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Song DK, Hong YS, Sung YA, Lee H. The effect of menopause on cardiovascular risk factors according to body mass index in middle-aged Korean women. PLoS One 2023; 18:e0283393. [PMID: 36952503 PMCID: PMC10035845 DOI: 10.1371/journal.pone.0283393] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Menopausal status and obesity are associated with an increased risk for cardiovascular diseases. However, there are few studies on the effect of menopause on cardiovascular risk factors according to the degree of obesity during the menopausal transition. We aimed to evaluate the effect of menopause on cardiovascular risk factors according to body mass index (BMI) in middle-aged Korean women. METHODS We analyzed 361 postmenopausal women and 758 premenopausal women (age: 45-55 years) without diabetes mellitus, hypertension, or dyslipidemia, using a cohort database released by the Korean National Health and Nutrition Examination Survey 2016-2018. Subjects were divided into two groups based on BMI. Women who underwent a hysterectomy or were pregnant were excluded from this study. Differences between groups adjusted for age and BMI were assessed. RESULTS Postmenopausal women (52 ± 2 years) were older than premenopausal women (48 ± 2 years), and BMI did not differ between the two groups (22.8 ± 2.9 vs. 23.0 ± 3.1 kg/m2). After adjustment for age and BMI in total and non-obese subjects (not obese subjects), postmenopausal women exhibited higher hemoglobin A1c and total cholesterol levels than premenopausal women. Subgroup analysis for 138 postmenopausal and 138 age- and BMI-matched premenopausal women showed that postmenopausal women had higher total cholesterol levels than premenopausal women with marginal significance (201 ± 25 vs. 196 ± 27 mg/dL). CONCLUSION Menopausal status was associated with increased glucose and cholesterol levels independent of age and BMI in middle-aged Korean women. Menopausal status showed a significant relationship with increased total cholesterol levels even after adjusting for age and BMI in non-obese women but not obese women. Therefore, intensive monitoring and treating of lipid status is necessary to prevent cardiovascular events during the menopausal transition, especially in non-obese subjects.
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Affiliation(s)
- Do Kyeong Song
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeon-Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyejin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Frequency of Metabolic Syndrome and Study of Anthropometric, Clinical and Biological Characteristics in Peri- and Postmenopausal Women in the City of Ksar El Kebir (Northern Morocco). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106109. [PMID: 35627646 PMCID: PMC9140909 DOI: 10.3390/ijerph19106109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to determine the frequency of metabolic syndrome and to identify its predictive factors in peri- and post-menopausal women in the city of Ksar El Kebir, in northern Morocco. A total of 373 peri- and post-menopausal women between 45 and 64 years old participated in the study. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition. Body mass index (BMI) was calculated to assess the degree of obesity in women; anthropometric, clinical and biological parameters were collected during interviews. The mean ages of peri- and postmenopausal women were 48.84 ± 2.4 years and 56.65 ± 4.29 years, respectively. Postmenopausal women had higher means of anthropometric and biological parameters than peri-menopausal women. We also noted a predominance of metabolic syndrome in postmenopausal women (n = 158) compared to peri-menopausal women (n = 81). Waist circumference was the predominant marker in the subjects studied, whereas triglycerides were the lower marker. In the overall population, the incidence of metabolic syndrome and its associated factors were higher in postmenopausal women than in peri-menopausal women, from which it can be concluded that post menopause may be a predictor of metabolic syndrome.
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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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Association between Non-HDL-C/HDL-C Ratio and Carotid Intima–Media Thickness in Post-Menopausal Women. J Clin Med 2021; 11:jcm11010078. [PMID: 35011818 PMCID: PMC8745439 DOI: 10.3390/jcm11010078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 02/01/2023] Open
Abstract
Atherogenic lipoproteins (particularly, very low-density lipoproteins, VLDL) are associated with subclinical atherosclerosis. The present study aims at evaluating whether routinely analysed lipid parameters are associated with carotid intima–media thickness, a proxy for subclinical atherosclerosis. Lipid parameters from 220 post-menopausal women undergoing ultrasound investigation of the carotid arteries were analysed. Forty-five percent of women showed subclinical atherosclerosis on carotid ultrasound. The mean carotid intima–media thickness was 1.26 ± 0.38 mm. The mean value of the non-HDL-C/HDL-C ratio was 3.1 ± 1.2. Univariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (r = 0.21, p = 0.001). After adjusting for cardiovascular risk factors (age, systolic blood pressure, smoking, body mass index Homeostasis model assessment: insulin resistance and high-sensitivity C-Reactive-Protein), multivariate analysis showed a significant association between non-HDL-C/HDL-C ratio and intima–media thickness (β = 0.039, p = 0.04). Logistic regression analysis showed that the highest tertile of the non-HDL-C/HDL-C ratio was associated with the presence of carotid plaques (OR = 3.47, p = 0.003). Finally, a strong correlation between non-HDL-C/HDL-C ratio and cholesterol bound to VLDL (r = 0.77, p < 0.001) has been found. Non-HDL-C/HDL-C ratio is associated with the presence of carotid atherosclerosis in post-menopausal women and is strongly correlated to VLDL-C levels.
