Metabolic syndrome and menopause

The paradox of haemodialysis: the lived experience of the clocked treatment of chronic illness

Studies exploring the relationship between time and chronic illness have generally focused on measurable aspects of time, also known as linear time. Linear time follows a predictable, sequential order of past, present and future; measured using a clock and predicated on normative assumptions. Sociological concepts addressing lifecourse disruption following diagnosis of chronic illness have served to enhance the understanding of lived experience. To understand the nuanced relationship between time and chronic illness, however, requires further exploration. Here, we show how the implicit assumptions of linear time meet in tension with the lived experience of chronic illness. We draw on interviews and photovoice work with people with end-stage kidney disease in receipt of in-centre-daytime haemodialysis to show how the clocked treatment of chronic illness disrupts experiences of time. Drawing on concepts of 'crip' and 'chronic' time we argue that clocked treatment and the lived experience of chronic illness converge at a paradox whereby clocked treatment allows for the continuation of linear time yet limits freedom. We use the concept of 'crip time' to challenge the normative assumptions implicit within linear concepts of time and argue that the understanding of chronic illness and its treatment would benefit from a 'cripped' starting point.

Clinacanthus nutans leaf extract reduces pancreatic β-cell apoptosis by inhibiting JNK activation and modulating oxidative stress and inflammation in streptozotocin-induced diabetic rats

Background

Controlling apoptosis induced by oxidative stress in pancreatic β-cells provides promising strategies for preventing and treating diabetes. Clinacanthus nutans leaves possess bioactive constituents with potential antioxidant and anti-diabetic properties.

Aim

This study aimed to investigate the molecular mechanisms by which C. nutans extract protects pancreatic β-cells from apoptotic damage in streptozotocin (STZ)-induced diabetic rats.

Methods

Diabetes was induced in male Wistar rats by intraperitoneal injection of 45 mg/kg STZ, followed by 28 days of treatment with C. nutans leaf extract and Glibenclamide as the standard drug. At the end of the study, blood samples were collected to measure glucose levels, oxidative stress markers, and inflammation. Pancreatic tissue was stained immunohistochemically to detect c-Jun N-terminal kinase (JNK) and Caspase-3 expression.

Results

The administration of C. nutans leaf extract to diabetic rats significantly reduced fasting blood glucose, malondialdehyde, and tumor necrosis factor-α levels, while concurrently enhancing the activity of superoxide dismutase. The immunohistochemical studies revealed a decrease in the expression of JNK and caspase-3 in the pancreatic islets of diabetic rats.

Conclusion

Clinacanthus nutans exhibits the potential to protect pancreatic β-cells from apoptosis by suppressing oxidative stress and inflammation.

Nootropic activity of methanolic extract from Evolvulus alsinoides Linn. in mice with scopolamine-induced amnesia

Plants have been used as therapeutic agents in both un-ionized (Unani, Ayurveda) and unstructured forms since ancient times. Therefore, it is of interest to document the nootropic activity of methanolic extract from Evolvulus alsinoides Linn (Vishnukranthi) in mice with scopolamine-induced amnesia. Healthy male Swiss albino mice ranging between 25 and 30 g were used in the study. Scopolamine induced amnesia, the following two tests are performed, elevated plus maze test, passive avoidance test. The mean time spent in the open arm, closed arm, and central platform for each group of animals. The total transitions were 12.6±0.89 by GS group mice, 3.4±0.55 by GSP group mice, 7±0.71 by GSLD group mice and 10±0.71 by GSHD group mice. A significant difference was seen between GS and GSP group mice means. The mean time in the safe zone and shock zone for each group of animals when comparing to Group 2 Vs Group 3, 4 showed a statistical significance of p < 0.05. The findings of this study suggest that Evolvulus alsinoides may be a promising candidate for the development of new treatments for memory impairment and other cognitive disorders. It should be noted that more data is needed to confirm the safety and efficacy of Evolvulus alsinoides in humans and to investigate its long-term effects.

Experimental diabetic animal models to study diabetes and diabetic complications

Diabetes is an endocrine illness involving numerous physiological systems. To understand the intricated pathophysiology and disease progression in diabetes, small animals are still the most relevant model systems, despite the availability and progression in numerous invitro and insilico research methods in recent years. In general, experimental diabetes is instigated mainly due to the effectiveness of animal models in illuminating disease etiology. Most diabetes trials are conducted on rodents, while some research is conducted on larger animals. This review will discuss the methodology and mechanisms in detail for preparing diabetic animal models, considering the following important points. The exact pathophysiology of the disease may or may not be replicated in animal models, the correct induction doses must be given and the combination of different approaches for the models is recommended to get desired results.•Animal models are essential to understand diabetes etiology and pathophysiology.•Diabetic models can be developed in both rodents and non-rodents.•Chemically induced and genetic models of diabetes are widely used to study diabetes and diabetic complications.

Exploring the anti-obesity bioactive compounds of Thymelaea hirsuta and Ziziphus spina-christi through integration of lipase inhibition screening and molecular docking analysis

Activity-guided fractionation of the ethanolic extracts of Thymelaea hirsuta and Ziziphus spina-christi furnished eight compounds with pancreatic lipase inhibitory activity. Six compounds were isolated from the chloroform fraction of T. hirsuta. It is worth mentioning that this is the first report for the isolation of 5,7,4'-trihydroxy-8-methoxycarbonyl flavanol (2), daphnodorin G-3''-methyl ether (4) and daphnodorin G (5) from genus Thymelaea. Moreover, daphnoretin (1), neochamaejasmin A (3) and daphnodorin B (6) were also isolated from the chloroform fraction of the same plant. On the other hand, quercetin 3-O-α-l-rhamnopyranosyl-(1 → 2)-[α-l-rhamnopyranosyl-(1 → 6)]-β-d-galactopyranoside (7) and 3-O-[α-l-fucopyranosyl-(1 → 2)-β-d-glucopyranosyl-(1 → 3)-α-l-arabinopyranosyl] jujubogenin (christinin A) (8) were isolated from the n-butanol fraction of Z. spina-christi. Structure elucidation of the isolated compounds was carried out by detailed analysis of 1D and 2D spectral data. These compounds showed percentage inhibitions of 72% (1), 52% (2), 61.8% (3), 39% (4), 69.5% (5), 3.5% (6), 68% (7) and 75% (8) at the concentration of 250 μM and XP-G scores of lipase inhibition were 11.40 (1), 8.71 (2), 6.13 (3), 8.23 (4), 6.22 (5), 9.76 (6), 14.66 (7) and 12.00 (8). This is the first report of the isolation of lipase inhibitors from both plants T. hirsuta and Z. spina-christi. In addition to that, this might result in presenting the biscoumarin, daphnoretin, and the dammarane saponin, christinin A, as potent lipase inhibitors.

Protective potential of fish oil supplementation against insulin resistance and pancreatic islet damage in STZ-induced Wistar rats

Background

Fish oil, which is regarded as the primary source of omega-3 fatty acids, has been long studied for its potential as an antidiabetic therapy. However, its protective ability against insulin resistance and pancreatic islet alteration remains unclear and controversial.

Aim

To investigate the beneficial effects of fish oil consumption on the progression of insulin resistance and pancreatic islet dysfunction in a rat model of diabetes.

Methods

Diabetic rats model (n = 30) were divided into five groups and received; 1) NS injection + NS oral (normal control); 2) NS injection + 3 g/kg fish oil (fish oil control); 3) streptozotocin (STZ) injection + NS oral [diabetes control (DC)]; 4) STZ injection + 1 g/kg fish oil (DFO1); and 5) STZ injection + 3 g/kg fish oil (DFO3). Fasting blood insulin was analyzed by commercial rat insulin enzyme-linked immunosorbent assay; meanwhile, the determination of insulin sensitivity was calculated by homeostatic model assessment of insulin resistance (HOMA-IR) and homeostatic model assessment of beta-cell function. A histological study was conducted on pancreas tissue using H and E staining.

