Nitric oxide and pro-inflammatory cytokine serum levels in postmenopausal women with the metabolic syndrome

Background: The metabolic syndrome (METS) increases after the menopause which may enhance cardiovascular risk in part explained by a pro-inflammatory state. Objective: Measure nitric oxide (NO), tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) serum levels in postmenopausal women with and without the METS (Adult Treatment Panel III criteria). Methods: Analyte levels were compared among those with and without the syndrome and each of its diagnostic components. Rho Spearman coefficients were also calculated to determine correlations between analyte levels and various numeric variables. Results: Median age of all studied women (n = 88) was 54.4 years, 62.5% had abdominal obesity, 14.8% hyperglycemia, 59.1% high triglycerides (TG) and 44.3% hypertension. Women with the METS (n = 44) displayed higher body mass index values and higher rates of abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension and low HDL-C levels. Median NO and IL-6 levels were significantly higher in women with the METS as compared to controls (p < 0.05). Independent of presenting the METS, analytes were higher in those displaying abdominal obesity (IL-6), hypertension (IL-6 and TNF-α) and more METS diagnostic criteria and abnormal HDL-C, TG and glucose levels (NO). Both cytokines positively correlated with the number of METS criteria, age and time since menopause, IL-6 positively with waist circumference and TNF-α positively with blood pressure levels. NO levels inversely correlated with HDL-C values and positively with the number of METS criteria, glucose, and TG levels; correlation with the latter being the highest (r² = 0.65, p = 0.0001). Conclusion: Postmenopausal women with the METS displayed higher IL-6 and NO levels, with significant correlations found between studied analytes and some of the components of the syndrome.     

The metabolic syndrome and its components in postmenopausal women

Abstract

Background: Prevalence of the metabolic syndrome (METS) increases significantly after the menopause.

Objective: To assess the prevalence of the METS and its components in postmenopausal women. Factors relating to each of the composing items of the METS were also analyzed.

Methods: Natural postmenopausal women (40–65 years) were invited to participate in this cross-sectional study in order to assess the presence of the METS using modified Adult Treatment Panel III (ATP-III) criteria. Participants were also requested to fill out a general socio-demographic questionnaire.

Results: A total of 204 women were surveyed with a median age of 56 years. A 52.9% presented the METS according to modified ATP-III criteria, with 37.3% presenting hyperglycemia, 51.5% hypertension, 58.3% abdominal obesity, 45.6% high triglyceride levels and 56.4% low HDL-C levels. Women with the METS presented a higher rate of dyslipidemia (high triglyceride and low HDL-C levels), hyperglycemia, hypertension and abdominal obesity than those without the syndrome. Those with abdominal obesity and hyperglycemia significantly displayed higher rates of low HDL-C levels (bivariate analysis). Multiple linear regression analysis found a positive correlation between glucose and triglyceride levels. Systolic blood pressure significantly and positively correlated to age and abdominal circumference. Abdominal circumference displayed an inverse correlation with educational level.

Conclusion: Prevalence of the METS in this postmenopausal female sample was high and associated to metabolic and lipid derangements. As abdominal obesity was significantly associated to lower education, there is an urgent need of implementing educational programs directed to high-risk populations in order to increase awareness of the problem.     

The metabolic syndrome among postmenopausal women in Ecuador

Background.?The prevalence of the metabolic syndrome increases with age and after the onset of menopause, and may explain in part the apparent acceleration of cardiovascular disease in postmenopausal women.

Objective.?To determine the prevalence of metabolic syndrome and related risk determinants among postmenopausal women in Ecuador.

Methods.?Postmenopausal women ≥40 years of age, non-users of hormone therapy and with an intact uterus, were asked to participate in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador. Sociodemographic data, waist circumference and blood pressure measurements were recorded, and a fasting blood sample obtained for serum glucose and lipid profile determinations. Woman were counseled and managed according to the results. Metabolic syndrome was defined in accordance with the criteria of the Third Adult Treatment Panel (ATP III).

