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Chikwati RP, Chikowore T, Mahyoodeen NG, Jaff NG, George JA, Crowther NJ. The association of menopause with cardiometabolic disease risk factors in low- and middle-income countries: a systematic review and meta-analyses. Menopause 2024; 31:77-85. [PMID: 38113417 PMCID: PMC7615510 DOI: 10.1097/gme.0000000000002292] [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] [Indexed: 12/21/2023]
Abstract
IMPORTANCE Menopause is an integral part of women's health, and studies in high-income countries have shown an increase in cardiometabolic disease (CMD) risk factors in postmenopausal compared with premenopausal women. However, to date, no study has combined and assessed such studies across low- and middle-income countries. This would better inform early monitoring and intervention strategies for reducing CMD risk factor levels in midlife women in these regions. OBJECTIVE This study aimed to evaluate evidence from the literature on differences in CMD risk factors between premenopausal and postmenopausal midlife women living in low- and middle-income countries. EVIDENCE REVIEW A systematic review with meta-analysis of original articles of all study designs from the databases PubMed, PubMed Central, Scopus, and ISI Web of Science was conducted from conception until April 24, 2023. Studies that met the inclusion criteria were included in the analysis. Quality assessment of the articles was done using the Newcastle-Ottawa Scale, adapted for each study design. The study protocol was registered with the International Prospective Register of Systematic Reviews and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. For the meta-analysis, fixed-effects models were used to pool the odds ratios (OR), as measures of association. FINDINGS Our search identified 4,849 relevant articles: 44 for the systematic review and 16 for the meta-analysis, in accordance with our inclusion criteria. Compared with premenopausal women, the postmenopausal stage was associated with metabolic syndrome (OR, 1.18 [95% CI, 1.11-1.27]), high waist-to-hip ratio (OR, 1.22 [95% CI, 1.12-1.32]), hypertension (OR, 1.10 [95% CI, 1.04-1.16]), elevated triglycerides (OR, 1.16 [95% CI, 1.11-1.21]), and elevated plasma glucose (OR, 1.21 [95% CI, 1.15-1.28]). CONCLUSIONS AND RELEVANCE This study confirmed that CMD risk factors are present at higher levels in postmenopausal than premenopausal women. This demonstrates an urgent need for public health policies that focus on early monitoring and interventions targeted at reducing CMD risk and related adverse outcomes in midlife women in these nations.
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Affiliation(s)
| | | | - 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
- From the Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Bowo-Ngandji A, Kenmoe S, Ebogo-Belobo JT, Kenfack-Momo R, Takuissu GR, Kengne-Ndé C, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Lontuo Fogang R, Zeuko'o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Wandji Nguedjo M, Assam Assam JP, Enyegue Mandob D, Ngondi JL. Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis. PLoS One 2023; 18:e0289155. [PMID: 37498832 PMCID: PMC10374159 DOI: 10.1371/journal.pone.0289155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations. METHODS A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study. RESULTS In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6). CONCLUSION This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.
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Affiliation(s)
- Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | | | - Maxwell Wandji Nguedjo
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
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Prevalence of Metabolic Syndrome and Its Components in Urban Cambodia: A Cross-Sectional Study. J Epidemiol Glob Health 2022; 12:224-231. [PMID: 35947272 PMCID: PMC9470791 DOI: 10.1007/s44197-022-00053-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background The incidence of noncommunicable diseases, such as cardiovascular diseases and diabetes mellitus, is increasing in Cambodia. Urbanization and lifestyle changes due to rapid economic development have affected the components of metabolic syndrome (MetS). This study aimed to determine the prevalence of MetS, MetS components, and health status among Cambodians living in urban areas. Methods This cross-sectional study enrolled adult Cambodians (age ≥ 20 years) who underwent a health checkup at a Japanese hospital in Phnom Penh. MetS was defined based on the harmonized diagnostic definition from the joint interim statement. Results Among the 6090 (3174 men and 2916 women) participants who were enrolled in the study, the prevalence of MetS was 60.1% in men and 52.4% in women. The prevalence of elevated blood pressure was 73.2% in men and 65.3% in women, and was the highest MetS component in both men and women. In contrast, the lowest prevalence rates were observed for abdominal obesity (44.8%) in men and for high triglyceride levels (33.5%) in women. The MetS group showed a significantly higher proportion of patients with hypertension, diabetes, dyslipidemia, and obesity compared with the non-MetS group. Conclusion The high prevalence of MetS in this study was attributed to urbanization, as in economically developed countries. It is necessary to explore the lifestyle habits of Cambodians that contribute to MetS and to develop preventive measures to reduce the incidence and prevalence of MetS.