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Tran NTT, Blizzard CL, Luong KN, Truong NLVN, Tran BQ, Otahal P, Nelson MR, Magnussen CG, Van Bui T, Srikanth V, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Sex differences in total cholesterol of Vietnamese adults. PLoS One 2021; 16:e0256589. [PMID: 34415963 PMCID: PMC8378708 DOI: 10.1371/journal.pone.0256589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The mid-life emergence of higher levels of total cholesterol (TC) for women than for men has been observed in different Western and Asian populations. The aim of this study was to investigate whether there is evidence of this in Vietnam and, if so, whether it can be explained by ageing, by body size and fatness, or by socio-demographic characteristics and behavioural factors. METHODS Participants (n = 14706, 50.9% females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Linear regression was used to assess the independent contributions of potential explanatory factors to mean levels of TC. Data were analysed using complex survey methods. RESULTS Men and women had similar mean levels of body mass index (BMI), and men had modestly higher mean levels of waist circumference (WC), in each 5-year age category. The mean TC of women increased more or less continuously across the age range but with a step-up at age 50 years to reach higher concentrations on average than those of their male counterparts. The estimated step-up was not eliminated by adjustment for anthropometric indices including BMI or WC, or by adjustment for socio-demographic characteristics or behavioural factors. The estimated step-up was least for women with the greatest weight. CONCLUSION There is a marked step-up in TC at age 50 years for Vietnamese women that cannot be explained by their age, or by their body fatness or its distribution, or by their socio-demographic characteristics or behavioural factors, and which results in greater mean levels of TC for middle-aged women than for their male counterparts in Vietnam.
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Affiliation(s)
- Nga Thi Thu Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Ngoc Le Van Ngoc Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Li H, Sun R, Chen Q, Guo Q, Wang J, Lu L, Zhang Y. Association between HDL-C levels and menopause: a meta-analysis. Hormones (Athens) 2021; 20:49-59. [PMID: 32557344 PMCID: PMC7889539 DOI: 10.1007/s42000-020-00216-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Menopause modifies women's lipid profiles. However, the fact that it is still unclear whether high-density lipoprotein-cholesterol (HDL-C) levels decrease in postmenopausal women necessitated a systematic review and meta-analysis. METHODS The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched and 498 articles published between 1987 and 2020 were retrieved. Studies reporting HDL-C, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) levels in both postmenopausal and premenopausal populations were included. The quality of the included studies was assessed using the Cross-Sectional/Prevalence Study Quality tool. The standard mean difference (SMD) and 95% confidence interval (CI) were estimated using random effects models. A meta-regression analysis and subgroup analysis were performed to identify potential modifiers. Egger's test and funnel plots were constructed to evaluate publication biases. RESULTS Lipid profiles from 18 cross-sectional studies and two cohort studies including 5652 postmenopausal women and 7825 premenopausal women were meta-analyzed. HDL-C levels were not significantly different between the postmenopausal and premenopausal women (SMD = - 0.053, 95% CI - 0.171 to 0.066, p = 0.383) and were not affected by country, publication year, study quality in the meta-regression analysis, or significant publication bias. Higher LDL-C, TC, and TG levels were detected in postmenopausal women than in premenopausal controls. CONCLUSION Unlike increased LDL-C, TC, and TG levels, HDL-C levels in pre- and postmenopausal women were not different in this first meta-analysis of lipid profiles in premenopausal and postmenopausal women. Prospective studies with large populations examining HDL-C levels and functions in women with different menopausal statuses are essential in the future. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- Hongwei Li
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China
| | - Runlu Sun
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China
| | - Qian Chen
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China
| | - Qi Guo
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China
| | - Junjie Wang
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China
| | - Liming Lu
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Yuling Zhang
- Cardiovascular Medicine Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, the West of Yanjiang Road, Guangzhou, 510120, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China.
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Abstract
OBJECTIVES The aim of the study was to determine lipid profile differences between premenopausal and postmenopausal women. METHODS The present review used a meta-analytic approach. Sixty-six studies were included, which provided a total sample of 114,655 women consisting of 68,394 that were premenopausal and 46,261 that were postmenopausal. RESULTS The main findings were that (1) lipoproteins were significantly higher in postmenopausal women compared to premenopausal women including triglycerides (0.27 mmol/L, 95% confidence interval, 0.22-0.31), total cholesterol (0.58, 0.50-0.65), low-density lipoprotein (0.45, 0.38-0.53), and total cholesterol to high-density lipoprotein levels (0.39, 0.16-0.62); (2) there was no difference in high-density lipoprotein levels between premenopausal and postmenopausal women (0.02, -0.00-0.04); and (3) the differences in lipid levels was partly attributable to the mean age difference between premenopausal and postmenopausal women. CONCLUSIONS These findings are important as they provide precise estimates of lipid differences in women around menopause. Furthermore the results suggest that the unfavorable lipid profile that develops in postmenopausal women puts them at higher risk of cardiovascular disease such as heart disease and stroke if appropriate lifestyle/pharmacological interventions are not implemented.