Results.?Three hundred and twenty-five postmenopausal women entered the program. Mean (±standard deviation) age was 55.9 ± 8.1 years, 53.5% of them were aged ≥54 years (median). The prevalence of metabolic syndrome, according to ATP III criteria, was 41.5%. Using the same criteria, 38.8%, 16.6%, 56.9% and 54.2% of the women presented with hypertension, diabetes, hypertriglyceridemia and abdominal obesity, respectively. More than 40% of women determined to have hypertension or diabetes lacked knowing so. Logistic regression analysis determined that age increased the risk of presenting hypertension and diabetes (odds ratio (95% confidence interval): 2.0 (1.2–3.2) and 1.6 (0.9–3.0), respectively, p < 0.05), entities which in turn duplicated the risk of having high triglyceride levels. Sedentary women with <5 years since menopause onset were at higher risk of having abdominal obesity, which was directly related to diabetes and hypertension.

Conclusions.?In this postmenopausal Ecuadorian population the prevalence of the metabolic syndrome was high and its determinant factors related to age, time since menopause onset and sedentary habits. Because of the implications for cardiovascular risk, counseling programs directed toward high-risk populations should be encouraged.     

Nonalcoholic fatty liver disease and metabolic syndrome in postmenopausal women

Nonalcoholic fatty liver disease (NAFLD) is considered the most common cause of chronic liver disease in the Western countries. NAFLD includes a spectrum ranging from a simple steatosis to a nonalcoholic steatohepatitis (NASH) which is defined by the presence of inflammatory infiltrate, cellular necrosis, hepatocyte ballooning, and fibrosis and cirrhosis that can eventually develop into hepatocellular carcinoma. Studies emphasize the role of insulin resistance, oxidative stress, pro-inflammatory cytokines, adipokines in the development and progression of NAFLD. It seems to be independently associated with type II diabetes mellitus, increased triglycerides, decreased HDL-cholesterol, abdominal obesity and insulin resistance. These findings are in accordance with the criteria used in the diagnosis of metabolic syndrome (MetS). Here, we will discuss the current knowledge on the epidemiology, pathophysiology and diagnosis of NAFLD and the association of metabolic syndrome in postmenopausal women.     

Obesity in pregnancy as a model to identify women at risk for later metabolic syndrome

The aim of our study is to identify – in a cohort of obese women – cardiovascular and clinical risk factors in women with previous complicated pregnancies and protective factors in women with previous physiological pregnancies. A total of 135 nonpregnant obese women referring to Policlinico Gemelli in Rome were prospectively collected in 2009–2010. Thirty-two women matched inclusion criteria: 16 reported a previous physiological pregnancy and 16 reported previous obstetric complications. A clinical, instrumental and laboratory evaluation has been performed for each patient. Statistical analysis was performed using StatView Software. Values are expressed as mean?±?standard error (SEM). All tests were two-tailed with a confidence level of 95% (p?p?=?.0338), increased serum values of vascular cell adhesion molecule (p?=?.0154) and higher systolic blood pressure values (p?=?.0427) have been detected in obese women with previous complicated pregnancies due to gestational diabetes and/or hypertension. In conclusion, obese patients with previous complicated pregnancies develop signs of endothelial dysfunction in the postpartum period. Future research should focus on the early identification of possible molecular mechanisms implicated in the development of glyco-metabolic and cardiovascular diseases in obese patients, since they are at higher risk of metabolic syndrome.     

Age- and body mass index-related differences in the prevalence of metabolic syndrome in women with polycystic ovary syndrome

Abstract

Aim: To compare the prevalence of metabolic syndrome (MetS) between women with polycystic ovary syndrome (PCOS) and controls across different age (≤20, 21–30 and 31–39 years old) and body mass index (BMI) (normal weight, overweight and obese) groups.

Methods: We studied 1223 women with PCOS and 277 BMI-matched controls. The prevalence of MetS in women with PCOS and controls was estimated according to four different MetS definitions.