Results

Fish oil supplementation reduced hyperglycemia and ameliorated HOMA-IR in STZ-induced animal models indicating that fish oil supplementation improved insulin sensitivity. Furthermore, animals treated with fish oil at a dose of 3 g/kg (DFO3) showed an enhancement in pancreatic islets, which was displayed by less abnormal structures than DC animals. This could imply that the administration of fish oil, especially rich in bioactive omega-3 fatty acids effectively inhibits insulin resistance and restore islet of Langerhans alteration in rats injected with STZ.

Conclusion

Thus, the current study suggested that fish oil supplementation could support the treatment of diabetes but should not be considered as an alternative therapy.

Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review

Complex metabolic dysregulation leads to metabolic syndrome (MetS) causing various symptoms such as type II diabetes, central obesity, cardiovascular diseases (CVD), altered glucose metabolism, hypertension, and dyslipidemia, and is thought to be influenced by a number of factors, including migration from rural to urban areas. socioeconomic changes, and a sedentary lifestyle. Therefore, the primary goal of this scoping review was to determine the prevalence of MetS and its components as well as to understand the association between MetS and menopausal symptoms in post-menopausal women. The search strategy included articles that were published from 2010 onwards in MEDLINE/PubMed, Scopus, and Web of Science databases. The eligibility criteria included population, concept and context (PCC) format and based on it, 10 articles were included in this review. The review concluded that in comparison to pre-menopausal women, MetS is more common in post-menopausal women who are likely to experience somatic complaints and positive correlation of vasomotor symptoms with MetS. Hence, post-menopausal women can be counselled regarding menopausal symptoms related to MetS for which appropriate and adequate treatment or measures should be taken.

Association between sensitivity to thyroid hormones and dyslipidemia in patients with coronary heart disease

BACKGROUND

Thyroid hormones affect lipid metabolism via central and peripheral regulation. However, there have been few studies on the association between thyroid hormone sensitivity and dyslipidemia. We aimed to investigate the association between thyroid hormone sensitivity and dyslipidemia in patients with coronary heart disease (CHD).

METHODS

A total of 31,678 patients with CHD were included in this large multicenter retrospective study. Central thyroid hormone sensitivity was evaluated using the thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyroid-stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI); peripheral thyroid hormone sensitivity was assessed by the ratio of free triiodothyronine (FT3)/free thyroxine (FT4). Logistic regression analysis was used to analyze the association between thyroid hormone sensitivity and dyslipidemia.

RESULTS

Among 31,678 participants, 21,648 (68.34%) had dyslipidemia. In the multi-adjusted models, the risk of dyslipidemia was positively correlated with TFQI (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.03-1.05), PTFQI (OR: 1.09; 95% CI: 1.06-1.12), TSHI (OR: 1.08; 95% CI: 1.06-1.11), and TT4RI (OR: 1.08; 95% CI: 1.05-1.11). Conversely, the risk of dyslipidemia was negatively correlated with FT3/FT4 (OR: 0.94; 95% CI: 0.92-0.97). In stratified analyses, the association between thyroid hormone sensitivity and dyslipidemia was statistically significant for different sexes, glucose levels, and blood pressure states.

CONCLUSION

There is a significant association between sensitivity to thyroid hormones and dyslipidemia, regardless of sex, glucose level, or blood pressure. Graphical abstract.

LC-MS-based metabolite profiling of aqueous extract of Pergularia tomentosa L. and its anti-hyperglycemic effect

Objectives

In this study, to find scientific evidence for the traditional use of Pergularia tomentosa as an anti-diabetic remedy, the effects of its aqueous extract on streptozotocin-induced diabetes mellitus in rats were evaluated.

Materials and Methods

Wistar rats were fasted overnight and diabetes mellitus was induced using streptozotocin (50 mg/kg body weight). The rats were randomly and equally divided into four groups (n=5): group I (normoglycaemic control), group II (diabetic rats), group III (diabetic rats treated with 200 mg/kg BW of an aqueous extract of P. tomentosa), group IV (normoglycemic rats treated with 200 mg/kg BW of an aqueous extract of P. tomentosa). Chemical profiling of the aqueous extract was carried out using liquid chromatography coupled with electrospray ionization and multiple-stage linear ion-trap and orbitrap high-resolution mass spectrometry (LC-ESI/LTQOrbitrap/MS/MS). In addition, the quantitative determination of the main cardenolides in the extract was carried out by an analytical approach based on LC coupled to tandem mass spectrometry with ESI source and hybrid triple quadrupole-linear ion trap mass analyzer (LC-ESI/QTrap/MS/MS).

Results

Aqueous extract of P. tomentosa showed a reasonable reduction in blood glucose level. Probably, the P. tomentosa effect on hyperglycemic and hyperlipidemic diabetic animals was associated with antioxidant properties, triglyceride levels, as well as liver enzymes. Meanwhile, LC-ESI/LTQOrbitrap/MS/MS analysis led to identification of double-linked cardenolides along with cardenolides and flavone glycosides as the main bioactive compounds.

Conclusion

The extract decreased the glucose level and induced a beneficial effect on the lipid profile, probably due to the presence of cardenolide glycosides.

Metabolic Disorders in Menopause

Menopause is an aging process and an important time equivalent to one-third of a woman's lifetime. Menopause significantly increases the risk of cardiometabolic diseases, such as obesity, type 2 diabetes, cardiovascular diseases, non-alcoholic liver disease (NAFLD)/metabolic associated fatty liver disease (MFFLD), and metabolic syndrome (MetS). Women experience a variety of symptoms in the perimenopausal period, and these symptoms are distressing for most women. Many factors worsen a woman's menopausal experience, and controlling these factors may be a strategy to improve postmenopausal women's health. This review aimed to confirm the association between menopause and metabolic diseases (especially MetS), including pathophysiology, definition, prevalence, diagnosis, management, and prevention.

Health Behavior Profiles Among Midlife Women: Identifying At-Risk Subgroups for Metabolic Syndrome Using Latent Class Analysis

BACKGROUND

Metabolic syndrome is known as a lifestyle disease that results from poor health behaviors. Yet, little is known about the subgroups of midlife women with distinct health behavior profiles who are at risk for developing metabolic syndrome.

PURPOSE

This study aims to identify latent subgroups of midlife women with distinct health behavior profiles (physical activity, alcohol, diet, and smoking), to describe the characteristics of latent subgroups, and to examine the association between latent class membership and future development of metabolic syndrome.

METHOD

This is a secondary data analysis using baseline and follow-up data from years 1, 3, 5, and 7 (N = 3,100) from the Study of Women's Health Across the Nation (SWAN). Latent class analysis was used to identify latent subgroups of midlife women based on their distinct health behavior profiles. Bivariate and multiple logistic regression was conducted to examine the individual characteristics of each latent subgroup and its association with the future development of metabolic syndrome.

RESULT

A 4-class model was selected: Class 1 (Healthy), Class 2 (Healthy except alcohol), Class 3 (Healthy except diet), and Class 4 (Unhealthy). Significant differences in individual characteristics were found among the four latent classes (p < .001). The regression analysis found that Class 2 had lower odds of developing metabolic syndrome at all future visits with statistical significance reached at visit 3 (p < .05) while Class 4 had higher odds of developing metabolic syndrome at all visits except visit 3 when both compared to Class 1.

CONCLUSION

Clinicians should use the study findings to offer personalized approach to promote healthy behaviors and to guide future development of health promotion programs for midlife women.

Are there differences in symptoms experienced by midlife climacteric women with and without metabolic syndrome? A scoping review

INTRODUCTION

Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome.

METHODS

A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria.

RESULTS

The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters.

CONCLUSION

Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions.

