensive questionnaires, laboratory visits, anthropometric measurements, and physical activity monitoring by accelerometers were used to characterize the menopausal groups and serum lipid profiles were analyzed to quantify CV (cardiovascular) risk factors. Based on our findings, LTPA may attenuate menopause-associated atherogenic changes in the serum CV risk factors of healthy middle-aged women. However, LTPA does not seem to entirely offset the lipid profile changes associated with the menopausal transition.
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Affiliation(s)
- Sira Karvinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Matthew J Jergenson
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Matti Hyvärinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Pelvic Floor Research and Therapy Unit, Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Vuokko Kovanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K Laakkonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Louis XL, Raj P, Chan L, Zieroth S, Netticadan T, Wigle JT. Are the cardioprotective effects of the phytoestrogen resveratrol sex-dependent? 1. Can J Physiol Pharmacol 2018; 97:503-514. [PMID: 30576226 DOI: 10.1139/cjpp-2018-0544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cardiovascular disease (CVD) is the number one cause of death in both men and women. Younger women have a lower risk for CVD, but their risk increases considerably after menopause when estrogen levels decrease. The cardiovascular protective properties of estrogen are mediated through decreasing vascular inflammation and progression of atherosclerosis, decreasing endothelial cell damage by preventing apoptosis and anti-hypertrophic mechanisms. Estrogen also regulates glucose and lipid levels, which are 2 important risk factors for CVD. Resveratrol (RES), a cardioprotective polyphenolic compound, is classified as a phytoestrogen due its capacity to bind to and modulate estrogen receptor signalling. Due to its estrogen-like property, we speculate that the cardioprotective effects of RES treatment could be sex-dependent. Based on earlier reports and more recent data from our lab presented here, we found that RES treatment may have more favourable cardiovascular outcomes in females than in males. This review will discuss estrogen- and phytoestrogen-mediated cardioprotection, with a specific focus on sex-dependent effects reported in preclinical and clinical studies.
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Affiliation(s)
- Xavier Lieben Louis
- a Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada.,b Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R2E 3N4, Canada
| | - Pema Raj
- c Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R2E 0J9, Canada.,d Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen, Research Centre, Winnipeg, MB R2H 2A6, Canada
| | - Laura Chan
- a Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada.,b Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R2E 3N4, Canada
| | - Shelley Zieroth
- c Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R2E 0J9, Canada.,e Section of Cardiology, Department of Medicine, University of Manitoba, Winnipeg, MB R3A 1R9, Canada
| | - Thomas Netticadan
- d Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen, Research Centre, Winnipeg, MB R2H 2A6, Canada.,f Agriculture and Agri-Food Canada, Winnipeg, MB R3C 3G7, Canada
| | - Jeffrey T Wigle
- a Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada.,b Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R2E 3N4, Canada
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Deng Y, Xue W, Wang Y, Zhu S, Ma X, Sun A. Effects of different menopausal hormone replacement regimens on body composition in Chinese women. Climacteric 2018; 21:607-612. [PMID: 30380948 DOI: 10.1080/13697137.2018.1523387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim of this study was to determine the effects of different menopausal hormone therapy regimens on body composition in healthy postmenopausal Chinese women. MATERIALS AND METHODS One hundred and twenty-three healthy postmenopausal Chinese women were randomly assigned to either group A (0.625 mg conjugated equine estrogens [CEE] plus 100 mg micronized progesterone [MP]), group B (0.3 mg CEE plus 100 mg MP), or group C (0.625 mg CEE plus 10 mg dydrogesterone). Body composition was assessed by dual-energy X-ray absorptiometry. RESULTS One hundred and two women completed the trial at 1 year. A small but significant gain in lean body mass (619 ± 1019 g, p = 0.002) and a decrease of fat mass in all separate regions was observed in group A. A significant shift from gynoid to android fat distribution was observed in group B and group C (android/gynoid fat percentage ratios increased by 0.06 ± 0.08, p = 0.000 and 0.03 ± 0.08, p = 0.018, respectively), whereas no significant change was observed in group A (0.02 ± 0.06, p = 0.103). CONCLUSIONS In healthy postmenopausal Chinese women, 0.625 mg of CEE combined with 100 mg of MP was associated with a more favorable fat distribution compared with 0.3 mg CEE plus 100 mg MP or 0.625 mg CEE plus 10 mg dydrogesterone.
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Affiliation(s)
- Y Deng
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
| | - W Xue
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
| | - Y Wang
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
| | - S Zhu
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
| | - X Ma
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
| | - A Sun
- a Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China
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