Results: In subjects ≤20 and 21–30 years old, the prevalence of MetS did not differ between women with PCOS and controls regardless of the MetS definition, even though women with PCOS were more obese than controls in the ≤20 years old group. In subjects 31–39 years old, the prevalence of MetS was higher in women with PCOS than in controls but the former were more obese than controls. The prevalence of MetS did not differ significantly between women with PCOS and controls in any of the BMI groups (normal weight, overweight or obese) regardless of the MetS definition.

Conclusion: The prevalence of Mets appears to be primarily determined by obesity and age whereas PCOS per se appears to be a less important contributing factor.     

The vitamin D receptor gene BsmI polymorphism is not associated with anthropometric and biochemical parameters describing metabolic syndrome in postmenopausal women

Aim. Vitamin D could have a direct effect on adipocyte differentiation and metabolism and might be involved in glucose regulation of insulin secretion. In recent years several polymorphisms in the gene encoding the vitamin D receptor (VDR), which are potent to alter the activity of VDR protein, have been described. The present study aimed to investigate the prevalence of the VDR BsmI polymorphism and its association with anthropometric and biochemical features of metabolic syndrome in postmenopausal women.

Materials and methods. We studied 351 randomly selected healthy postmenopausal women, with mean age of 55.43 ± 2.75 years and mean body mass index (BMI) of 27.5 ± 4.78 kg/m², to evaluate the frequency of BsmI polymorphism (by restriction fragment length polymorphism–polymerase chain reaction) in the VDR gene and to find out whether there is an association between this polymorphism and BMI, total fat volume and visceral fat (as determined by total body dual-energy X-ray absorptiometry), blood pressure, lipid profile (total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides) glucose and fasting insulin in the whole group, as well as subgroups of obese and non-obese women.

Results. The prevalence of BsmI genotypes in the study group was 51.0% Bb, 37.3% bb and 11.7% BB. Genotype distribution did not differ from that expected under Hardy–Weinberg equilibrium conditions (χ² = 2.95, p = 0.22). Apart from LDL-C levels (F = 3.46, p = 0.032), there were no significant differences in anthropometric or metabolic parameters between genotypes.

Conclusions. The BsmI polymorphism in the VDR gene does not seem to predispose to obesity and insulin resistance, but the BB genotype is connected with an unfavorable lipid profile.     

The prevalence of metabolic syndrome in premenopausal and postmenopausal women in Southern Thailand

Objective: To assess the prevalence of metabolic syndrome (MetS) in premenopausal and postmenopausal women in Southern Thailand.

Methods: A cross-sectional study was conducted with 361 healthy women (218 premenopausal women and 143 postmenopausal women) in Southern Thailand. Blood pressure, anthropometric indices, fasting plasma glucose and serum lipid levels were measured. MetS was defined according to criteria of the “National Cholesterol Education Program Adult Panel Treatment III” (NCEP ATPIII). Logistic regression analysis was used to evaluate factors associated with MetS.

Results: Waist circumference, systolic blood pressure, diastolic blood pressure, and levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were significantly higher in postmenopausal women, when compared with premenopausal women (p?p?=?0.005). The most frequent component of MetS in postmenopausal women was central obesity (58.74%), followed by hypertension (58.04%), high triglyceride (27.97%), low HDL-C (23.08%), and high FPG (11.19%). Multivariate analysis revealed that age and higher body mass index (BMI) increased the risk of developing MetS.

Conclusion: The prevalence of MetS is higher in postmenopausal women than in premenopausal women, and its significant predictors include age and BMI.     

beta3-Adrenergic receptor polymorphism and metabolic syndrome in postmenopausal women

Objectives. Some studies indicate that the Trp64Arg polymorphism in the gene encoding the β₃-adrenergic receptor (ADRB3) is associated with obesity, insulin resistance and earlier onset of type 2 diabetes mellitus. The aim of the present study was to evaluate the frequency of ADRB3 polymorphism and its association with metabolic syndrome in postmenopausal women.