Aging and changes in adiposity indices: the impact of menopause

PURPOSE

Aging is associated with significant changes in fat distribution and menopause may alter this process. This study aimed to investigate the longitudinal effect of menopause on changes in adiposity indices (AI).

METHODS

A total number of 3876 non-menopausal women, aged > 20 years, who participated in the Tehran Lipid and Glucose study, were selected for the present study. They were followed from 1998 to 2018 at a 3-year interval and their adiposity indices were measured. Throughout the study, participants were categorized into two groups according to their menopausal status as group 1): women who reached menopause and group 2): women who did not reach menopause. The generalized estimation equation (GEE) models were used to compare the trend of changes in AIs between these two groups.

RESULTS

At the end of the study, a total number of 1479 (38.2%) participants reached menopause. The odds of general obesity decreased by 5% (OR: 0.95, 95% CI: 0.90-0.99), and the odds of central obesity increased by 6% in group1 compared to group2 (OR: 1.06, 95% CI: 1.01-1.12).

CONCLUSIONS

Menopause alters the impact of aging on central fat distribution. Increasing awareness of the related risk in menopausal women and their healthcare professional may prevent adverse related outcomes.

Severity and factors of menopausal symptoms in middle-aged women in Gansu Province of China: a cross-sectional study

OBJECTIVE

To investigate the severity and risk factors of menopausal symptoms in the middle-aged women in Gansu Province of China.

METHODS

In this cross-sectional study, a total of 7319 women (aged 40-55 years) attended the health survey in Gansu Province in China were enrolled. Information on demographics, menopausal status, reproductive history, and history of chronic diseases was collected via a structured questionnaire. Severity of menopausal symptom was evaluated by the Modified Kupperman Menopausal Index. Ordinal logistic regression model was applied to explore its risk factors.

RESULTS

A total of 7319 participants were included in present study, among them, 3606 (49.27%) had moderate or severe menopausal symptom. Compared with premenopausal women, perimenopausal and postmenopausal women have a higher mKMI score. We observed that older age, higher BMI, non-married status, longer duration of menstruation (≥ 7 days), number of pregnancy (> 3 times), longer duration of breastfeeding (> 12 months), peri- or post-menopausal status, and menopause hormone therapy was positively associated with menopausal symptom score, while higher level of family income, educational and physical activity, and history of gynecological, breast or chronic disease were negatively associated with the score.

CONCLUSIONS

Numerous factors were associated with the severity of menopausal symptom among the Chinese women. Because it was gradually increased with aging, more attention is warranted to manage the menopausal symptom.

Impact of menopause on women with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic and systemic inflammation affecting multiple organ systems, including an increased risk of cardiovascular disease due to the SLE-associated hyperinflammatory state. SLE shows a strong female predominance, suggesting a potential role of sex hormones in the pathogenesis of the disease. Evidence suggests an earlier age of menopause among women with SLE, despite mixed findings regarding other markers of ovarian aging. In healthy populations, the menopausal transition is associated with important physiologic changes resulting in increased cardiometabolic risk and risk of osteoporosis. Thus, women with SLE who experience the inflammatory effects of the autoimmune condition combined with the (potentially earlier) menopausal transition may represent a particularly vulnerable group of individuals during a particular window of time. Little is known, however, about strategies for cardiovascular risk or bone loss mitigation in women with SLE during the menopausal transition. Further, despite lack of knowledge regarding the burden of menopausal symptoms in women with SLE, existing recommendations provide only cautionary guidance for the use of hormone replacement therapy to address menopausal symptoms in this population. Importantly, the data regarding both SLE and menopause-associated cardiovascular and osteoporotic risk demonstrate the critical need for additional research to identify the type and timing of treatments or interventions needed to best mitigate this increased risk.

Resistance Band Exercise Training Prevents the Progression of Metabolic Syndrome in Obese Postmenopausal Women

Metabolic syndrome (MetS) is classified as a combination of risk factors for cardiovascular disease (CVD), and postmenopausal women are specifically at an increased risk for MetS, in part due to the hormonal and metabolic changes that occur at the menopause transition. It is crucial to combat the components of MetS with appropriate lifestyle interventions in this population, such as exercise. This study aimed to examine the effects of a resistance band exercise training program in obese postmenopausal women with MetS. A total 35 postmenopausal women were randomly assigned to either a control group (CON, n = 17) or a resistance band exercise training group (EX, n = 18). Participants in the EX group trained 3days/week. Levels of blood glucose, insulin, homeostatic model of insulin resistance (HOMA-IR), blood lipid profile, anthropometrics, and blood pressure (BP) were measured at baseline and after the exercise intervention. There were significant group by time interactions (p < 0.05) for blood glucose (Δ-4.5 mg/dl), insulin (Δ -1.3 μU/ml), HOMA-IR (Δ -0.6), triglycerides (Δ -9.4 mg/dl), low-density lipoprotein cholesterol(Δ -10.8 mg/dl), systolic BP(Δ -3.4 mmHg), body fat percentage (Δ -3.0 %), and waist circumference (Δ -3.4 cm), which significantly decreased (p < 0.05), and lean body mass (Δ 0.7 kg) and high-density lipoprotein cholesterol (Δ 5.1 mg/dl), which significantly increased (p < 0.05) after EX compared to no change in CON. The present study indicates that resistance band exercise training may be an effective therapeutic intervention to combat the components of MetS in this population, potentially reducing the risk for the development of CVD.

Identification of Symptom Clusters Among Midlife Menopausal Women with Metabolic Syndrome

The aim of this study was to identify and compare symptom clusters in midlife menopausal women with and without metabolic syndrome based on symptom occurrence and severity dimension through secondary data analysis of the Study of Women's Health Across the Nation. Exploratory factor analysis was used to group symptoms that are highly correlated with each other and verified by confirmatory factor analysis. Midlife menopausal women with metabolic syndrome (n = 424) experienced mental health, vasomotor, and somatic cluster across both symptom dimensions. In contrast, midlife menopausal women without metabolic syndrome (n = 1022) experienced mental health/sleep/urinary, vasomotor, and somatic cluster for symptom occurrence dimension and mental health/sleep, vasomotor/genital, and somatic cluster for symptom severity dimension. This is the first study to identify symptom clusters in midlife menopausal women with metabolic syndrome, who are at risk for experiencing complex symptoms associated with menopause transition and metabolic syndrome, and to compare symptom clusters to those without metabolic syndrome.

Interaction between major dietary patterns and cardiorespiratory fitness on metabolic syndrome in Iranian adults: a cross-sectional study

Background

Several researches have been conducted on the associations between diet and cardiorespiratory fitness (CRF) and major cardiovascular risk factors. However, there is no report about the interaction between major dietary patterns and CRF on metabolic syndrome (MetS) and its components. To investigate the combined association of major dietary patterns and CRF on MetS and its components.

Methods

This cross-sectional study was conducted on 270 apparently healthy adults living in Tehran, Iran. Dietary intake was evaluated using a validated food frequency questionnaire (FFQ). CRF was assessed using a graded exercise treadmill test. Socio-economic status, anthropometric measures, biochemical parameters, and blood pressure were evaluated according to standard methods. Major dietary patterns were identified by factor analysis.

Results

Three major identified dietary patterns were (healthy, mixed, and western). Significant positive association was found between mixed dietary pattern and metabolic syndrome (OR = 2.68, 95% CI (1.92,7.78), P = 0.04). There were not relations between tertiles of identified dietary patterns and remained outcomes. Those who had higher adherence to mixed pattern with also higher CRF showed a significant decrease for diastolic blood pressure (P < 0.01). Also we found that there was no significant interaction between any of dietary patterns and CRF on odds of MetS.

Conclusions

Overall, adherence to mixed dietary pattern in this population was associated with increasing odds of MetS. However, nor CRF neither the combination of dietary patterns and CRF was related to the odds of MetS among Iranian adults. More studies are needed to clarify these associations and to consider interpersonal determinants.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00695-4.