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Abstract
OBJECTIVES There is evidence that the menopausal transition in women is accompanied by changes in the metabolic profile. We evaluated the lipid profile during the perimenopause to postmenopause transition and its association with menopausal status. METHODS This is a retrospective observational study of laboratory studies from women presenting to the gynecology unit of Hospital Quirón Salud, Madrid (2007-2018) with irregular menstruation, amenorrhea or menopausal symptoms. Inclusion criteria were one or more blood samples with determinations of fasting glucose and lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-c], high-density lipoprotein cholesterol [HDL-c] and triglycerides [TGs]) from women with a menopause diagnosis recorded in the hospital database. The determinations were classified as perimenopausal or postmenopausal based on the date of last menstruation. RESULTS In total, 13,517 laboratory studies (3,073 perimenopausal and 10,444 postmenopausal) from 275 women were analyzed. Total cholesterol, LDL-c, and TG levels were significantly higher in postmenopausal women than in perimenopausal women, whereas HDL-c levels were significantly lower (P < 0.05 in all cases). Further adjustment by age showed differences only in LDL-c levels. Menopausal status, TG levels, and the number of pregnancies were independently related with total cholesterol and LDL-c levels. HDL-c levels were independently affected by menopausal age, TG levels, and number of pregnancies. Finally, TG concentration was independently affected by total cholesterol, LDL-c, and HDL-c levels. CONCLUSION Our study suggests that significant changes in LDL-c levels occur during the menopausal transition. Total cholesterol and LDL-c changes are independently affected by menopausal status and HDL-c is influenced by menopausal age.
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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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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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Associations of consuming specific fruit and vegetable subgroups with LDL-C status in early postmenopausal Chinese women. Menopause 2019; 25:436-443. [PMID: 29088018 DOI: 10.1097/gme.0000000000001008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Aging and menopausal changes contribute to increased cardiovascular risks in postmenopausal women. This study examined the associations of total and specific fruit and vegetable consumption with low-density lipoprotein cholesterol (LDL-C) status, a critical cardiovascular risk factor, in early postmenopausal Chinese women. METHODS A total of 508 postmenopausal Hong Kong Chinese women aged 50 to 64 years were recruited into a cohort study on cardiovascular risks. Sociodemographic characteristics, medical conditions, use of medications, and lifestyle factors were obtained via structured interviews. Dietary intake was assessed using a validated food frequency questionnaire. LDL-C and total cholesterol concentrations were determined using biochemical enzymatic techniques and categorized according to the Adult Treatment Panel III classification. RESULTS Ordinal logistic regression analysis showed that women with total fruit and vegetable intake in the highest quartile were 33% less likely (odds ratio [OR] = 0.67; 95% CI, 0.44-1.03) to have a worse LDL-C status than those with lower intake after adjustments. The intakes of total vegetables (OR = 0.63; 95% CI, 0.41-0.96) and vegetable subgroups in the highest quartiles, including darkgreen leafy vegetables (OR = 0.60; 95% CI, 0.41-0.89) and corn and tubers (OR = 0.62; 95% CI, 0.40-0.96), were significantly inversely associated with LDL-C status. Further adjustment for total cholesterol did not attenuate the associations. CONCLUSIONS A daily consumption of vegetables equivalent to about four servings or more might be beneficial for LDL-C control in early Chinese postmenopausal women. In particular, darkgreen leafy vegetables, as well as corn and tubers, deserve greater advocacy for their ability to improve lipid profiles and hence cardiovascular health.
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Wang Y, Wang H, Howard AG, Adair LS, Popkin BM, Su C, Du W, Zhang B, Gordon‐Larsen P. Six-Year Incidence of Cardiometabolic Risk Factors in a Population-Based Cohort of Chinese Adults Followed From 2009 to 2015. J Am Heart Assoc 2019; 8:e011368. [PMID: 31165668 PMCID: PMC6645625 DOI: 10.1161/jaha.118.011368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 05/06/2019] [Indexed: 12/26/2022]
Abstract
Background China faces a substantial burden from cardiometabolic diseases, but longitudinal studies on a wide range of cardiometabolic risk factors are limited. We examined the 6-year incidence of 8 cardiometabolic risk factors in a diverse, population-based cohort. Methods and Results In the China Health and Nutrition Survey, anthropometry, blood pressure, and fasting blood samples were collected from 9621 adults (47.6% men) aged 18 to 99 years in 2009 who were followed into 2015. Using inverse probability weights to account for loss to follow-up, we estimated the 6-year incidence of 8 cardiometabolic risk factors and compared the incidence of each risk factor across age groups using inverse probability-weighted sex-stratified logistic regression models. Incidence was noted for the following cardiometabolic risk factors during 2009-2015: hypertension (systolic/diastolic blood pressure ≥140/90 mm Hg; men: 29.2%; women: 24.9%), high waist circumference/height ratio (≥0.5; men: 42.4%; women: 43.8%), and high total to HDL (high-density lipoprotein) cholesterol ratio (≥5; men: 17.0%; women: 14.5%). Older men and women (aged ≥65 years) had the highest incidence of hypertension. Incidence of high waist circumference/height ratio and high LDL (low-density lipoprotein) cholesterol (≥130 mg/ dL ) was highest among older (aged ≥65 years) women, whereas incidence of overweight (body mass index ≥25) and high triglycerides (≥150 mg/ dL ) was highest among younger (aged 18-35 and 35-50 years) men. Conclusions We found increases in cardiometabolic risk among Chinese adults during this recent, short, 6-year period that are higher than previous studies in China. The higher incidence of overweight and elevated dyslipidemia markers in younger versus older men portends an increasing burden of cardiometabolic diseases in China as the younger population ages.
