Effects of vitamin K in postmenopausal women: Mini review

Possible benefits of vitamin K on bone health, fracture risk, markers of bone formation and resorption, cardiovascular health, and cancer risk in postmenopausal women have been investigated for over three decades; yet there is no clear evidence-based universal recommendation for its use.     

470例社区围绝经期、绝经后妇女骨骼健康相关影响因素

目的:探讨广州社区围绝经期、绝经后妇女骨骼健康的相关影响因素。方法:以广州2个社区470例围绝经期、绝经后妇女为研究对象,采用法国Diagnostic Medical Systems(DMS)公司生产的UBIS5000型超声骨密度/骨质量测定仪对右跟骨的BUA进行测定,通过问卷调查影响骨骼健康的相关因素。结果:在与骨骼健康相关的因素中,年龄、初潮年龄、绝经年限、产次与骨密度呈负相关,体重、身高、体重指数、是否素食呈正相关,其中危险因素为初潮年龄和年龄,保护因素为高体重和非素食。结论:社区围绝经期、绝经后妇女骨骼健康与多种因素有关,应综合考虑采取相应措施进行防治,体重及饮食为可控因素,重视可控因素是防治骨质疏松的有效途径。     

雌激素受体基因多态性与绝经后干眼症的相关性的研究

目的:研究雌激素受体(estrogen receptor,ER)基因多态性与绝经后干眼症的相关性。方法:收集绝经后干眼症患者65例及正常对照73例血液标本,提取基因组DNA,用聚合酶链反应方法检测ER基因的XbaⅠ和PvuⅡ酶切多态性并进行统计学分析。结果:干眼症患者与正常人比较,ER基因的PvuⅡ酶切多态性存在显著性差异(P<0.05),而ER基因的XbaⅠ酶切多态性没有明显差异(P>0.05)。结论:ER基因的PvuⅡ酶切多态性与绝经后干眼症发病存在相关性,不同个体的基因差异可能影响干眼症的发生。     

绝经后阴道出血400例分析

目的明确引起绝经后阴道出血的病因及诊断方法.方法对400例绝经后阴道出血患者进行临床及病理分析.结果400例中恶性肿瘤78例,占19.5%,其中宫颈癌34例,占恶性肿瘤的43.59%;子宫内膜癌28例,占35.90%;卵巢癌16例,占20.51%;检出良性病变322例,占80.5%;患者年龄越大(＞58岁),绝经时间越长(＞10 a),恶性肿瘤的发生率越高.结论对绝经后阴道出血患者的诊断应注重常规的妇科检查和必要的辅助检查以明确病因,做到早诊早治,可预防和减少恶性肿瘤的发生.     

Bone loss during oestriol therapy in postmenopausal women

In contrast to all other oestrogens examined thus far oestriol hemisuccinate (12 mg/day) did not prevent bone loss in 28 postmenopausal women. The average bone loss, however, was somewhat less than expected from placebo studies, while the bone loss achieved by a group taking 4–6 mg/day was equal to that achieved by previous placebo groups. To be an effective agent for prevention of post-menopausal osteoporosis oestriol would have to be prescribed in daily doses considerably in excess of 12 mg.     

Selected adnexal cystic masses in postmenopausal women can be safely managed by laparoscopy

The aim of this study was to assess the efficacy and safety of laparoscopic treatment for adnexal cystic masses that were predicted to be benign in postmenopausal women. Postmenopausal women found to have an adnexal cystic mass were retrospectively evaluated with transvaginal ultrasonography, and serum CA-125 levels. The selection criteria were adnexal cystic masses greater than 3 cm but less than 10 cm, the masses were in the benign range (4-8) of Sassone's scoring system for transvaginal ultrasonography, and the patients had serum CA-125 levels less than 65 IU/mL. Two hundred nineteen women fulfilled the criteria and underwent operative laparoscopy. Almost all the masses (99.5%) were accurately predicted to be benign except for one borderline ovarian tumor. Two hundreds thirteen (97.3%) women were successfully managed by operative laparoscopy and six (2.7%) required laparotomy. For the patients managed by laparoscopy, the mean operative time was 51.3 min; the mean hospital stay was 2.5 days. There was no significant morbidity and surgery-related mortality. The combination of the Sassone's scoring system for transvaginal ultrasonography and serum CA-125 level can accurately predict benign cystic masses, and operative laparoscopy is technically feasible and safe for the management of adnexal mass in postmenopausal women.     

Effects of conjugated equine estrogen vs. raloxifene on serum insulin-like growth factor-i and insulin-like growth factor binding protein-3: a 2-year, double-blind, placebo-controlled study