Does physical activity lower the risk for metabolic syndrome: a longitudinal study of physically active older women

Background

The associations between physical activity and metabolic syndrome (MetS) have been mainly found in cross-sectional studies. The aim of this longitudinal study was to examine the relationship between meeting step-based guidelines and changes in the risk of metabolic syndrome.

Methods

This study included data from older women (baseline age 62.9 ± 4.3 years) from a 7-year longitudinal study in Central Europe. At baseline and follow-up, physical activity was measured by an accelerometer, and the risk for MetS was assessed according to the NCEP-ATP III criteria. In 59 women, multivariate repeated measures ANOVA was used to compare differences in changes in the risk of MetS in groups based on meeting step-based guidelines (10,000 steps/day and 9000 steps/day for women aged <65 and ≥ 65 years, respectively).

Results

Over 7 years, steps/day increased from 10,944 ± 3560 to 11,652 ± 4865, and the risk of MetS decreased from 41 to 12% in our sample. Women who longitudinally met step-based guidelines had a significantly higher mean concentration of high-density cholesterol (HDL-C) (64.5 and 80.3 mg/dL at baseline and follow-up, respectively) and a lower concentration of triglycerides (TGs) (158.3 and 123.8 mg/dL at baseline and follow-up, respectively) at follow-up compared to baseline. Moreover, women who increased their daily steps over 7 years to the recommended steps/day value significantly decreased the concentration of TGs (158.3 mg/dL and 123.8 mg/dL at baseline and follow-up, respectively).

Conclusions

Our study might suggest that the long-term meeting of step-based guidelines or an increase in daily steps/day to achieve the recommended value could be related to a lower risk of MetS, specifically in concentrations of HDL-C and TG. These findings may help in designing interventions aiming to decrease the risk of MetS in older women.

Prevalence of the Metabolic Syndrome Among Batswana Adults in Urban and Semi-Urban Gaborone

PURPOSE

The metabolic syndrome (MetS) is on the rise in Sub-Saharan Africa, attributed to increased and uncontrollable urbanization accompanied by its lifestyle changes. Non-communicable diseases, such as hypertension, diabetes, and obesity, which are components of the (MetS) are also on the increase in Botswana. To date, no study has determined the prevalence of the MetS in the apparently healthy Batswana adults. The objective of the study was to determine the prevalence of the MetS among the 25-65-year-old Batswana residing in urban and neighboring semi-urban areas of Gaborone.

PARTICIPANTS AND METHODS

A cross-sectional study was used to collect data from N=794 participants, n=383 men and n=411 women, residing in Gaborone and two surrounding semi-urban areas. Data collected included demographic, anthropometric measurements, blood pressure (BP), blood glucose, triglycerides, high-density lipoprotein cholesterol (HDL-C) and total cholesterol.

RESULTS

A high prevalence of 26.8% was reported, with women mostly afflicted (35.0% vs 18.0%). The MetS risk factors found to be common in women were low HDL-C at (50% vs 48.7%) compared to men, while proportions with elevated BP (50.3% vs 39.4%) were prominent in men. The prevalence increased with age, with the oldest age group showing a higher prevalence in both women and men, respectively (55-65 years; 38.5% vs 41.2%).

CONCLUSION

An unprecedented high MetS prevalence was revealed among perceived to be healthy Batswana adults, with women at a higher risk. This public health concern creates an opportunity to establish evidence of risk factors, develop guidelines and strategies with appropriate public health measures to prevent and control the MetS.

Are There Any Beneficial Effects of Spirulina Supplementation for Metabolic Syndrome Components in Postmenopausal Women?

Spirulina is a phytosynthetic filamentous cyanobacterium with microscopic dimensions, which naturally grows in the highly-salted alkaline lakes of Africa, Mexico, America, and Asia. Several bioactive peptides extracted from Spirulina were demonstrated to possess antimicrobial, antiviral, antitumor, immunomodulatory, antiallergic and antihypertensive properties. It has been reported that the consumption of Spirulina could prevent or manage metabolic syndrome components. In women, metabolic disorders are more prevalent during menopause. Postmenopausal women present higher waist circumference, increased blood pressure, hypertriglyceridemia, hyperglycemia, and decreased HDL-cholesterol values, leading to an increased risk of cardiovascular events. Therefore, in order to prevent cardiovascular diseases, it is essential to manage the components of the metabolic syndrome during the postmenopausal period. As recent reports indicated the efficiency of Spirulina supplementation in the management of the metabolic syndrome components, our study aims to review all the clinical trials conducted on this topic. Our main objective is to have a better understanding of whether and how this cyanobacterium could manage the abnormalities included in the metabolic syndrome and if it could be used as a therapeutic approach in postmenopausal women with this condition. We selected relevant articles from PubMed, Google Scholar and CrossRef databases, and a total number of 20 studies met our criteria. All included clinical trials indicated that Spirulina has positive effects in managing metabolic syndrome components. Spirulina is a valuable cyanobacterium that can be used as a food supplement for the management of metabolic syndrome, and it is able to reduce the risk of cardiovascular events. The optimal dose and period of administration remain a debated subject, and future investigations are required. Considering the beneficial effects reported against each component of the metabolic syndrome, Spirulina could also be effective in the postmenopausal period, when this syndrome is the most prevalent, but there is a strong need for human clinical trials in order to sustain this observation.

Associations of Relative Humidity and Lifestyles with Metabolic Syndrome among the Ecuadorian Adult Population: Ecuador National Health and Nutrition Survey (ENSANUT-ECU) 2012

The effects of the physical environment on metabolic syndrome (MetS) are still largely unexplained. This study aimed to analyze the associations of relative humidity of residence, lifestyles, and MetS among Ecuadorian adults. Data from 6024 people aged 20 to 60 years were obtained from an Ecuador national population-based health and nutrition survey (i.e., ENSANUT-ECU, 2012) and the mean annual relative humidity (%) from the Ecuador National Institute for Meteorology and Hydrology (2012). Odds ratio (OR) with 95% confidence intervals (CI) for MetS according to groups of relative humidity were calculated using multiple logistic regression. Living in high relative humidity (>80%) increased ORs of reduced high-density lipoprotein (HDL) cholesterol (1.25; 95 % CI, 1.06–1.56) and MetS (OR = 1.20; 95 % CI,1.01–1.42) in women. Furthermore, physically active men living in high relative humidity showed lower OR of elevated triglycerides (0.56; 95 % CI,0.37–0.85) while menopausal women living in high relative humidity showed increased ORs of MetS (5.42; 95 % CI, 1.92–15.27), elevated blood pressure (3.10; 95 % CI, 1.15–8.35), and increased waist circumference (OR = 1.34; 95 % CI, 1.09–1.63). Our results show that residence in high relative humidity and menopausal status increase ORs of MetS and its components in Ecuadorian women; however, physical activity significantly reduces the OR of elevated triglycerides in men. The obtained findings may help make public health policies regarding environmental humidity management, nutritional education, menopausal care, and physical activity promotion to prevent the onset of MetS among Ecuadorian adults.

Metabolic syndrome in postmenopausal women is associated with lower erythrocyte PUFA/MUFA and n-3/n-6 ratio: A case-control study

The aim of this study was to compare fatty acid (FA) intake and status in postmenopausal women with or without metabolic syndrome (MetS). 131 women were recruited to a case-control study in 2016-2018 in Poznań, Poland. Dietary intake, anthropometric and biochemical measurements, FA level in red blood cells (RBCs), and FADS1 (rs174546) and FADS2 (rs3834458) genotypes were determined. Compared to women without MetS, those with MetS had lower levels of EPA, n-3, EPA/α-linolenic acid (ALA), EPA/AA, DHA/AA, EPA+DHA/AA, PUFA/saturated FA, PUFA/monounsaturated FA, and n-3/n-6 ratios in RBCs. Participants with at least one minor allele of each polymorphism had lower levels of EPA, and EPA/AA, and a higher level of DHA/EPA in RBCs than did women with major alleles. MetS is associated with lower levels FAs that have a protective effect on cardiometabolic health. FADS1 and FADS2 polymorphisms are associated with unfavorable FA and status EPA/AA in RBC contributes to MetS.