Methods. We performed the study on 284 randomly chosen postmenopausal women, aged 50–60 years, who were then selected to the study. Measurements of anthropometric parameters and biochemical estimations such as lipid profile, glucose and insulin level in serum were carried out using commercial kits. ADRB3 genotyping was performed by polymerase chain reaction and mini-sequencing.

Results. The frequency of the Trp64/Arg64 genotype in the investigated population was 13%, and of the Trp64/Trp64 genotype, 85%. The Arg64/Arg64 genotype was present in only 2% of women. Metabolic syndrome was recognized in 22% of women bearing Trp64/Arg64 genotype and in 14% of women bearing Trp64/Trp64 genotype, without a statistically significant difference between the two groups (p > 0.05 in the χ² test). Women bearing the Trp64/Arg64 genotype had lower serum levels of high-density lipoprotein cholesterol (HDL-C) than Trp64/Trp64 genotype women (63.2 ± 13.0 vs. 71.4 ± 17.4 mg/dl). Both groups did not differ in any other investigated parameter.

Conclusion. Trp64Arg polymorphism of the β₃-adrenergic receptor gene is not related to metabolic syndrome in postmenopausal Polish women; however, it seems to be associated with decreased HDL-C levels.     

Serum adiponectin is a potential biomarker for metabolic syndrome in peri-and postmenopausal women

Abstract

Metabolic syndrome (MetS) increases its prevalence during menopausal period and there is no appropriate marker for screening before the cardiovascular damage begun. This study aims to find the diagnostic accuracy and the appropriate cutoff level of serum adiponectin for the screening of MetS in peri- and postmenopausal women. Women aged at least 40?years old attending health checkup clinic were recruited. Anthropometric measurements, blood pressure, MENQOL, and blood chemistry (glucose, adiponectin, HDL-C, LDL-C, and TG) were recorded. MetS was defined by JIS 2009 criteria. 290 peri-and postmenopausal women mean age 54.25?±?8.6?years were recruited. 66% was postmenopause and 21.4% of them has MetS. The socioeconomic and lifestyle factors seem similar among women with and without MetS. In the participants with MetS, the prevalence of abdominal obesity was higher (96.8% vs 49.6%, p?<?.001, respectively) and more prevalence of android fat distribution pattern was observed (76.2% vs 36%, p?<?.001, respectively). Serum adiponectin was significantly lower in women with MetS (6.0?±?4.6 vs 9.2?±?5.2?μg/mL, p?<?.001 in MetS and non-MetS, respectively). Serum adiponectin is a good biomarker for MetS and we recommend the cutoff level of serum adiponectin lower than 7.15?μg/mL for screening of MetS (AUC (95% CI) of = 0.72 (0.64–0.79), p?<?.001).     

Serum adiponectin is independently associated with the metabolic syndrome in Hong Kong,Chinese women with polycystic ovary syndrome

Objective: To evaluate the association of serum adiponectin level with the metabolic syndrome in Chinese women with polycystic ovary syndrome (PCOS).

Methods: This was a cross-sectional study carried out in Hong Kong Chinese women with PCOS at a university-affiliated tertiary hospital between January 2010 and January 2011. Clinical and biochemical parameters of the women were analysed. Prediction of the metabolic syndrome was determined by receiver–operator characteristic (ROC) curves, univariate and multivariate logistic regression analyses.

Results: A total of 116 women diagnosed to have PCOS were analysed. The area under the ROC curve of adiponectin for the prediction of metabolic syndrome was 0.820, 95% confidence interval (CI) 0.737–0.886. Univariate binary logistic regression showed that testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), waist circumference, body mass index (BMI), quantitative insulin-sensitivity check index (QUICKI), homeostasis model assessment of insulin resistance (HOMA-IR) and adiponectin were significantly associated with the metabolic syndrome. On multivariate logistic regression analysis, adiponectin (p?= 0.020), HOMA-IR, age (p?= 0.011) and BMI (p?= 0.019) were independently associated with the metabolic syndrome, but not FAI (p?= 0.256).