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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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Matta RA, AbdElftah ME, Essawy MG, Saedii AA. Interplay of serum hepcidin with female sex hormones, metabolic syndrome, and abdominal fat distribution among premenopausal and postmenopausal women. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background and purpose
Hepcidin is the central regulatory molecule of systemic iron homeostasis. Serum ferritin, insulin resistance (IR) and metabolic syndrome (MetS), female sex hormones, and abdominal fat distribution are related to each other and all are linked to menopausal state. Our study was the first to assess the impact of these parameters on hepcidin level among premenopausal women (group I) during the early follicular phase (group I-F) and mid-luteal-phase (group I-L) of the same reproductive cycle and among postmenopausal women (group II). Serum iron parameters, estrogen, progesterone and hepcidin, and plasma insulin were assessed. Abdominal subcutaneous fat (SCF) and peritoneal visceral fat (PVF) thickness were measured by unenhanced- CT. Group I and group II were divided into MetS and non-MetS subgroups.
Results
The entire group II and MetS-stratified subgroups had significant higher hepcidin level than corresponding group I-F and group I-L. Group I-L had significant higher hepcidin than group I-F. Among group I-F, group I-L, and group II, MetS subgroups had higher hepcidin but not hepcidin/ ferritin ratio (H/F) than corresponding non-MetS; and hepcidin had positive correlations with ferritin, insulin, IR, and SCF. In group I-F and group II, hepcidin had positive correlations with estrogen and progesterone; hepcidin levels increase significantly and linearly with increasing number of MetS features; and cut off values of hepcidin for prediction of MetS were 5.8 ≥ and ≥ 10.3 ng/ml respectively. Main contributors to hepcidin were iron and ferritin in all groups, SCF and progesterone in group I-F, and insulin, progesterone, and MetS in group II. H/F ratio was higher in group II.
Conclusion
Postmenopausal state (postMS), MetS, and luteal phase are independently associated with high hepcidin level. Serum iron parameters (iron and ferritin) as main regulators of hepcidin are preserved regardless of menopausal state. Its regulation differs based on menopausal state: IR, MetS, and progesterone in postMS meanwhile abdominal SCF and progesterone in premenopausal states. Despite positive associations of estrogen and progesterone with hepcidin, they do not explain its higher level in postMS. Hepcidin levels linearly increase with number of Mets feature and it had high sensitivity for diagnosis of MetS.
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Abstract
IMPORTANCE With improved HIV care, more women living with HIV (WLWH) are aging and entering menopause. Understanding any increased risk conferred by a potentially earlier menopause transition is important for the care of these women. OBJECTIVE There is conflicting literature regarding the association between HIV and an earlier onset of menopause. We conducted a systematic review to summarize the literature on the association between HIV and age at menopause. EVIDENCE REVIEW A search of Ovid MEDLINE, EMBASE, and Web of Science identified 894 articles. We included cohort studies that assessed age at menopause, primary ovarian insufficiency (POI), or early menopause among WLWH and used the World Health Organization definition of menopause as ≥12 months of amenorrhea. FINDINGS Nine studies were included and eight reported on age at menopause. Across studies, the age at menopause for WLWH fell between 46 and 50 years. Five of seven studies reported that WLWH had an earlier menopausal transition than HIV negative controls/the general population. Six studies reported on the prevalence of POI or early menopause among WLWH, with all studies demonstrating an increased prevalence of both among WLWH. CONCLUSIONS Our systematic review summarizes the literature around HIV and age at menopause. Many studies reported a high prevalence of POI and early menopause among WLWH; a factor that may partially account for the observed lower age at menopause. As only one study included biochemical confirmation of menopause, it remains unclear whether individuals with early menopause or POI were truly menopausal or had prolonged amenorrhea due to other causes. Overall, our findings highlight the need for further investigation with studies that include an HIV negative control group and biochemical confirmation of menopause to better understand whether menopause truly is occurring earlier among WLWH.