Gender heterogeneity in dyslipidemia prevalence, trends with age and associated factors in middle age rural Chinese

Background

Heterogeneity should be carefully addressed to facilitate establishment of effective population-level blood lipid management. The primary aim of the study was to investigate gender heterogeneity in prevalence of dyslipidemia, including trends with age and associated factors in middle age rural Chinese.

Methods

This is a cross-sectional study based on a baseline investigation of a population-based randomized controlled trial in rural China, involving 26,378 permanent residents of age 45–69. The age-specific prevalence of dyslipidemia was estimated for men and women, and the trends of prevalence with age were compared. Logistic regression was used to explore the factors associated with prevalent risk of dyslipidemia.

Results

The overall prevalence of dyslipidemia was significantly higher in females than in males for borderline high and above (BHA) total cholesterol (TC ≥ 200 mg/dL), BHA triglycerides (TG ≥ 150 mg/dL) and BHA low-density lipoprotein cholesterol (LDL-C ≥ 130 mg/dL), but was lower for low high-density lipoprotein cholesterol (HDL-C < 40 mg/dL) in females than the corresponding prevalence in males. The prevalence of borderline high and above TC, TG and LDL-C all rose with age in females, but was stable or even decreased with age in males. In contrast, graphic representation of the prevalence of low HDL-C showed no striking age related trend in both genders. Risk of dyslipidemia was associated predominantly with obesity in males, but was more predominantly associated with hypertension in females.

Conclusion

Heterogeneity was found in comparing the prevalence of dyslipidemia in men and women, and gender heterogeneity was found in its trend with age and associated factors in middle aged rural Chinese. The effectiveness of population-level blood lipid management and CVD primary prevention programs in China is expected to be improved if gender heterogeneity is considered.

Prevalence and Incidence of Metabolic Syndrome in Iran: A Systematic Review and Meta-Analysis

Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders.

Habitual Combined Exercise Protects against Age-Associated Decline in Vascular Function and Lipid Profiles in Elderly Postmenopausal Women

Postmenopausal status is associated with increased risks for cardiovascular diseases (CVD). This study investigated differences in vascular function, lipids, body composition, and physical fitness in elderly postmenopausal women active in combined resistance and aerobic exercise (CRAE) training for 1 year versus a sedentary cohort of similar-in-age counterparts. Elderly postmenopausal women performing habitual CRAE training for 1 year (age ~75 year; CRAE, n = 57) and elderly sedentary postmenopausal women (age ~78 year; SED, n = 44) were recruited. Arterial stiffness (brachial-to-ankle pulse-wave velocity, baPWV), blood pressure, blood lipids, anthropometrics, 2-min walking distance, and muscular strength were assessed for both groups. There were significant differences for baPWV, systolic blood pressure, low-density lipoprotein, and body fat percentage, which were significantly lower (p < 0.05) in CRAE vs. SED, and both 2 min walking distance and muscular strength were significantly greater (p < 0.05) in CRAE vs. SED. These results indicate that elderly postmenopausal women participating in habitual CRAE training may have better protection against risks for CVD and have better physical fitness compared to SED counterparts.

Prevalence of metabolic syndrome and its association with risk factors in patients with established atherosclerosis disease

Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. The aim of this study was to describe the prevalence and which risk factors cause more impact in metabolic syndrome in patients with established atherosclerosis disease. A cross-sectional study was performed as a subanalysis of Programa Alimentação Cardioprotetora Brasileira. Weight, height, waist circumference, blood pressure, lipid profile and fasting glucose were collected. Metabolic syndrome was defined according to the harmonized criteria. Linear regression was used to analyze the association between number of components of metabolic syndrome and risk factors. 82 patients were included and the prevalence of metabolic syndrome was 84.1%. Being overweight was associated with an increase by 0.55 point in diagnostic criteria of metabolic syndrome in crude analysis (95%CI 0.09-1.00) and 0.64 in adjusted analysis (95%CI 0.18-1.09), while former/current smoker status was responsible for raising by 0.48 the number of components of metabolic syndrome, only in adjusted analysis (95%CI 0.04-0.92). Overweight and former/current smoker status are associated with MS, increasing the probability of atherosclerotic events. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population.

Serum uric acid to creatinine ratio and metabolic syndrome in postmenopausal Chinese women

This study aimed to investigate the association between Serum Uric Acid (UA) to Creatinine (Cr) Ratio (UA/Cr) and metabolic syndrome (MetS) in postmenopausal women.A total of 455 patients with MetS and 457 age- and gender- matched controls were included in the present retrospective study. Serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), Cr, and UA were measured. We employed logistic regression analysis to investigate the association between serum UA/Cr and MetS in postmenopausal women.Serum UA/Cr levels were significantly higher in patients with MetS than that in control subjects (P < .05). In the correlation analysis, serum UA/Cr showed a significantly positive correlation with age, hypertension, systolic pressure (SBP), diastolic pressure (DBP), Waist, body mass index (BMI), TG, UA and negative correlation with type 2 diabetes mellitus (T2DM) and Cr (P all < .001). Moreover, multivariate analysis revealed that serum UA/Cr was still an independent risk factor for MetS (OR = 2.928, 95% CI = 2.385-3.596, P < .001) after adjustments for other confounders.Serum UA/Cr are strongly associated with the risk of MetS in postmenopausal Chinese women.

Transgenerational Effects of Periconception Heavy Metal Administration on Adipose Weight and Glucose Homeostasis in Mice at Maturity

We previously demonstrated that periconception maternal administration (2 mg/kg body weight each) of cadmium chloride (CdCl2) plus methylmercury (II) chloride (CH3HgCl) impaired glucose homeostasis and increased body weights and abdominal adipose tissue weight of male offspring in the F1 generation. However, transgenerational effects of this exposure have not been studied. Therefore, the effects of periconception Cd+Hg administration on indices of chronic diseases at adulthood in F2-F4 generations were examined. Male and female progeny of Cd+Hg periconceptionally treated females, and offspring of vehicle control females were bred with naïve CD1 mice to obtain F2 offspring, with additional crosses as above to the F4 generation (F1-F4 animals were not administered Cd+Hg). Birth weights and litter size were similar in all generations. Indices of impaired glucose homeostasis were observed in matrilineally descended F2 male offspring, including reduced glucose tolerance, along with increased basal phosphorylation of insulin receptor substrate 1 (IRS1) at serine 307 suggesting altered insulin signaling. Reduced glucose tolerance was also seen in F4 males. Increased body weight and/or abdominal adiposity were observed through the F4 generation in males descended matrilineally from the treated female progenitors. Patrilineally derived F2 females displayed reduced glucose tolerance. Females (F2) patrilineally and matrilineally derived displayed significant kidney enlargement. Periconception administration of cadmium and mercury caused persistent transgenerational effects in offspring through the F4 generation in the absence of continued toxicant exposure, with persistent transgenerational effects inherited specifically through the matrilineal germline.

Vasomotor Symptoms: More Than Temporary Menopausal Symptoms

Vasomotor symptoms (VMS), such as hot flashes and night sweating, are classic menopausal symptoms experienced by a majority of perimenopausal and postmenopausal women. VMS have received a great deal of attention due to their relationship with cardiometabolic risk. Further, accumulating evidence indicates that VMS are associated with an increased risk of several chronic diseases, including metabolic syndrome, type 2 diabetes mellitus, nonalcoholic fatty liver diseases, and osteoporosis in perimenopausal and postmenopausal women. These findings suggest VMS as biomarkers of impaired cardiometabolic conditions rather than just temporary symptoms in menopausal women, warranting further studies to confirm the casual relationship of VMS with these diseases and the exact underlying mechanism in this context.