Conclusions: Serum adiponectin is independently associated with the metabolic syndrome in Chinese women with PCOS. Further longitudinal follow-up studies are needed to determine whether serum adiponectin adds to the prediction of long-term cardiometabolic morbidity conferred by age, BMI and measures of insulin resistance.     

The relationship between serum uric acid and metabolic syndrome in premenopausal and postmenopausal women in the Jinchang Cohort

The aim of the study was to explore the association between serum uric acid (SUA) and metabolic syndrome (MetS) in premenopausal and postmenopausal women in the Jinchang Cohort. We studied 3808 female Jinchuan Nonferrous Metals Corporation workers aged 40–60 years. Cohort data from epidemiological surveys and medical exams were used. MetS was defined using the 2009 Joint Interim Society criteria. The relationship between SUA and MetS was evaluated using multiple logistic regression after adjusting for potential confounders. MetS and hyperuricemia were more prevalent in postmenopausal women than premenopausal ones (35.3% versus 15.2% and 9.2% versus 4.2%, respectively). Premenopausal and postmenopausal women with hyperuricemia had 2.81 (95% CI: 1.72–4.61) and 2.10 (95% CI: 1.44–3.08), respectively, times the odds of having MetS than their counterparts without hyperuricemia. Even within normal SUA quartiles, only premenopausal women in the highest and second-highest quartile had 3.57 (95% CI: 2.24–5.68) and 2.78 (95% CI: 1.71–4.50), respectively, times the odds of having MetS than those in the lowest quartile. Even in the normal range, the odds ratios for MetS increased gradually according to SUA levels in all women (P_trend?<_?0.001). In conclusion, there was a significant correlation between SUA levels and MetS, and the association was stronger in premenopausal women than postmenopausal ones.     

The prevalence of metabolic syndrome in pre- and post-menopausal women attending a tertiary clinic in Turkey

Objective

To determine the prevalence of metabolic syndrome among pre- and post-menopausal women attending a tertiary clinic in Turkey.

Study design

This is a cross-sectional study consisting of one hundred and eighty healthy postmenopausal women and fifty-three healthy premenopausal women evaluated for presence or absence of metabolic syndrome. The t test and Fischer exact test were used for continuous variables and chi-square test was used for categorical variables.

Results

The prevalence of metabolic syndrome among pre-menopausal women was 15.09% according to NCEP criteria. The prevalence of metabolic syndrome among postmenopausal women was 19.44% according to NCEP criteria. There was no significant difference in the prevalence of metabolic syndrome between premenopausal and postmenopausal women in our study population.

Conclusion

There was no significant difference in the prevalence of metabolic syndrome between premenopausal and postmenopausal women attending a tertiary clinic in Turkey.     

Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome

Objective

To evaluate the clinical, endocrine and metabolic effects of metformin and N-acetyl-cysteine (NAC) in patients with polycystic ovary syndrome (PCOS).

Study design

In this prospective trial, 100 women with PCOS were randomly divided to receive metformin (500 mg p.o. three times daily) or NAC (600 mg p.o. three times daily) for 24 weeks. Hyperandrogenism, lipid profiles, hirsutism scores, menstrual irregularity, insulin sensitivity and tumour necrosis factor-α (TNF-α) levels were measured at baseline and after the treatment period.

Results

Both treatments resulted in a significant decrease in body mass index, hirsutism score, fasting insulin, HOMA index, free testosterone and menstrual irregularity compared with baseline values, and both treatments had equal efficacy. NAC led to a significant decrease in both total cholesterol and low-density lipoprotein levels, whereas metformin only led to a decrease in total cholesterol level. Although TNF-α levels increased following treatment for both groups, the difference from baseline was not significant.