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Affiliation(s)
- Yiqing Wang
- Department of NutritionGillings School of Global Public Health & School of MedicineUniversity of North Carolina at Chapel HillNC
| | - Huijun Wang
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Annie Green Howard
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Linda S. Adair
- Department of NutritionGillings School of Global Public Health & School of MedicineUniversity of North Carolina at Chapel HillNC
- Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Barry M. Popkin
- Department of NutritionGillings School of Global Public Health & School of MedicineUniversity of North Carolina at Chapel HillNC
- Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Chang Su
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Wenwen Du
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Bing Zhang
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Penny Gordon‐Larsen
- Department of NutritionGillings School of Global Public Health & School of MedicineUniversity of North Carolina at Chapel HillNC
- Carolina Population CenterUniversity of North Carolina at Chapel HillNC
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Guo Y, Zhao M, Bo T, Ma S, Yuan Z, Chen W, He Z, Hou X, Liu J, Zhang Z, Zhu Q, Wang Q, Lin X, Yang Z, Cui M, Liu L, Li Y, Yu C, Qi X, Wang Q, Zhang H, Guan Q, Zhao L, Xuan S, Yan H, Lin Y, Wang L, Li Q, Song Y, Gao L, Zhao J. Blocking FSH inhibits hepatic cholesterol biosynthesis and reduces serum cholesterol. Cell Res 2019; 29:151-166. [PMID: 30559440 PMCID: PMC6355920 DOI: 10.1038/s41422-018-0123-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 11/15/2018] [Indexed: 12/19/2022] Open
Abstract
Menopause is associated with dyslipidemia and an increased risk of cardio-cerebrovascular disease. The classic view assumes that the underlying mechanism of dyslipidemia is attributed to an insufficiency of estrogen. In addition to a decrease in estrogen, circulating follicle-stimulating hormone (FSH) levels become elevated at menopause. In this study, we find that blocking FSH reduces serum cholesterol via inhibiting hepatic cholesterol biosynthesis. First, epidemiological results show that the serum FSH levels are positively correlated with the serum total cholesterol levels, even after adjustment by considering the effects of serum estrogen. In addition, the prevalence of hypercholesterolemia is significantly higher in peri-menopausal women than that in pre-menopausal women. Furthermore, we generated a mouse model of FSH elevation by intraperitoneally injecting exogenous FSH into ovariectomized (OVX) mice, in which a normal level of estrogen (E2) was maintained by exogenous supplementation. Consistently, the results indicate that FSH, independent of estrogen, increases the serum cholesterol level in this mouse model. Moreover, blocking FSH signaling by anti-FSHβ antibody or ablating the FSH receptor (FSHR) gene could effectively prevent hypercholesterolemia induced by FSH injection or high-cholesterol diet feeding. Mechanistically, FSH, via binding to hepatic FSHRs, activates the Gi2α/β-arrestin-2/Akt pathway and subsequently inhibits the binding of FoxO1 with the SREBP-2 promoter, thus preventing FoxO1 from repressing SREBP-2 gene transcription. This effect, in turn, results in the upregulation of SREBP-2, which drives HMGCR nascent transcription and de novo cholesterol biosynthesis, leading to the increase of cholesterol accumulation. This study uncovers that blocking FSH signaling might be a new strategy for treating hypercholesterolemia during menopause, particularly for women in peri-menopause characterized by FSH elevation only.
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Affiliation(s)
- Yanjing Guo
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Meng Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Tao Bo
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Shizhan Ma
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, 250012, Jinan, Shandong, China
| | - Wenbin Chen
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Zhao He
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Xu Hou
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Jun Liu
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Zhenhai Zhang
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Qiang Zhu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Qiangxiu Wang
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Xiaoyan Lin
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Zhongli Yang
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Min Cui
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Lu Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Yujie Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Chunxiao Yu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Xiaoyi Qi
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Qian Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Lifang Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Shimeng Xuan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Huili Yan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Yanliang Lin
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
| | - Li Wang
- Department of Physiology and Neurobiology, and Institute for Systems Genomics, University of Connecticut, Storrs, CT, 06269, USA
| | - Qihang Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China.
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China.
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China.
- Department of Physiology and Neurobiology, and Institute for Systems Genomics, University of Connecticut, Storrs, CT, 06269, USA.
| | - Ling Gao
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China.
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China.
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, Jinan, Shandong, China.
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, 250021, Jinan, Shandong, China.
- Institute of Endocrinology and metabolism, Shandong Academy of Clinical Medicine, 250021, Jinan, Shandong, China.
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Risk of Hyperlipidemia in Women with Hysterectomy-A Retrospective Cohort Study in Taiwan. Sci Rep 2018; 8:12956. [PMID: 30154502 PMCID: PMC6113310 DOI: 10.1038/s41598-018-31347-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/17/2018] [Indexed: 12/17/2022] Open
Abstract
Hysterectomy has been associated with metabolic change and cardiovascular risk for women after removing the uterus, but inconclusive. This large retrospective cohort study evaluated the hyperlipidemia risk for women with a hysterectomy and/or oophorectomy. From claims data of one million people in the National Health Insurance (NHI) database of Taiwan, we established a cohort consisting of 5887 women newly received a surgery of hysterectomy from 2000-2013, 563 women had a hysterectomy and a oophorectomy, and 556 women had a oophorectomy. From the claims data, 28024 women without any of the surgeries were identified to form the comparison cohort, frequency matched by birth year and surgery year of the women with hysterectomy. By the end of 2013, the incidence of hyperlipidemia was 1.3 times greater in women with a hysterectomy than in comparison women (3.43 vs. 2.65 per 100 person-years), with an adjusted hazard ratio (aHR) of 1.27 (95% CI = 1.19-1.35) for hysterectomy women after controlling for age, oophorectomy, hormone therapy and comorbidities. The incidence of hyperlipidemia increased to 4.93 per 100 person-years in women with both a hysterectomy and an oophorectomy. The relative risk of hyperlipidemia was higher for young women than the elderly women with the surgery. Women with comorbidity of obesity, hypertension or diabetes had a higher incidence of hyperlipidemia. In conclusion, the risk of developing hyperlipidemia could be elevated for women who had a hysterectomy and/or an oophorectomy. Women with hysterectomy should routinely monitor their metabolic status, particularly for young women and those with comorbidity of metabolic symptoms.