Investigating the Systems-Level Effect of Pueraria lobata for Menopause-Related Metabolic Diseases Using an Ovariectomized Rat Model and Network Pharmacological Analysis

This study was conducted to evaluate the biological activities of Pueraria lobata (PL) on menopause-related metabolic diseases and to explore the underlying mechanism of PL by network pharmacological analyses. We used ovariectomized (OVX) rats as a postmenopausal model and administered PL at different doses (50, 100, and 200 mg/kg). In OVX rats, decreased uterine weights and PPAR-γ (peroxisome proliferator-activated receptor-gamma) mRNA expression in the thigh muscle were significantly recovered after PL administration. PL also significantly alleviated OVX-induced increases in total cholesterol, triglyceride, alanine aminotransferase (ALT/GPT), and aspartate aminotransferase (AST/GOT) levels. To identify the systems-level mechanism of PL, we performed network pharmacological analyses by predicting the targets of the potential bioactive compounds and their associated pathways. We identified 61 targets from four potential active compounds of PL: formononetin, beta-sitosterol, 3’-methoxydaidzein, and daidzein-4,7-diglucoside. Pathway enrichment analysis revealed that among female sex hormone-related pathways, the estrogen signaling pathways, progesterone-mediated oocyte maturation, oxytocin signaling pathways, and prolactin signaling pathways were associated with multiple targets of PL. In conclusion, we found that PL improved various indicators associated with lipid metabolism in the postmenopausal animal model, and we also identified that its therapeutic effects are exerted via multiple female sex hormone-related pathways.

PPARG and FTO polymorphism can modulate the outcomes of a central European diet and a Mediterranean diet in centrally obese postmenopausal women

The aim of this study was to test the hypothesis that polymorphism of genes with the biggest effects on body mass (FTO and PPARG) can affect the results of dieting in centrally obese postmenopausal women. A total of 144 volunteers were randomized to a 16-week intervention with two hypocaloric diets: either a Mediterranean diet (MED) moderate in fat (37% total energy as fat) or the Central European diet (CED) moderate in carbohydrates (55% total energy as carbohydrates). The associations between FTO and PPARG polymorphism on the baseline body mass, body composition, blood pressure, lipid and non-lipid parameters, and their changes after the trial were analyzed. None of the examined baseline outcomes differed in the rs9939609 FTO subgroups; abdominal fat was higher in the minor (G) allele carriers of the PPARG rs1801282. After the intervention, in the CED group, the PPARG G allele carriers showed greater reductions in weight (-6.58 ± 0.61 vs -9.58 ± 0.83; P < .01), lean mass (-0.38 ± 0.29 vs -1.79 ± 0.38; P < .05) and high-density lipoprotein (HDL) cholesterol (-0.46 ± 0.77 vs -5.25 ± 1.49; P < .01) than the CC homozygotes, and the TT individuals of the rs9939609 FTO had greater reductions in diastolic blood pressure (-9.03 ± 1.78 vs. -7.58 ± 1.50; P < .05). In the MED group, greater reductions in abdominal fat were observed in the G allele carriers than in the CC homozygotes (-3.31 ± 0.26 vs. -4.23 ± 0.41; P < .05). PPARG and FTO polymorphism may affect the outcomes of the diets aimed at weight reduction in postmenopausal women.

Metabolic syndrome and its components in premenopausal and postmenopausal women: a comprehensive systematic review and meta-analysis on observational studies

OBJECTIVES

To perform a meta-analysis on the global prevalence of metabolic syndrome (MetS) in postmenopausal women. The meta-analysis also sought to measure the relationship menopause status has with MetS and its components.

METHODS

The Web of Science, Medline, PubMed, Scopus, Embase, CINAHL, DOAJ, and Google Scholar were all searched using the relevant keywords. Articles published during the period 2004 to 2017 that met our inclusion criteria and reported the prevalence of MetS among premenopausal and postmenopausal women were included. In the presence of heterogeneity, random-effects models were used to pool the prevalence and odds ratios (ORs), as measures of association in cross-sectional and comparative cross-sectional studies, respectively.

RESULTS

The prevalence of MetS among postmenopausal women (119 studies [n = 95,115]) and the OR comparing the prevalence of MetS among postmenopausal and premenopausal women (23 studies [n = 66,801]) were pooled separately. The pooled prevalence of MetS among postmenopausal women was found to be 37.17% (95% confidence interval [CI] 35.00%-39.31%), but varied from 13.60% (95% CI 13.55%-13.64%) to 46.00% (95% CI 1.90%-90.09%), depending upon the diagnostic criteria used. The overall pooled OR for MetS in postmenopausal women, compared with premenopausal women, was OR 3.54 (95% CI 2.92-4.30), but this ranged from OR 2.74 (95% CI 1.32-5.66) to OR 5.03 (95% CI 2.25-11.22), depending upon the criteria used. Furthermore, the odds of high fasting blood sugar (OR 3.51, 95% CI 2.11-5.83), low high-density lipoprotein cholesterol (OR 1.45, 95% CI 1.03-2.03), high blood pressure (OR 3.95, 95% CI 2.01-7.78), high triglycerides (OR 3.2, 95% CI 2.37-4.31), and high waist circumference (OR 2.75, 95% CI 1.80-4.21) were all found to be higher in postmenopausal women than in premenopausal women.

CONCLUSIONS

The prevalence of MetS is relatively high in postmenopausal women and was more prevalent among postmenopausal than premenopausal women. Menopausal hormone therapy should be used with caution in patients with MetS, as its safety has not yet been evaluated among MetS patients and meticulous evaluation of each individual patient before starting MHT is needed.

The association between metabolic syndrome and peanuts, pine nuts, almonds consumption: The Ansan and Ansung Study

BACKGROUND

Previous studies reported an inverted relationship between nut consumption and the incidence of metabolic syndrome (MetS). The present study investigated the incidental risk for MetS according to peanut, almond, and fine nut consumption in the Korean population.

METHODS

In a community-based Korean cohort, 5306 Korean adults were divided into four groups according to their peanut, almond, and fine nut intake (<1/month, 1/month-0.5/week, 0.5-1/week, and ≥1/week, in which one serving = 15 g) and were followed-up for 10 years. A Cox proportional hazard model was used to evaluate the hazard ratios (HRs) with confidence intervals (CI) for MetS in each study group. Age subgroup (≥50 or <50 years) analysis was also conducted.

RESULTS

The age and multivariable-adjusted HRs with 95% CIs for MetS showed a significant inverse dose-response relationship between peanut, almond, and fine nut intake and the incidence of MetS in men and women (multivariable-adjusted HRs [95% CI] in men; 0.91 [0.76-1.09] in 1/month-0.5/week, 1.03 [0.80-1.31] in 0.5-1/week, 0.72 [0.56-0.93] in ≥1/week and in women; 0.81 [0.65-1.003] in 1/month-0.5/week, 0.76 [0.54-1.07] in 0.5-1/week, 0.57 [0.41-0.79] ≥1/week)). Subgroup analysis showed a significant difference in middle-aged men (≥1/week) and old-aged women (≥0.5/week).

CONCLUSION

The results of the present study suggested that peanut, almond, and fine nut intake (≥15 g/week) may be inversely related to incidence risk of MetS in the Korean general population. Additionally, the association between nut consumption and MetS incidence risk may differ in sex and age subgroups.

Associations of obesity with osteoporosis and metabolic syndrome in Korean postmenopausal women: a cross-sectional study using national survey data

In a representative sample of 3058 Korean postmenopausal women, we studied which types of obesity were more or less desirable for developing concomitant osteoporosis and metabolic syndrome (MS), with the goal of helping clinicians identify steps to reduce patients' risk. Different definitions of obesity showed different relationships with osteoporosis and MS in this population.