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Affiliation(s)
- Clara E Van Ommen
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth M King
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
| | - Melanie C M Murray
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Women's Health Research Institute, BC Women's Hospital, Vancouver, BC, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
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Reis VMCP, Rocha JSB, Fonseca AA, Freitas RF, Passos BMA, Baldo MP, Freire RS, Reis GCV, Oliveira FPSLD, Magalhães TAD, Silveira MF. A Comparison of the Prevalence of Metabolic Syndrome According to Different Definitions in Climacteric Women. Metab Syndr Relat Disord 2021; 19:436-442. [PMID: 34227853 DOI: 10.1089/met.2020.0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The prevalence of metabolic syndrome (MS) varies according to the different definitions available for clinical practice. The study aimed to estimate and compare the prevalence of MS according to the definitions of the American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHBI), International Diabetes Federation (IDF), and Joint Interim Statement (JIS) in a sample of climacteric women in Brazil. Methods: A population-based cross-sectional study, using a probabilistic sampling by clusters, involved 874 climacteric women. Clinical and anthropometric variables were acquired while fasting, and MS was defined according to three recommendations. To define the agreement between different definitions on MS, we calculated the sensitivity and specificity for the diagnosis of MS based on AHA/NHBI and IDF in relationship to the JIS definition. Results: The prevalence of MS was 56.9% according to the AHA/NHBI definition, 61.6% by the IDF, and 64.8% by the JIS definition, without statistical significance. When prevalence of MS was stratified by climacteric stages, the ability of the different definitions identifying MS was also similar among groups. It was observed that the MS definition proposed by AHA/NHBI identified 87.4% of MS cases from the total cases diagnosed by JIS, with agreement levels by the Kappa index of 0.835. The IDF detected 95.3% of MS cases compared to the JIS definition and the agreement level was 0.934. Conclusions: The study indicates a high prevalence of MS in climacteric women regardless of the definition used (AHA/NHBI, IDF e JIS). We did not observe significant divergences between definitions.
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Affiliation(s)
| | - Josiane Santos Brant Rocha
- Department of Physical Education and Sports from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Alenice Aliane Fonseca
- Department of Health, Society and Environment from the Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ronilson Ferreira Freitas
- Department of Health, Society and Environment from the Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Betânia Maria Araújo Passos
- Department of Physical Education and Sports from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Rafael Silveira Freire
- Department of Health Sciences from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Gabriel Chaves Veloso Reis
- Department of Mechanical Engineering from the Federal University of São João Del Rey, Minas Gerais, Brazil
| | | | | | - Marise Fagundes Silveira
- Department of Health Sciences from the State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
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Jaballah A, Soltani I, Bahia W, Dandana A, Hasni Y, Miled A, Ferchichi S. The Relationship Between Menopause and Metabolic Syndrome: Experimental and Bioinformatics Analysis. Biochem Genet 2021; 59:1558-1581. [PMID: 33973091 DOI: 10.1007/s10528-021-10066-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
Menopausal hormonal changes have been associated with the emergence of the metabolic syndrome (MetS) and its consequences such as type 2 diabetes (T2D) and cardiovascular diseases (CVD). The common gene signature and the associated signaling pathways of MetS, T2D, CVD and menopause status have not been widely studied. We analyzed a total of 314 women aged between 35 and 75 years. The sample was divided into two groups: Group I, including women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of MetS and its components were evaluated, as well as occurrence of T2D and CVD in both groups. We also exploited the translational bioinformatics approach to choose the common gene signatures for MetS, T2D, CVD and the menopause status. The frequency of the MetS was significantly higher in postmenopausal women than in premenopausal ones (67.1 vs. 27.2%, p < 0.001). Gene mining analysis revealed that a total of 47 genes were commonly associated with MetS, T2D, CVD and the menopausal changes. The gene enrichment analysis showed that these genes were markedly enriched in biological processes, including positive regulation of binding, positive regulation of leukocyte cell-cell adhesion, regulation of lipid localization. Furthermore, P53 signaling pathway, prolactin signaling pathway, parathyroid hormone synthesis, secretion and action were the top enriched pathways. Additionally, network analysis revealed TGFB1, SPP1, MMP2, MMP9, CCL2, IGF1, EGFR, ICAM1, TNF and IL6 as important hub genes with significant interacting partners. These hub genes identified in our study may play key role in menopausal changes and influence the risks of MetS, T2D and CVD.