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15
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Body composition, cardiometabolic risk factors, physical activity, and inflammatory markers in premenopausal women after a 10-year follow-up: a MONET study. Menopause 2018; 25:89-97. [PMID: 28763400 DOI: 10.1097/gme.0000000000000951] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Menopausal transition and postmenopause are usually associated with changes in body composition and a decrease in physical activity energy expenditure (PAEE). This study investigated body composition, cardiometabolic risk factors, PAEE, and inflammatory markers in premenopausal women after a 10-year follow-up. METHODS In all, 102 premenopausal women participated in the 5-year observational longitudinal Montreal Ottawa New Emerging Team (MONET) study. This present substudy included 48 participants (age: 60.0 ± 1.7 years; body mass index: 23.2 ± 2.2 kg/m) 6.0 ± 0.3 years after completion of the initial MONET study. Measures included body composition, waist circumference (WC), fasting glucose and insulin levels, insulin sensitivity (QUICKI model), plasma lipid levels, PAEE, and inflammatory markers. RESULTS Compared with baseline measures of the MONET study, analyses revealed no significant increase in body weight, although there were significant increases in WC, fat mass (FM), % FM, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, haptoglobin, apolipoprotein B, ferritin, adiponectin, and soluble cluster of differentiation 14 (all P < 0.001) after the 10-year follow-up. However, significant decreases were observed for fat-free mass, PAEE, fasting glucose levels, interleukin-8 levels, and soluble tumor necrosis factor receptors 1 and 2 (sTNFR-1 and sTNFR-2) levels (all P < 0.05). To determine the effect of postmenopausal years, data were restructured based on final menstrual period (FMP), and one-way analyses of variance were performed.Waist circumference, % FM, total cholesterol, high-density lipoprotein cholesterol, apolipoprotein B, ferritin, adiponectin, and soluble cluster of differentiation 14 were higher in early and late postmenopausal periods in these women. sTNFR-1 and sTNFR-2 levels were higher at the FMP and early postmenopausal years as compared with the late postmenopausal periods. Finally, interleukin-8 levels were lower in years after FMP. CONCLUSION The number of years elapsed since the FMP can affect body composition, cardiometabolic risk factors, and inflammatory markers in healthy premenopausal women going through menopausal transition and postmenopausal periods.
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Chang HC, Hsieh CF, Tantoh DM, Ko PC, Kung YY, Lin MC, Liaw YC, Liaw YP. HDL and associated factors stratified by sex and menopausal status: results from a community-based survey in Taiwan. Oncotarget 2018; 9:16354-16367. [PMID: 29662650 PMCID: PMC5893245 DOI: 10.18632/oncotarget.24677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/27/2018] [Indexed: 12/21/2022] Open
Abstract
Aim To investigate factors, especially modifiable factors associated with high-density lipoprotein (HDL) in Taiwanese based on sex and menopausal status. Materials and Methods Participants comprised 2022 men and 2392 women (1267 menopausal and 1125 non-menopausal) aged ≥30 years who resided in Pingzhen district, Taoyuan from 2006-2011. Their data, obtained through questionnaires and measurements were retrieved from the Li-Shin Hospital. Results Higher HDL was associated with total cholesterol, underweight, and alcohol drinking in both men and women. It was also associated with education, blood group B, and marital status in men as well as with age in women. Moreover, it was associated with total cholesterol, underweight, and age in both menopausal and non-menopausal women. Furthermore, it was associated with marital status in non-menopausal women and alcohol drinking in menopausal women. Lower HDL was associated with triglycerides, low-density lipoprotein (LDL), overweight, obesity, waist-hip ratio (WHR), uric acid, and smoking in both men and women and with coffee drinking in only women. It was also associated with uric acid, triglycerides, LDL, overweight, obesity, WHR, and body fat in both menopausal and non-menopausal women. Moreover, it was associated with coffee drinking in menopausal women. Conclusion Modifiable factors associated with HDL differ according to sex and menopausal status. Sex and menopausal status should be considered when implementing lifestyle changes to raise HDL. For example, both men and women should maintain a normal weight as well as quit smoking.