Conclusions

Metformin and NAC appear to have comparable effects on hyperandrogenism, hyperinsulinaemia and menstrual irregularity in women with PCOS. The effects of metformin and NAC on insulin sensitivity are not associated with TNF-α.     

Serum platelet-activating factor acetylhydrolase activity: relationship with metabolic syndrome in women with history of gestational diabetes mellitus

Objective.?The aim of this study was to evaluate plasma platelet-activating factor acetylhydrolase (PAF-AH) activity in euglycaemic women with history of gestational diabetes (GDM), and to explore whether this activity is associated with metabolic syndrome (MS) in this group of women.

Methods.?The cross-sectional study included 36 women with history of GDM and 40 women with history of normal glucose tolerance in pregnancy (control group).

Results.?Compared to the controls, the GDM group had significantly higher mean values for serum glucose, insulin, HOMA-IR, triglyceride, GGT and plasma PAF-AH activity, and a statistically higher prevalence of MS. Within the GDM group, women diagnosed with MS had significantly higher PAF-AH activity than those without MS (p?=?0.002).

Conclusion.?This is the first study to have shown that plasma PAF-AH activity and GGT levels may be significant for evaluating atherosclerosis risk and metabolic hepatic damage in women with history of GDM.     

The relationship between metabolic status and levels of adiponectin and ghrelin in lean women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance, obesity, dyslipidemia and hypertension. Adiponectin, an adipocyte-specific protein with important roles in glucose and lipid homeostasis, possesses antidiabetic and insulin-sensitizing properties. Ghrelin, a protein ligand for the growth hormone secretagog receptor, has been shown to stimulate food intake and to influence energy balance, insulin signaling and glucose metabolism. We aimed to evaluate the relationships between metabolic alterations and adiponectin and ghrelin levels in lean PCOS women, compared with lean and obese women. The study was carried out on 20 non-obese PCOS women aged 20 – 48 years and age-matched groups of 45 healthy lean and 37 obese women. Hormonal and biochemical parameters, adiponectin and ghrelin concentrations and anthropometric data were determined. In PCOS subjects, we found increased homeostasis model assessment – insulin resistance index (HOMA-IR) with non-significant differences in adiponectin and ghrelin concentrations compared with healthy women, although the PCOS group showed a tendency to lower adiponectin levels. However, ghrelin levels in PCOS women were significantly higher than in obese women. Moreover, we observed a negative correlation between adiponectin and testosterone, cholesterol, triglycerides, glucose and diastolic blood pressure in PCOS. In conclusion, it can be suggested that higher values of HOMA-IR with lower adiponectin levels may indicate future development of metabolic syndrome or other metabolic disturbances in lean PCOS women.     

Follicle-stimulating hormone associates with metabolic factors in postmenopausal women

Abstract

Current studies have focused more on the relationships among estrogen, androgen, and metabolic syndrome (MetS). The main aim of the study was to investigate whether the variation of FSH is associated with metabolic factors in postmenopausal women. A total of 561 postmenopausal women aged 39–69 years were selected. FSH, estradiol, fasting blood glucose, and lipid profiles were analyzed. Compared with women in the highest FSH quartile, women in the lowest quartile had higher body mass index (BMI), fast blood glucose (FBG), triglyceride (TG), blood pressure, and serum estradiol (E₂) but lower high-density lipoprotein (HDL) (all p?<?.05). Compared with women in the groups of normal levels of MetS biomarkers, women in the abnormal groups had lower FSH (all p?<?.01). Increased quartiles of FSH were associated with significantly decreased rates of abnormal levels of metabolic factors (all p?<?.05). High FSH levels had protective effects regarding SBP, DBP, and FBG, with odds ratios (ORs) of 0.84 (95% CI 0.76–0.92, p?<?.001), 0.85 (95% CI 0.78–0.94, p?<?.01), 0.90 (95% CI 0.83–0.98, p?<?.01), respectively. Low FSH appears to be a risk factor of all domains of MetS in postmenopausal women, which merits further study.