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Affiliation(s)
- Abir Jaballah
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.
| | - Ismael Soltani
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Wael Bahia
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Azza Dandana
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Yosra Hasni
- Dept. Endocrinology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Abdelhedi Miled
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.,Dept. Biochemistry, Farhat Hached University Hospital, Sousse, Tunisia
| | - Salima Ferchichi
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.,Dept. Biochemistry, Farhat Hached University Hospital, Sousse, Tunisia
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Prevalence of Metabolic Syndrome and Nonalcoholic Fatty Liver Disease among Premenopausal and Postmenopausal Women in Ho Municipality: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2168381. [PMID: 32420328 PMCID: PMC7210522 DOI: 10.1155/2020/2168381] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
Methods A cross-sectional study was conducted among 185 participants: 88 premenopausal and 97 postmenopausal women obtaining healthcare service from Ho Teaching Hospital (HTH) and Ho Municipal Hospital from November 2018 to January 2020. Questionnaires were administered, and direct anthropometric measurements were taken. Blood samples were collected between 8:00 am and 10:00 am after overnight fast (12 to 18 hours; ≥8 hours) to assess fasting blood glucose, fasting lipids, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) concentrations at HTH laboratory using standard measuring procedures. This study in diagnosing metabolic syndrome and nonalcoholic fatty liver disease employed the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria and the Bedogni fatty liver index algorithm, respectively. Results The overall prevalence of MetS and NAFLD was 24.86% and 40.00% using NCEP-ATPIII and Bedogni fatty liver index algorithm, respectively. The prevalence of MetS and NAFLD among postmenopausal women was 32.99% and 49.48%, respectively, higher than 15.91% and 29.55%, respectively, observed among premenopausal women. The most prevalent MetS component among the study population was abdominal obesity (68.65%) which was significantly higher among the postmenopausal women (82.47%) than premenopausal women (53.41%) (<0.001). Hyperglycemia and hypertension were the major significant risk factors for developing MetS among premenopausal women whereas high triglyceride was the highest risk factor found among the postmenopausal women. Obesity and abdominal obesity were the most likely risk factors for developing nonalcoholic fatty liver disease among both premenopausal and postmenopausal women. Comorbidities of MetS and NAFLD were significant risk factors for developing cardiovascular diseases (CVD) (OR = 5.2, 95%CI = 2.2-12.4; p < 0.001). Conclusion This study established a significant association between coronary artery disease and comorbidities of MetS and NAFLD among the studied participants. Both conditions were found to be more prevalent among postmenopausal women compared to premenopausal women. Abdominal obesity was the most prevalent MetS component among the population. Women should be monitored for the two conditions and be educated on adopting healthy lifestyles to minimize the incidence of these conditions.
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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: 112] [Impact Index Per Article: 22.4] [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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Tabatabaei-Malazy O, Djalalinia S, Asayesh H, Shakori Y, Esmaeili Abdar M, Mansourian M, Mahdavi Gorabi A, Noroozi M, Qorbani M. Menopause and metabolic syndrome in the Middle East countries; a systematic review and meta-analysis study. J Diabetes Metab Disord 2018; 17:357-364. [PMID: 30918871 PMCID: PMC6405407 DOI: 10.1007/s40200-018-0375-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Metabolic syndrome (MetS) prevalence that is associated with increasing risk of diabetes and cardiovascular diseases (CVD) has accelerated with age. Since, menopause is known as a partial cause of CVD accelartion with againg among women, determining the prevalence of MetS is important in this condition. We aimed to assess critically the prevalence rate of MetS among menopaused women in the Middle East Countries in this systematic review meta-analysis study. METHODS & MATERIALS International webdata bases including Scopus, ISI web of Science and PubMed were systematically searched using Medical Subject Headings terms from January 2000 to February 2017. We included all cross-sectional conducted in the Middle East that reported prevalence of MetS in menopause status regardless of MetS definition. Quality assessment was considered for each included study. The pooled prevalence of MetS based on the Adult Treatment Panel III (ATP III) was estimated using random effect method due to between-study heterogeneity by STATA software, version 11.0 (StataCorp, USA). RESULTS Within 60 studies, 21 and 17 studies were included in qualitative synthesis and meta-analysis respectively. The prevalence of MetS among menopaused women was estimated 54.87% (95% CI: 53.76-55.97) in the Middle East countries. In sub-group analysis based on country the prevalence rate of MetS in Iran and Turkey was estimated 58.78% (95% CI: 57.54-60.02), and 39.02% (95% CI: 36.57-41.47), respectively. CONCLUSIONS MetS was highly prevalent as an alarming sign among menopaused women in the Middle East countries. Thus, it is an emergency requirement to promote healthy lifestyle. Also, early detection and treatment of women who reach menopause and are at great risk of developing MetS is necessary for prevention of diabetes and CVD in the region.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Yalda Shakori