OBJECTIVE: To assess and compare the effect of conjugated estrogen and of the selective estrogen receptor modulator raloxifene on serum levels of insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) and on the IGF-I/IGFBP-3 ratio. DESIGN: A 2-year randomized, double-blind, placebo-controlled study. SETTING: Endocrinology outpatient department. PATIENT(S): Fifty-six postmenopausal, hysterectomized women. INTERVENTION(S): Women received raloxifene hydrochloride in doses of 60 mg/day (n = 15) or 150 mg/day (n = 13), conjugated equine estrogen (CEE) in doses of 0.625 mg/day (n = 15), or a placebo (n = 13) over the course of 2 years. MAIN OUTCOME MEASURE(S): At baseline and after 6, 12, and 24 months of treatment, serum levels of IGF-I, IGFBP-3, and insulin were measured, and an IGF-I/IFGBP-3 ratio was calculated. RESULT(S): Both raloxifene and CEE decreased serum IGF-I concentration. In contrast to CEE, which had no effect, both raloxifene doses of 60 and 150 mg/day significantly increased serum IGFBP-3 during the 2 years. Compared with placebo, the decrease in IGF-I/IGFBP-3 ratio was -32.5% (95% CI: -20.1; -44.8%) for CEE; -16.4% (95% CI: -3.6; -29.2%) for raloxifene at 150 mg/day; and -15.4% (95% CI: -1.0; -29.8%) for raloxifene at 60 mg/day. No effect of CEE or raloxifene was found on insulin concentration at any time point. CONCLUSION(S): Long-term use of both CEE and raloxifene decreases serum IGF-I and the IGF-I/IGFBP-3 ratio, but, unlike CEE, raloxifene produced a significant yet small increase in IGFBP-3.     

Vitamin A intake and the risk of hip fracture in postmenopausal women: the Iowa Women’s Health Study

Excessive intake of vitamin A is postulated to have a detrimental effect on bone by inducing osteoporosis. This may lead to an increased risk of fracture, particularly in persons who are already at risk of osteoporosis. However, few studies have specifically examined the association of vitamin A intake through diet and supplement use, with fractures in a cohort of older, community-dwelling women. We prospectively followed a cohort of 34,703 postmenopausal women from the Iowa Womens Health Study to determine if high levels of vitamin A and retinol intake through food and supplement use were associated with an increased risk of hip or all fractures. A semiquantitative food frequency questionnaire was used to obtain the participants baseline vitamin A and retinol intake. Participants were followed for a mean duration of 9.5 years for incident self-reported hip and nonhip fractures. After multivariate adjustment, it was revealed that users of supplements containing vitamin A had a 1.18-fold increased risk of incident hip fracture (n=525) compared with nonusers (95% CI, 0.99 to 1.41), but there was no evidence of an increased risk of all fractures (n=6,502) among supplement users. There was also no evidence of a dose-response relationship in hip fracture risk with increasing amounts of vitamin A or retinol from supplements. Furthermore, our results showed no association between vitamin A or retinol intake from food and supplements, or food only, and the risk of hip or all fractures. In conclusion, we found little evidence of an increased risk of hip or all fractures with higher intakes of vitamin A or retinol among a cohort of older, postmenopausal women.     

针刺血清对体外培养破骨细胞数量的影响

目的:探讨针刺抑制骨吸收的细胞学机制。方法:40只12月龄雌性SD大鼠,随机分为假手术组、模型组、针刺预防组和针刺治疗组。针刺预防组和针刺治疗组分别在造模术后的3d、3个月开始针刺。取“肾俞”“脾俞”“足三里”“大椎”。自新生SD大鼠四肢长骨分离破骨细胞,接种于24孔培养板中,加入含10%上述各组大鼠血清的培养液培养48h后,抗酒石酸酸性磷酸酶(TRAP)染色并计数TRAP( )多核细胞数。结果:与假手术组比较,模型组TRAP( )多核细胞数明显增加(P<0.01);与模型组比较,针刺预防组和针刺治疗组TRAP( )多核细胞数明显减少(P<0.05)。结论:针刺血清能够减少破骨细胞的数量,预防组和治疗组之间的作用无统计学差异。     

Pro-inflammatory cytokine levels in postmenopausal women with the metabolic syndrome

Background.?Prevalence of the metabolic syndrome (METS) and its components significantly increase after the menopause. Related increased cardiovascular risk may partially be explained by a pro-inflammatory state.

Objective.?To assess pro-inflammatory cytokine serum levels in postmenopausal women with and without the METS.

Methods.?Serum of 90 postmenopausal women who previously participated in a METS screening programme was analysed for tumour necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6). Cytokine levels were compared among those with and without the syndrome, and for each of its components. Linear relationships were also assessed between cytokine levels and several continuous variables including each diagnostic METS criteria and menopausal symptoms assessed with the Menopause Specific Quality of Life tool (MENQOL).

Results.?For all studied women mean age was 55.1?±?7.3 years with 63.3% having abdominal obesity, 15.6% hyperglycaemia, 58.9% high triglycerides, 44.4% hypertension and 25.6% high total cholesterol levels. Women with the METS (n?=?45) significantly had higher body mass index values, and higher rates of abdominal obesity, hyperglycaemia, hypertriglyceridemia, hypertension and lower HDL-C levels. Cytokine levels did not differ among women with or without the METS; however, independent of METS diagnosis those with abdominal obesity displayed significantly higher IL-6 levels and those with hypertension higher levels of both cytokines. Levels of both cytokines positively correlated with age and time since menopause, IL-6 positively correlating with waist circumference values and TNF-α positively with both systolic and diastolic blood pressure levels. A significant positive correlation was also found between the number of positive METS criteria (0–5) and both cytokine levels. Cytokine levels did not correlate with vasomotor and psycho-social MENQOL scores.

Conclusion.?Pro-inflammatory cytokine levels in this postmenopausal series positively correlated with age, time since the menopause, abdominal circumference, blood pressures levels and the number of positive METS diagnostic criteria. There is a need for more research in this regard.