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Affiliation(s)
- Huan-Cheng Chang
- Division of Family Medicine, Department of Community Medicine, Landseed Hospital, Taoyuan, Taiwan.,Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Chuan-Fa Hsieh
- Department of Medical Education and Research, Landseed Hospital, Taoyuan, Taiwan.,Center for General Education, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
| | - Disline Manli Tantoh
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Pei-Chieh Ko
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Ya-Yu Kung
- Division of Health Management, Landseed Hospital, Taoyuan, Taiwan
| | - Mei-Chi Lin
- Division of Health Management, Landseed Hospital, Taoyuan, Taiwan
| | - Yi-Ching Liaw
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Department of Family and Community Medicine, Chung Shan Medical University, Taichung, Taiwan
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17
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Çelik F, Belviranli M, Okudan N. Circulating levels of leptin, nesfatin-1 and kisspeptin in postmenopausal obese women. Arch Physiol Biochem 2016; 122:195-199. [PMID: 27011110 DOI: 10.3109/13813455.2016.1171365] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The roles of leptin, nesfatin-1 and kisspeptin in the regulation of food intake and/or reproduction are well known; however, the interactions between these hormones remain unclear, especially in humans. The aim of this study was to determine the roles of leptin, nesfatin-1 and kisspeptin in pre- and postmenopausal obese and non-obese women. The study included 83 women who were divided into four groups based on menopausal status and body mass index. The leptin level was significantly higher in the obese women than in the non-obese women (p < 0.05), but did not differ significantly between pre- and postmenopausal women (p > 0.05). The nesfatin-1 and kisspeptin-1 levels did not differ significantly between any of the study groups (p > 0.05). The present findings show that nesfatin-1 and kisspeptin levels are not affected by obesity or menopausal status.
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Affiliation(s)
- Feyza Çelik
- a Department of Physiology , Faculty of Medicine, Selçuk University , Konya , Turkey
| | - Muaz Belviranli
- a Department of Physiology , Faculty of Medicine, Selçuk University , Konya , Turkey
| | - Nilsel Okudan
- a Department of Physiology , Faculty of Medicine, Selçuk University , Konya , Turkey
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18
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Matsui S, Yasui T, Kasai K, Keyama K, Kato T, Uemura H, Kuwahara A, Matsuzaki T, Irahara M. Changes of liver enzymes and triglyceride during the menopausal transition in Japanese women. J OBSTET GYNAECOL 2016; 36:806-811. [PMID: 27167882 DOI: 10.3109/01443615.2016.1154516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We examined detailed changes in liver enzymes as surrogate markers for metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) during the menopausal transition and the associations of liver enzymes with lipid profiles related to risk of metabolic syndrome and endocrinological hormones. We divided 393 women into seven stages by menstrual regularity, follicle-stimulating hormone level and years since menopause. Serum levels of alanine aminotranferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase, lipid parameters, glucose, and endocrinological hormones were measured. Both levels of AST and ALT increased towards early post-menopause. AST remained high in late post-menopause but ALT decreased. The AST/ALT ratio decreased towards late menopausal transition and very early post-menopause and increased thereafter. This ratio was negatively correlated with triglyceride. Significant changes in ALT and AST/ALT ratio during the menopausal transition, which were associated with triglyceride, might be involved in the occurrence of metabolic syndrome and NAFLD in Japanese women.
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Affiliation(s)
| | | | - Kana Kasai
- a Department of Obstetrics and Gynecology
| | | | | | - Hirokazu Uemura
- c Department of Preventive Medicine , Institute of Biomedical Sciences Tokushima University Graduate School , Tokushima , Japan
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Fernandez ML, Murillo AG. Postmenopausal Women Have Higher HDL and Decreased Incidence of Low HDL than Premenopausal Women with Metabolic Syndrome. Healthcare (Basel) 2016; 4:E20. [PMID: 27417608 PMCID: PMC4934554 DOI: 10.3390/healthcare4010020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 11/17/2022] Open
Abstract
It is well known that plasma lipids, waist circumference (WC) and blood pressure (BP) increase following menopause. In addition, there is a perceived notion that plasma high-density lipoprotein-cholesterol (HDL-C) concentrations also decrease in postmenopausal women. In this cross-sectional study, we evaluated plasma lipids, fasting glucose, anthropometrics and BP in 88 post and 100 pre-menopausal women diagnosed with metabolic syndrome. No differences were observed in plasma low-density lipoprotein-cholesterol cholesterol, triglycerides, fasting glucose or systolic and diastolic BP between groups. However, plasma HDL-C was higher (p < 0.01) in postmenopausal women and the percentage of women who had low HDL (<50 mg/dL) was higher (p < 0.01) among premenopausal women. In addition, negative correlations were found between WC and HDL-C (r = -0.148, p < 0.05) and BMI and HDL-C (r = -0.258, p < 0.01) for all subjects indicating that increases in weight and abdominal fat have a deleterious effect on plasma HDL-C. Interestingly, there was a positive correlation between age and plasma HDL-C (r = 0.237 p < 0.01). The results from this study suggest that although HDL is decreased by visceral fat and overall weight, low HDL is not a main characteristic of metabolic syndrome in postmenopausal women. Further, HDL appears to increase, not decrease, with age.