PURPOSE

To examine sample characteristics, prevalence, and the risk of osteoporosis and metabolic syndrome among four groups of postmenopausal women classified by obesity.

METHODS

Data from the Korea National Health and Nutrition Examination Survey were analyzed using the Rao-Scott chi-square test, analysis of variance, and multinomial logistic regression analysis. The four groups included body mass index (BMI)-based obese, waist circumference (WC)-based obese, BMI-, and WC-based obese, and non-obese women, using BMI and WC cutoffs for obesity of ≥ 25 kg/m² and ≥ 80 cm, respectively.

RESULTS

The prevalence of osteoporosis and MS was 40.8% and 48.5%, respectively. Age, socioeconomic status, smoking status, and hormone therapy use differed among the obese groups. The odds ratios of simultaneously having both osteoporosis and MS in the BMI- and WC-based obese, BMI-based obese, WC-based obese, and non-obese groups were 7.39 (95% confidence interval [CI] = 4.83-11.31), 0.74 (95% CI = 0.27-1.98), 7.07 (95% CI = 4.72-10.58), and 1, respectively.

CONCLUSIONS

The findings demonstrate the most and the least desirable types of obesity in terms of risk for both osteoporosis and MS. Public health practitioners may consider the type of obesity to reduce or prevent both conditions in postmenopausal women.

Obesity in Pregnancy: Obstetrician' s Obstacle

Obesity in pregnancy is associated with several complications which today's obstetricians have to face often. Overcoming these obstacles is truly challenging. There is a steady rise in incidence of overweight or obese women at reproductive age group in India and as well as other countries. Recent advances in bariatric medicine as well bariatric surgery have led to increasing number of pregnancies in obese women. Since obesity is associated with adverse maternal and fetal outcome, it is considered as a high-risk pregnancy and such pregnancies need to be managed in maternity units which are well equipped with necessary infrastructure and availability of expert multidisciplinary faculty. This editorial will look into various challenges and difficulties faced by obstetricians and provide practical tips for managing obese pregnant women. We are introducing a new type of article "Invited Debate," with this issue. It deals with pros and cons of bariatric surgery. I sincerely hope that readers are benefitted from views and reviews presented in the invited debate as well as the editorial.

Encapsulated Mulberry Fruit Extract Alleviates Changes in an Animal Model of Menopause with Metabolic Syndrome

Currently, the therapeutic strategy against metabolic syndrome and its complications is required due to the increasing prevalence and its impact. Due to the benefits of both mulberry fruit extract and encapsulation technology, we hypothesized that encapsulated mulberry fruit extract (MME) could improve metabolic parameters and its complication risk in postmenopausal metabolic syndrome. To test this hypothesis, female Wistar rats were induced experimental menopause with metabolic syndrome by bilateral ovariectomy (OVX) and high-carbohydrate high-fat (HCHF) diet. Then, they were orally given MME at doses of 10, 50, and 250 mg/kg BW for 8 weeks and the parameters, such as percentage of body weight gain, total cholesterol, triglycerides, HDL-C, LDL-C, atherogenic index, fasting blood glucose, plasma glucose area under the curve, serum angiotensin-converting enzyme (ACE), oxidative stress status, histology, and protein expression of PPAR-γ, TNF-α, and NF-κB in adipose tissues were determined. MME improved body weight gain, adiposity index, glucose intolerance, lipid profiles, atherogenic index, ACE, oxidative stress status, and protein expression of TNF-α and NF-κB. Moreover, MME attenuated adipocyte hypertrophy and enhanced PPAR-γ expression. Taken altogether, MME decreased metabolic syndrome and its complication via the increased PPAR-γ expression. Therefore, MME is the potential candidate for improving metabolic syndrome and its related complications. However, further research in clinical trial is still necessary.

Anti-Müllerian Hormone Levels and Cardiometabolic Disturbances by Weight Status Among Men in the 1999 to 2004 National Health and Nutrition Examination Survey

Context

Serum anti-Müllerian hormone level (AMH) and body mass index may be jointly associated with cardiometabolic risk.

Objectives

Examine the contribution of AMH to cardiometabolic disturbances by weight status among US adult men.

Design

Cross-sectional analysis using data from the 1999 to 2004 waves of the National Health and Nutrition Examination Survey.

Setting

Multistage probability sampling of the noninstitutionalized US population.

Participants

US men aged ≥18 years. Final analytic sample sizes ranged from 517 to 1063 participants.

Main Outcome and Exposure Measures

Cardiometabolic disturbances (metabolic syndrome and its components, insulin resistance, diabetes, and chronic inflammation) and AMH were obtained from trained staff and nurses in a mobile examination center or during in-home visits.

Results

AMH was directly associated with insulin resistance among obese men [OR 1.08 (95% CI 1.00, 1.15); P = 0.046; N = 146], whereas AMH was inversely associated with waist circumference (WC) among obese men [OR 0.95 (95% CI 0.91, 0.99); P = 0.049; N = 146]. An inverse relationship was also observed between categorical AMH and diabetes status [medium vs low AMH; OR 0.19 (95% CI 0.043, 0.84); P = 0.030; N = 145] among obese men, with a strong inverse relationship also detected among overweight men [high vs low AMH; OR 0.011 (95% CI 0.0004, 0.27); P = 0.007; N = 193]. An inverse relationship between continuous AMH and diabetes [OR 0.75 (95% CI: 0.59, 0.93); P = 0.011; N = 193] was also detected among overweight men.

Conclusions

AMH was associated with specific cardiometabolic risk factors, including WC, diabetes status, and insulin resistance, in overweight and obese US men.

Comparative characteristics of risk factors as predictors of coronary heart disease in women during an epidemiological and clinical examination

Aim. To analyze main risk factors (RF) according to the epidemiological and clinical study and to determine the predictors of the development of coronary artery disease (CAD) in women.

Material and methods. The study included 200 women with CAD who were divided into 2 groups: I-epidemiological and II-clinical (99 and 101 patients respectively). For verification of CAD, patients were provided with a full range of epidemiological and clinical-instrumental studies.

Results. It was shown that relative risk (RR) mean values (1-2) were in BMI, abdominal obesity, arterial hypertension, hypertriglyceridemia (HTG) and HDL-hypocholesterolemia. Its higher values are for hypercholesterolemia (RR=1,2), atherogenic index (RR=1,4) and LDL-hypercholesterolemia (RR=1,5). As for additional RF, the RR for estradiol was 1,2. The highest RR was for progesterone, reaching 3,5 and for testosterone — 2,8.

Conclusion. We determined that if among the traditional RF there are no independent predictors of CAD, specialists in clinical practice can primarily use hormones (progesterone and testosterone).

Prevalence of metabolic syndrome in Iran: A meta-analysis of 69 studies

AIMS

Metabolic syndrome increases the risk of chronic diseases including cardiovascular diseases and diabetes. The present study investigated the prevalence of metabolic syndrome in Iran.

MATERIALS AND METHODS

Published articles in English and Persian during 2000-2016 identified using keywords of prevalence, metabolic syndrome, and Iran in the following databases: Web of Science, PubMed, Scopus, Google scholar, SID and Magiran. Random effect model used to calculate the pooled estimates. Heterogeneity of studies assessed using Q statistic, and geographical distribution of metabolic syndrome demonstrated via GIS map. Data were analyzed by STATA-11.

RESULTS

The overall prevalence of metabolic syndrome was 30.4% (95%CI: 28.3-32.6) with no significant heterogeneity by diagnostic criteria. The lowest frequency was reported in Sistan and Baluchestan Province [18.3% (95% CI: 12.9-25.8)] compared to the highest in Bushehr [57.8% (95% CI: 41.8-80.0)]. It was significantly more prevalent in women [(34.8% (95%CI: 31.2-38.8)] compared to men [25.7% (95%CI: 23.4-28.3)] (P = 0.001)]. A significant increasing trend (P = 0.001) was observed in different age groups, as metabolic syndrome increased from 12.1% (95% CI: 9.37-15.6) in 20-29 years-old age group to 51.7% (95%CI: 47.4-56.4) in the over 60 years-old age group.