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Esmaeili Abdar
- Social Determinants of Health Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, ehran University of Medical Sciences, Tehran, Iran
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Ebtekar F, Dalvand S, Gheshlagh RG. The prevalence of metabolic syndrome in postmenopausal women: A systematic review and meta-analysis in Iran. Diabetes Metab Syndr 2018; 12:955-960. [PMID: 29891195 DOI: 10.1016/j.dsx.2018.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 06/05/2018] [Indexed: 11/18/2022]
Abstract
Metabolic syndrome is a set of cardiovascular risk factors that increase the risk of cardiovascular disease, diabetes and mortality. Women are at risk of developing metabolic syndrome as they enter the postmenopausal period. The present systematic review and meta-analysis was conducted to estimate the prevalence of metabolic syndrome in Iranian postmenopausal women. In this systematic review and meta-analysis, 16 national articles published in Persian and English were gathered without time limit. National databases such as SIDs, IranMedex and MagIran, and international databases such as Web of Science, Google Scholar, PubMed and Scopus were used to search the relevant studies. We searched for articles using the keywords "menopause", "postmenopausal", "metabolic syndrome", "MetSyn", and their combinations. Data were analyzed using the meta-analysis method and the random effects model. Analysis of 16 selected articles with a sample size of 5893 people showed that the prevalence of metabolic syndrome in Iranian postmenopausal women was 51.6% (95% CI: 43-60). The prevalence of metabolic syndrome based on ATP III and IDF criteria was 54% (95% CI: 59-63) and 50% (95% CI: 45-56), respectively. Based on the results of univariate meta-regression analysis, the increase in the mean age of postmenopausal women (p = 0.001) and sample size (p = 0.029), the prevalence of metabolic syndrome increased significantly. More than half of postmenopausal women in Iran suffer from metabolic syndrome. Providing training programs for postmenopausal women to prevent and control cardiovascular disease and its complications seems to be necessary.
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Affiliation(s)
- Fariba Ebtekar
- Dept. of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Sahar Dalvand
- Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Reza Ghanei Gheshlagh
- Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Hormone Replacement Therapy: Would it be Possible to Replicate a Functional Ovary? Int J Mol Sci 2018; 19:ijms19103160. [PMID: 30322209 PMCID: PMC6214095 DOI: 10.3390/ijms19103160] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Throughout history, menopause has been regarded as a transition in a woman’s life. With the increase in life expectancy, women now spend more than a third of their lives in menopause. During these years, women may experience intolerable symptoms both physically and mentally, leading them to seek clinical advice. It is imperative for healthcare providers to improve the quality of life by reducing bothersome menopausal symptoms and preventing disorders such as osteoporosis and atherosclerosis. The current treatment in the form of hormone replacement therapy (HRT) is sometimes inadequate with several limitations and adverse effects. Objective and rationale: The current review aims to discuss the need, efficacy, and limitations of current HRT; the role of other ovarian hormones, and where we stand in comparison with ovary-in situ; and finally, explore towards the preparation of an HRT model by regeneration of ovaries tissues through stem cells which can replicate a functional ovary. Search methods: Four electronic databases (MEDLINE, Embase, Web of Science and CINAHL) were searched from database inception until 26 April 2018, using a combination of relevant controlled vocabulary terms and free-text terms related to ‘menopause’, ‘hormone replacement therapy’, ‘ovary regeneration’, ‘stem cells’ and ‘ovarian transplantation’. Outcomes: We present a synthesis of the existing data on the efficacy and limitations of HRT. HRT is far from adequate in postmenopausal women with symptoms of hormone deprivation as it fails to deliver all hormones secreted by naïve ovarian tissue. Moreover, the pharmacokinetics of synthetic hormones makes them substantially different from natural ones. Not only does the number and type of hormones given in HRT matter, but the route of delivering and their release in circulation are also imperative. The hormones are delivered either orally or topically in a non-physiological uniform manner, which brings along with it several side effects. These identify the need for a hormone delivery system which replicates, integrates and reacts as per the requirement of the female body. Wider implications: The review outlines the strengths and weaknesses of HRT and highlights the potential areas for future research. There is a tremendous potential for research in this field to understand the collective roles of the various ovarian hormones and to devise an auto-regulated hormone delivery system which replicates the normal physiology. Its clinical applications can prove to be transformative for postmenopausal women helping them to lead a healthy and productive life.