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Affiliation(s)
- Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ana Gabriela Murillo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
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20
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Yan F, Liu J, Zhao X, Hu X, Wang S, Ma Z, Liang K, Song J, Wang C, Hou X, Chen S, Chen L. Association of the Number of Years Since Menopause with Metabolic Syndrome and Insulin Resistance in Chinese Urban Women. J Womens Health (Larchmt) 2015; 24:843-8. [PMID: 26418517 DOI: 10.1089/jwh.2014.5183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Fei Yan
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
| | - Jidong Liu
- Department of Poisoning and Occupational Diseases, Qilu Hospital of Shandong University, Jinan, China
| | | | - Xiuping Hu
- Department of Endocrinology, Second People's Hospital of Jining, Jining, China
| | | | - Zeqiang Ma
- China National Heavy Duty Truck Group Corporation Hospital, Jinan, China
| | - Kai Liang
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
| | - Jun Song
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
| | - Chuan Wang
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
| | - Xinguo Hou
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
| | - Shihong Chen
- Department of Endocrinology, The Second Hospital of Shandong University, Jinan, Shandong, China
| | - Li Chen
- Department of Endocrinology of Qilu Hospital and Institute of Endocrinology and Metabolism, Shandong University, Jinan, China
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21
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Stefanska A, Bergmann K, Sypniewska G. Metabolic Syndrome and Menopause: Pathophysiology, Clinical and Diagnostic Significance. Adv Clin Chem 2015; 72:1-75. [PMID: 26471080 DOI: 10.1016/bs.acc.2015.07.001] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Menopause is a risk factor for cardiometabolic diseases, including metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases. MetS is a constellation of interdependent factors such as insulin resistance, abdominal obesity, dyslipidemia, and hypertension. The prevalence of MetS in postmenopause is due to loss of the protective role of estrogens and increased circulating androgens resulting in changes to body fat distribution and development of abdominal obesity. Excessive visceral adipose tissue plays an important role due to synthesis and secretion of bioactive substances such as adipocytokines, proinflammatory cytokines, reactive oxygen species, prothrombotic, and vasoconstrictor factors. MetS may also impact risk assessment of breast cancer, osteoporosis and chronic kidney disease, and quality of life during the menopausal transition. Increased MetS has stimulated the exploration of new laboratory tests for early detection and therapies.
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Affiliation(s)
- Anna Stefanska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Katarzyna Bergmann
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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22
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Effects of lifestyle intervention improve cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. Menopause 2015; 21:1263-8. [PMID: 24781851 DOI: 10.1097/gme.0000000000000248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to test the efficacy of a 12-month lifestyle intervention in improving cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. METHODS One hundred healthy menopausal transition and early postmenopausal women aged 40 to 60 years were randomly assigned to receive either lifestyle change intervention (n = 53) or usual care (n = 47). Menopause status was defined by the menstrual change criteria of the Stages of Reproductive Aging Workshop + 10 based on prospective menstrual calendars. Women in the intervention group were provided with a colorful booklet that included dietary and physical activity recommendations, were individually interviewed, and completed biophysical cardiovascular risk assessments at the Women's Health Center (Beijing, China). Women were encouraged to follow a healthy eating pattern and to increase their aerobic activity (moderate level, 3 d/wk, 40 min/d). Women in the control group continued their usual eating patterns and activities. Weight, body mass index (BMI), waist circumference-to-hip circumference ratio (WHR), waist circumference (WC), body composition, blood pressure (BP), blood glucose, and serum lipids were assessed at baseline, 3 months, 6 months, and 12 months in both groups. RESULTS Women in the intervention group were observed to have significant decreases in weight, BMI, WC, WHR, systolic BP, total cholesterol, and low-density lipoprotein cholesterol compared with women in the control group. At 3 months, there were significant decreases in weight (-0.28 vs 0.68 kg, P = 0.002), BMI (-0.06 vs 0.44 kg/m2, P = 0.003), WC (-0.28 vs 1.43 cm, P = 0.001), and WHR (-0.01 vs 0.01, P = 0.045) in the intervention group compared with the control group. At 6 months, there were significant decreases in WC (-0.73 vs 1.02 cm, P = 0.012), WHR (-0.02 vs -0.003, P = 0.020), and systolic BP (-7.52 vs -0.63 mm Hg, P = 0.012) favoring the intervention group over the control group. At 12 months, there were significant decreases in total cholesterol (-0.07 vs 0.03 mmol/L, P = 0.045) and low-density lipoprotein cholesterol (-0.13 vs 0.01 mmol/L, P = 0.022) in the intervention group versus the control group. CONCLUSIONS Lifestyle intervention may be an effective means for reducing cardiovascular disease risk factors in menopausal transition and early postmenopausal women in China.
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Abstract
OBJECTIVE Menopause is defined as the permanent cessation of menses. Although previous studies demonstrated a slight production of androgens and estrogens by postmenopausal ovaries, the impact of hormone production on lipid metabolism is still uncertain. The aim of this study was to evaluate whether the postmenopausal ovary is hormonally active and whether hormone status contributes to lipid metabolism. METHODS This was a prospective study of 87 women who were treated for gynecological diseases (29% had cervical cancer, 49% had endometrial cancer, 7% had fibroid tumors, and 15% had cervical intraepithelial neoplasia). They were categorized as early postmenopausal (n = 40; mean [SD], 56.8 [3.8] y) or late postmenopausal (n = 47; mean [SD], 66.6 [5.7] y) women. Serum specimens were collected from the peripheral and ovarian veins of participants undergoing bilateral oophorectomy. Sex steroid hormone levels and lipid profiles were determined. RESULTS Statistically significant differences in estradiol (E2) and testosterone were seen between the ovarian samples and the peripheral samples in all groups. E2 and estrone obtained from ovarian venous samples gradually decreased with age in postmenopausal women. There was a significant correlation between ovarian E2 and high-density lipoprotein cholesterol levels and the low-density lipoprotein-to-high-density lipoprotein ratio. However, there was no correlation between peripheral E2 levels and any of the lipid parameters examined. CONCLUSIONS Although this study investigates women with gynecological diseases, the postmenopausal ovary is hormonally active, and the E2 produced by postmenopausal ovaries may therefore contribute to the maintenance of lipid metabolism.