CONCLUSIONS

Approximately one-third of Iranian adults have metabolic syndrome which varied by regions, age and gender. Then, appropriate intervention based on behavioral patterns of inhabitants and local conditions may help to reduce the burden of disease.

Head-Out Aquatic Exercise for Generally Healthy Postmenopausal Women: A Systematic Review

BACKGROUND

Aquatic exercise (AE) is a method for exercise and rehabilitation to enhance function for various clients.

OBJECTIVES

Investigate the effects of head-out AE interventions on the physiological and psychological outcomes of healthy postmenopausal women of age 50-70 years.

SEARCH STRATEGIES

Databases searched included Scopus, ScienceDirect, ResearchGate, PubMed/MEDLINE, PEDro, CINAHL, The Cochrane Library, Nursing & Allied Health Collection: Comprehensive, JSTOR, and OTSeeker.com, through January 2015. Search Criteria: Randomized controlled trial and quasi-randomized controlled trial studies.

DATA COLLECTION AND ANALYSIS

Two researchers scanned studies based on inclusion and exclusion criteria. Studies included were critically appraised using the Physiotherapy Evidence Database scale (PEDro scale).

RESULTS

A total of 15 studies including postmenopausal women and head-out AE intervention were reviewed. Considerable variation existed in the interventions and assessments. Outcome measures showed anthropometric measures (body mass index, circumference, skinfolds, and body fat) were inconclusive; upper and lower body strength improved; flexibility improved; all functional movements (short-distance walk, long-distance walk/run, power, agility, balance and falls) improved; bone density improved; biochemical and hormonal variables were inconclusive; and quality of life outcomes improved.

CONCLUSIONS

Head-out AE appears to be an effective training and conditioning method for postmenopausal women to improve strength, flexibility, functional movements, bone density, and quality of life.

The prevalence of metabolic syndrome in postmenopausal women: A systematic review and meta-analysis in Iran

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.

Religion, spirituality, coping, and resilience among African Americans with diabetes

Study aims were to explore how religion and spirituality impacted attitudes about self-management practices among African Americans with homelessness histories and to understand resilience in diabetes care practices. Qualitative semi-structured face-to-face interviews were conducted with 42 African Americans older than 18 years. All audio-taped interviews lasted between 1-1.5 hr, transcribed verbatim, and analyzed using ATLAS.ti (version 7.0). Five resilience themes emerged. While participants recognized diabetes as an illness requiring professional treatment, the context of balancing treatment with religion and spiritual practices mattered. The study findings highlight the importance of spirituality, religious beliefs, and coping strategies in diabetes self-care activities.

Relationship between vasomotor symptoms and metabolic syndrome in postmenopausal women

Objective This study was performed to compare the vasomotor symptoms and bone mineral density of postmenopausal women with and without metabolic syndrome. Methods We performed a cross-sectional study of 200 postmenopausal women attending routine health check-ups at Marmara Faculty of Medicine Pendik Training and Research Hospital from June 2015 to December 2015. The vasomotor symptoms scored were hot flashes and night sweats. Metabolic syndrome was defined using the consensus criteria of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Results Women with vasomotor symptoms had no metabolic syndrome and were younger than those without vasomotor symptoms. There was no significant difference in vasomotor symptoms between patients with osteopenia in the femoral neck, total femur, and spine and patients with normal bone mineral density. The vasomotor symptoms were similar between smokers and nonsmokers. Conclusion The presence of metabolic symptoms is inversely associated with metabolic syndrome in postmenopausal women. Lipid abnormalities and a high body mass index may be important metabolic components associated with these symptoms. No relationship is present between vasomotor symptoms and the bone mineral density of the spine, femoral neck, and total femur.

Relationship between Marital Status and Metabolic Syndrome in Korean Middle-Aged Women: The Sixth Korea National Health and Nutrition Examination Survey (2013-2014)

Background

This study aimed to investigate the relationship between marital status and the incidence of metabolic syndrome in Korean middle-aged women.

Methods

Based on data from the sixth Korea National Health and Nutrition Examination Survey (2013–2014), 3,225 women aged 40–69 years were subjected to the analysis. Marital status was categorized as married, unmarried, separated, widowed, or divorced. The odds ratios (ORs) for metabolic syndrome were calculated based on marital status. After adjustment for age, income level, education level, alcohol intake, smoking status, leisure physical activity, menopause status, daily calories, and fat intake, changes in the OR for metabolic syndrome based on marital status were examined by multivariate logistic regression analysis.

Results

The OR for metabolic syndrome in the widowed group to the married group was 4.818 (95% confidence interval [CI], 3.861–6.002; P<0.001) and that after adjustment of age, economic level, education level, alcohol intake, smoking status, physical activity, menopause status, total daily calories, and fat intake was 2.141 (CI, 1.432–3.199; P<0.001), both of which were statistically significant. The OR for metabolic syndrome in the unmarried group to the married group was 0.246 (CI, 0.141–0.431; P<0.001) after adjustment of all components. On the contrary, the ORs of the separated group and the divorced group to the married group were not significant.

Conclusion

In comparison with the married middle-aged group, the widowed middle-aged group tended to have a higher risk of metabolic syndrome, which is speculated to be related to socioeconomic factors and health behavior.

Role of Exercise-Induced Cardiac Remodeling in Ovariectomized Female Rats

Myocardial extracellular matrix (ECM) is essential for proper cardiac function and structural integrity; thus, the disruption of ECM homeostasis is associated with several pathological processes. Female Wistar rats underwent surgical ovariectomy (OVX) or sham operation (SO) and were then divided into eight subgroups based on the type of diet (standard chow or high-triglyceride diet/HT) and exercise (with or without running). After 12 weeks, cardiac MMP-2 activity, tissue inhibitor of metalloproteinase-2, content of collagen type I, the level of nitrotyrosine (3-NT) and glutathione (GSH), and the ratio of infarct size were determined. Our results show that OVX and HT diet caused an excessive accumulation of collagen; however, this increase was not observed in the trained animals. Twelve weeks of exercise promoted elevation in the levels of 3-NT and GSH and similarly an increase in MMP-2 activity of both SO and OVX animals. The high infarct-size ratio caused by OVX and HT diet was mitigated by physical exercise. Our findings demonstrate that ovarian estrogen loss and HT diet caused collagen accumulation and increased ratio of the infarct size. However, exercise-induced cardiac remodeling serves as a compensatory mechanism by enhancing MMP-2 activity and reducing fibrosis, thus minimizing the ischemia/reperfusion injury.

Effects of moderate exercise on biochemical, morphological, and physiological parameters of the pancreas of female mice with estrogen deprivation and dyslipidemia

Menopausal women are at high risk of developing heart disease. However, physical exercise practice can reverse this scenario. We evaluated the biochemical, morphological, and physiological effects of moderate aerobic physical exercise on the pancreas of knockout mice for LDL receptor with estrogen deprivation by ovariectomy. Animals were divided into six groups (n = 5): sedentary non-ovariectomized control; sedentary ovariectomized control; trained ovariectomized control; sedentary non-ovariectomized LDL-R knockout; sedentary ovariectomized LDL-R knockout; and trained ovariectomized LDL-R knockout. Physical exercise practice promoted improvement in biometric and biochemical parameters analyzed, with reduction of visceral adipose tissue and VLDL, triglycerides, total cholesterol, and blood glucose levels. In addition, physical exercise practice altered the morphology of pancreatic islets and improved their response to the effects of menopause. Thus, physical exercise practice was fundamental to minimize the effects of dyslipidemia associated with ovariectomy in the pancreatic tissue of LDL-R knockout animals, contributing to reduce the risk of developing cardiac diseases in the menopause period.