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Li NY, Yu H, Li XL, Wang QY, Zhang XW, Ma RX, Zhao Y, Xu H, Liang W, Bai F, Yu J. Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome: A Prospective, Open-Labeled, Randomized Controlled Trial. Chin Med J (Engl) 2018; 131:516-526. [PMID: 29483384 PMCID: PMC5850666 DOI: 10.4103/0366-6999.226077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS. Methods: This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis. Results: A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E’; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E’ to the late diastolic mitral annular velocity (E’/A’; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E’ (E/E’; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E’ (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E’/A’ (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E’ (r = 0.472; P = 0.003) and E’/A’ (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E’ (r = −0.590; P < 0.001), E/E’ (r = 0.454; P = 0.004), and E’/A’ (r = −0.377; P = 0.018). Conclusions: Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD. Chinese Clinical Trial Register: ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.
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Affiliation(s)
- Ning-Yin Li
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Heng Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiu-Li Li
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Qiong-Ying Wang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiao-Wei Zhang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Rui-Xin Ma
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yang Zhao
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Han Xu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Wei Liang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Feng Bai
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Jing Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
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Bianchi VE, Locatelli V. Testosterone a key factor in gender related metabolic syndrome. Obes Rev 2018; 19:557-575. [PMID: 29356299 DOI: 10.1111/obr.12633] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 12/15/2022]
Abstract
Metabolic syndrome (MetS) is highly correlated with cardiovascular diseases. Although an excess of body fat is a determinant factor for MetS development, a reduced level of testosterone plays a fundamental role in its regulation. Low testosterone level is highly related to insulin resistance, visceral obesity and MetS. We have searched in Pubmed clinical trial with the password: testosterone and insulin resistance, and testosterone and MetS. We found 19 studies on the correlation between testosterone level with insulin resistance and 18 on the effect of testosterone therapy on MetS. A high correlation between low testosterone and insulin resistance has been found in men, but not in women. Testosterone administration in hypogonadal men improved MetS and reduced the mortality risk. Androgen and oestrogen receptors are expressed in adipocytes, muscle and liver tissue, and their activation is necessary to improve metabolic control. Normalization of testosterone level should be the primary treatment in men, along with caloric restriction and physical exercise. These findings come mainly from correlative data, and there remains a need for randomized trials to strengthen this evidence. This review will consider the effects of testosterone on the regulation and development of MetS in men and women.
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Affiliation(s)
- V E Bianchi
- Nutrition and Metabolism, Clinical Center Stella Maris, Falciano, San Marino
| | - V Locatelli
- Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
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16
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Abstract
OBJECTIVE Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease and diabetes. Menopause is associated with an increased risk for MetS. The purpose of this meta-analysis is to better understand the relationship between MetS and menopause. METHODS MEDLINE and EMBASE were searched for all the associated articles on (1) MetS components in postmenopausal women vs. premenopausal women, (2) comparison of MetS incidence between surgical menopause and natural menopause, (3) the effect of hormone therapy (HT) with 17β-estradiol (E2) compared to conjugated equine estrogen (CEE) on MetS components among postmenopausal women. A meta-analysis was applied by Review Manager 5.3 software. RESULTS All comparable indicators were significantly unfavorably changed in postmenopausal women compared to premenopausal women except for high density lipoprotein cholesterol. Women who underwent surgical menopause suffered a 1.51-fold higher risk for MetS compared to those with natural menopause. HT with E2 provided more benefits for levels of triglyceride and diastolic blood, while CEE showed a better effect on both high and low density lipoprotein cholesterol levels. CONCLUSIONS Menopause nearly adversely affects all components of MetS, and surgical menopause may lead to a higher incidence of MetS compared to natural menopause. HT with various preparations may have different effects on MetS components. These results may clarify the management of menopause-related MetS in clinical practice.
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Affiliation(s)
- D Pu
- a State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology , The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University , Nanjing , China
| | - R Tan
- a State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology , The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University , Nanjing , China
| | - Q Yu
- b Department of Obstetrics and Gynecology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing , China
| | - J Wu
- a State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology , The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University , Nanjing , China
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Akl C, Akik C, Ghattas H, Obermeyer CM. Gender disparities in midlife hypertension: a review of the evidence on the Arab region. Womens Midlife Health 2017; 3:1. [PMID: 30766703 PMCID: PMC6299986 DOI: 10.1186/s40695-017-0020-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/10/2017] [Indexed: 01/09/2023] Open
Abstract
Objective While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region. Methods We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region. We abstracted information on the prevalence of hypertension among women and men, in general populations during midlife. Results Nineteen studies provided data on the prevalence of hypertension by gender and age in the Arab world. Higher rates of hypertension were found among Arab women at midlife in most countries. In studies that included subjects younger than 35 years old, a decrease in sex ratios (M/F) at midlife was observed in all countries except Palestine. Higher female prevalence rates are observed in the 4th decade of life in most countries of the region, almost two decades earlier than in other parts of the world. Conclusions This review highlights the need for more systematic examinations of hypertension in the Arab region, its risk factors, and the reasons for the particular patterns of gender differences that are observed. Such research would have considerable implications for prevention, treatment, and improved well-being.