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Choi Y, Chang Y, Kim BK, Kang D, Kwon MJ, Kim CW, Jeong C, Ahn Y, Park HY, Ryu S, Cho J. Menopausal stages and serum lipid and lipoprotein abnormalities in middle-aged women. Maturitas 2015; 80:399-405. [PMID: 25631350 DOI: 10.1016/j.maturitas.2014.12.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/26/2014] [Accepted: 12/26/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Whether menopausal stage is associated with abnormalities in serum lipid and lipoprotein profiles remains unclear; studies have been conducted mostly in Western populations. This study aimed to examine the prevalence of lipid and lipoprotein abnormalities by recently updated menopausal stages in middle-aged women. STUDY DESIGN This study was cross-sectional analysis of 1553 women aged 44-56 years, who underwent a comprehensive health screening examination in the Kangbuk Samsung Hospital Total Healthcare Centers, Korea, during 2012-2013. Lipid and lipoprotein profiles including total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), lipoprotein (a) (Lp(a)), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B) were assessed. Prevalence ratios and 95% confidence intervals for lipid and lipoprotein abnormalities were estimated by menopausal stages as defined by the 2011 Stages of Reproductive Aging Workshop+10 criteria. RESULTS Increased prevalence of lipid and lipoprotein abnormalities were observed across menopausal stages. The increased prevalence of high non-HDL-C was associated with the late menopausal transition and post-menopausal stages and was more pronounced in women with body mass index (BMI) <23 kg/m(2) than in those with BMI ≥23 kg/m(2) (P for interaction=0.006). Similarly, there was an interaction between BMI and menopausal stages in relation to high Apo B (P for interaction=0.05) and high Apo B/Apo A1 ratio (P for interaction=0.06). CONCLUSIONS Our findings extend previous results and suggest that the increased prevalence of lipid and lipoprotein abnormalities was associated not only with the post-menopausal stage but also late menopausal transition period.
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Affiliation(s)
- Yuni Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Bo-Kyoung Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Chul Jeong
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Younjhin Ahn
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, Republic of Korea
| | - Hyun-Young Park
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Cao R, Bai Y, Xu R, Ye P. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing. Clin Interv Aging 2015; 10:55-60. [PMID: 25565787 PMCID: PMC4279610 DOI: 10.2147/cia.s66971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND N-terminal pro-brain natriuretic peptide (NT-proBNP) is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear. OBJECTIVE This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population. METHODS We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21-96 years) from a community-based population in Beijing, People's Republic of China. RESULTS In patients with high resting heart rate (≥75 beats/min), NT-proBNP was higher than in those having low resting heart rate (<75 beats/min). In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18-1.51; P=0.011). A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49-2.36; P=0.031); while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old). CONCLUSIONS Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage.
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Affiliation(s)
- Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Ruyi Xu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
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Chu FL, Hsu CH, Jeng C. Lowered cutoff points of obesity indicators are better predictors of hypertension and diabetes mellitus in premenopausal Taiwanese women. Obes Res Clin Pract 2014; 9:328-35. [PMID: 25154649 DOI: 10.1016/j.orcp.2014.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/01/2014] [Accepted: 08/01/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In previous study, we found that in order to prevent MS in women aged <65 years, the cutoff points of obesity indicators should be lowered. OBJECTIVE To investigate whether our proposed cutoff points of obesity indicators predict the occurrence of hypertension (HT), diabetes mellitus (DM), and hyperlipidemia in premenopausal women with greater sensitivity and specificity compared to reference cutoff points of obesity that are currently being used. METHODS Using the database of the "2002 Survey on the Prevalence of Hypertension, Hyperglycemia and Hyperlipidemia in Taiwan" provided by the Bureau of Health Promotion, Taiwan as research material, data from 2270 premenopausal women aged 20-65 years were used for the analyses. The receiver-operating characteristic curves (ROC) of the body-mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were used to predict HT, DM, and hyperlipidemia. RESULTS Obesity is not a good predictor of the occurrence of hyperlipidemia in premenopausal women aged <65 years. However, our proposed cutoff points had greater sensitivity and specificity than did the reference cutoff points. To prevent the risk of HT and DM in premenopausal women, the cutoff points of obesity indicators should be reduced. The proposed values are as follows: a WHR of 0.79; a WC of 74.7 cm; a WHtR of 0.49; and a BMI of 22.3 kg/m(2).
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Affiliation(s)
- Fu-Ling Chu
- Chang Gung University of Science and Technology, Taoyuan, Taiwan; Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chung-Huei Hsu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chii Jeng
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Glucosamine-induced insulin resistance in ovariectomized rats is relevant to decreasing the expression of glucose transport protein subtype 4 in the skeletal muscle and in increasing the size of pancreatic islets. Menopause 2012; 19:496-502. [DOI: 10.1097/gme.0b013e31823a40d9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
The incidence of cardiovascular disease, which is the leading single cause of death among women, increases substantially after menopause. This may be related to adverse changes in cardiovascular risk factors that occur during the menopausal transition. Proatherogenic changes in lipid and apolipoprotein profiles seem to be specifically related to ovarian aging; unfavorable changes in other cardiovascular risk factors may be influenced more by chronologic aging. Whether these changes are due to aging or to menopause itself, increased attention to risk factor modification in the pre- and perimenopausal years will help reduce future cardiovascular disease risk among women.
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