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Affiliation(s)
- Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut 1107-2020 Lebanon
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut 1107-2020 Lebanon
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut 1107-2020 Lebanon
| | - Carla Makhlouf Obermeyer
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut 1107-2020 Lebanon
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Kim J, Ahn S. Impact of Menopausal Status, Metabolic Syndrome and its Risk Factors on Impaired Quality of Life above Middle-aged Women. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2016; 22:275-286. [PMID: 37684876 DOI: 10.4069/kjwhn.2016.22.4.275] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/25/2016] [Accepted: 11/02/2016] [Indexed: 09/10/2023] Open
Abstract
PURPOSE This study explored influencing factors on quality of life (QoL) above middle-aged women in relation to demographic factors, health-related factors, menopausal status, metabolic syndrome (MS) and its risk factors. METHODS This study was secondary data analysis from the Sixth Korea National Health and Nutrition Examination Survey 2013~2015 that utilized a complex, multi-stage probability sample design. Study sample of 2,310 was inclusive of (28.8%) of women who were over 40. To evaluate the factors that would influence an impaired quality of life, χ² test, GLM, and logistic regression analysis were done. RESULTS Level of quality of life was lower in women with late post-menopause(over 10 years since menopause) than women with pre-menopause. Factors influencing impaired QoL were as follows: graduated middle school and elementary school or less (OR=2.43, 4.42, respectively, p<.05), no job (OR=1.92, p<.001), stress (OR=1.92, p=.001), depression (OR=1.93, p=.001), insufficient sleep (OR=1.64, p=.003), late post-menopause (OR=2.61, p=.044) and over 85cm of waist circumference (OR=1.76, p=.01). CONCLUSION These results suggest that late post-menopause may be an independent factor influencing an impaired QoL. To promote post-menopausal womens' health, a nursing strategy is required to teach women how to manage levels of stress, depression, insufficient sleep, and abdominal obesity through health education, nutritional counselling, and physical activity program.
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Affiliation(s)
- Jisoon Kim
- College of Nursing, Graduate School, Chungnam National University, Daejeon, Korea
| | - Sukhee Ahn
- College of Nursing, Graduate School, Chungnam National University, Daejeon, Korea
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Singh A, Sinha N. Metabolic Syndrome: Can We Keep Check? J Obstet Gynaecol India 2016; 66:466-470. [PMID: 27821989 PMCID: PMC5080218 DOI: 10.1007/s13224-015-0713-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is on the rise due to the epidemic increase of obesity. It increases the risk of atherosclerotic cardiovascular diseases and type II diabetes mellitus. AIMS To study the prevalence of MetS and its components in premenopausal and postmenopausal women. DESIGN Cross-sectional comparative study. MATERIAL AND METHOD Five hundred premenopausal women and 500 postmenopausal women in the age group 40-65 years, attending OPD of Obstetrics and Gynecology Department of Pt. J.N.M. Medical College, Raipur from September 2012 to August 2014 were analyzed and assessed for the MetS risk factors and evaluated according to the NCEP ATP III criteria. RESULTS The prevalence of MetS in postmenopausal women was 48.6 %, nearly 1.7 times the prevalence in premenopausal women (27.4 %). Except for central obesity and low HDL cholesterol, the frequency of hyperglycemia, high blood pressure, and hypertriglyceridemia were significantly higher in postmenopausal than in premenopausal women. All the five factors of NCEP ATP III criteria were present in 5 % of postmenopausal women in contrast to 0.4 % in premenopausal women. CONCLUSION Prevention is better than cure. The need of the hour is to target premenopausal women who are at risk of developing MetS in their postmenopausal age. It will delay and prevent them from future morbidities.
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Affiliation(s)
- Abha Singh
- Department of Obstetrics and Gynaecology, Pt. J.N.M. Medical College, Raipur, India
| | - Neha Sinha
- Department of Obstetrics and Gynaecology, Pt. J.N.M. Medical College, Raipur, India
- Pt. J.N.M. Medical College, Room No. 2, New Girls Hostel, Raipur, 492001 Chattisgarh India
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Suliga E, Kozieł D, Cieśla E, Rębak D, Głuszek S. Factors Associated with Adiposity, Lipid Profile Disorders and the Metabolic Syndrome Occurrence in Premenopausal and Postmenopausal Women. PLoS One 2016; 11:e0154511. [PMID: 27128677 PMCID: PMC4851395 DOI: 10.1371/journal.pone.0154511] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/14/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was the assessment of the dependencies between a woman’s menopausal status and adiposity, lipid profile and metabolic syndrome occurrence, as well as finding out whether the correlations between the socio-demographic profile and lifestyle elements and adiposity, lipid profile and the risk of MetS are the same before and after menopause. A cross-sectional study was carried out on 3636 women, aged between 40–59, which involved a questionnaire interview, anthropometric measurements and fasting blood samples, on the basis of which the concentration of triglycerides, cholesterol and glucose was estimated. Before menopause, a greater adiposity (BMIβ = 0.08; %BFβ = 0.07; WCβ = 0.06) was characteristic for women living in a stable relationship than for single women. Women who smoked in the past were characterized by a higher BMI (β = 0.09) and WC (β = 0.06) in comparison with women who have never smoked, while after menopause a greater adiposity (%BFβ = 0.12) and a worse lipid profile (TCβ = 0.08; LDLβ = 0.07; HDLβ = -0.05; TGβ = 0.14) were present in women currently smoking, in comparison to women who have never smoked. After menopause, in women who had two or more children, a greater adiposity (BMIβ = 0.07 and 0.09; %BFβ = 0.05 and 0.07) and a higher risk of MetS (OR = 1.22, 95%CI: 1.03–1.44) was observed compared to nulliparous women, than before menopause. In women with a higher level of education, the risk of MetS after menopause was significantly lower compared with women with a lower level of education (OR = 0.74, 95%CI: 0.61–0.90). Physical activity after menopause had a higher influence on the decrease in the women’s adiposity (BMIβ = -0.11 v. -0.06; %BFβ = -0.11 v. -0.06; WCβ = -0.14 v. -0.08), than before menopause. In women not undergoing hormone replacement therapy, some of the socio-demographic factors and lifestyle elements affected adiposity, lipid profile and the risk of MetS differently before and after menopause, which requires verification through long-term research.
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Affiliation(s)
- Edyta Suliga
- Department of the Prevention of Alimentary Tract Diseases, The Institute of Nursing and Midwifery, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
- * E-mail:
| | - Dorota Kozieł
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Institute of Public Health, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Dorota Rębak
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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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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Stachowiak G, Pertyński T, Pertyńska-Marczewska M. Metabolic disorders in menopause. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2015; 14:59-64. [PMID: 26327890 PMCID: PMC4440199 DOI: 10.5114/pm.2015.50000] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 12/02/2014] [Accepted: 01/14/2015] [Indexed: 12/25/2022]
Abstract
Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism (impaired glucose tolerance - IGT, type 2 diabetes mellitus - T2DM) or components of metabolic syndrome, constitute risk factors for cardiovascular disease in women. A key role could be played here by hyperinsulinemia, insulin resistance and visceral obesity, all contributing to dyslipidemia, oxidative stress, inflammation, alter coagulation and atherosclerosis observed during the menopausal period. Undiagnosed and untreated, metabolic disorders may adversely affect the length and quality of women's life. Prevention and treatment preceded by early diagnosis should be the main goal for the physicians involved in menopausal care. This article represents a short review of the current knowledge concerning metabolic disorders (e.g. obesity, polycystic ovary syndrome or thyroid diseases) in menopause, including the role of a tailored menopausal hormone therapy (HT). According to current data, HT is not recommend as a preventive strategy for metabolic disorders in menopause. Nevertheless, as part of a comprehensive strategy to prevent chronic diseases after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered (after balancing benefits/risks and excluding women with absolute contraindications to this therapy). Life-style modifications, with moderate physical activity and healthy diet at the forefront, should be still the first choice recommendation for all patients with menopausal metabolic abnormalities.
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Affiliation(s)
- Grzegorz Stachowiak
- Department of Gynecology and Gynecological Oncology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
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