绝经后女性内源性性激素及血脂水平与乳腺癌的关系

目的:探讨绝经后女性内源性性激素及血脂水平与乳腺癌的关系以及作为预测指标的可行性。方法:收集2011年7月—2014年6月期间手术治疗的绝经后女性乳腺癌患者274例(乳腺癌组)与同期因其他疾病收治的非乳腺疾病的绝经后患者279例(对照组);比较两组间性激素与血脂水平的差异,分析可能的乳腺癌预测指标。结果:乳腺癌组的雌二醇(E2)与睾酮(T)水平明显高于对照组(均P0.05),其他性激素与血脂指标两组间差异均无统计学意义(均P0.05)。分层分析显示,随E2与T水平升高,乳腺癌发病率增加,其中E2水平对乳腺癌的预测有较好的敏感性和特异性,受试者操作特征(ROC)曲线下面积(AUC)为0.730(95%CI=0.649~0.811),但T水平的预测作用不明显。结论:E2与T水平与绝经后女性乳腺癌有关,其中E2水平可作为预测因子之一,但尚未达到良好或者优秀标准。     

High-frequency vibration training increases muscle power in postmenopausal women

OBJECTIVE: To test whether training on a high-frequency (28Hz) vibrating platform improves muscle power and bone characteristics in postmenopausal women. DESIGN: Randomized controlled trial with 6-month follow-up. SETTING: Outpatient clinic in a general hospital in Italy. PARTICIPANTS: Twenty-nine postmenopausal women (intervention group, n=14; matched controls, n=15). INTERVENTION: Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session, twice weekly for 6 months. The controls did not receive any training. Both groups were evaluated at baseline and after 6 months. MAIN OUTCOME MEASURES: Muscle power, calculated from ground reaction forces produced by landing after jumping as high as possible on a forceplate, cortical bone density, and biomarkers of bone turnover. RESULTS: Over 6 months, muscle power improved by about 5% in women who received the intervention, and it remained unchanged in controls (P=.004). Muscle force remained stable in both the intervention and control groups. No significant changes were observed in bone characteristics. CONCLUSION: Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women.     

经阴道超声对绝经后子宫内膜变化与肥胖相关性研究

目的经阴道超声探讨与分析绝经后子宫内膜变化与肥胖的相关性。方法绝经和肥胖组80例．绝经和正常体重组80例，分别应用彩色多普勒阴道超声技术检测子宫内膜厚度。结合测量血雌二醇（E2）与内膜诊刮病理结果进行分析对照。结果绝经后肥胖组：子宫内膜厚度6－18mm。病理显示子宫内膜呈增生反映。部分腺上皮不典型增生。绝经后正常体重组子宫内膜厚度2—4mm。结论绝经后肥胖组子宫内膜均有不同程度增生。     

Lavender essential oil on postmenopausal women with insomnia: Double-blind randomized trial

BackgroundTo evaluate the effect of Lavandula angustifolia essential oil inhalation on sleep and menopausal symptoms in postmenopausal women with insomnia.Participants35 postmenopausal women with a clinical diagnosis of insomnia were included, 17 in Aroma Group (AG) and 18 in Placebo Group (PG).MethodsIn this double-blind, randomized controlled trial, PG participants inhaled sunflower oil and AG participants inhaledLavandula angustifolia essential oil, for 29 days. Both groups received sleep hygiene guidelines before the intervention and weekly follow-up during it. Evaluations were performed before and after intervention. All statistical analyses and intention-to-treat test were performed in SPSS 22. Sleep quality (Primary outcome) was measured by Pittsburgh Sleep Quality Index. Secondary outcomes were polysomnography data, severity of insomnia, anxiety and depression symptoms, and postmenopausal symptoms.ResultsThere were no significant differences between groups after intervention in the primary outcome (P = 0.22; effect size=0.69); however, a tendency of improvement in wake after sleep onset (WASO) was observed (P = 0.07; effect size=0.81; B = 42.2). Both groups presented better sleep quality over time (AG P < 0.001; PG P = 0.011). AG participants showed a significant decrease in sleep onset latency (P = 0.001), depression levels (P = 0.025), hot flashes (P < 0.001), postmenopausal symptoms (P < 0.001) and, in polysomnography data, increased sleep efficiency (P = 0.002) compared to baseline.ConclusionAlthough no significant differences were observed between groups, our data presented a tendency of improvement in WASO. Moreover, AG participants had enhanced overall sleep pattern, quality and sleep efficiency. Weekly follow-up and sleep hygiene instructions were essential for both groups to show improvement in almost all outcomes.Clinical trial registrationBrazilian Registry of Clinical Trials, www.ensaiosclinicos.gov.br, RBR-5q5t5z.     

绝经后女性骨标志物与骨质疏松症的相关性研究

目的:探讨绝经后女性骨代谢标志物与骨质疏松之间的关系.方法:双能X线骨密度仪测定患者股骨的骨密度(BMD),计算其BMD与正常年轻人的骨峰值比值(以t值表示),并按照骨密度值将120例患者分为63例非骨质疏松组和57例骨质疏松组.选用瑞士罗氏诊断公司COBAS6000全自动电化学发光免疫分析仪,测定骨代谢标志物总骨I型前胶原N端肽(PINP)、血清骨钙素(N-MID)和β胶原特殊序列(β-crosslaps)的水平.结果:PINP、N-MID和β-crosslaps水平骨质疏松组均高于非骨质疏松组;两组患者的BMD、PINP、N-MID和β-crosslaps水平之间均具有统计学差异(P＜0.05).结论:绝经后女性的骨代谢标志物与骨质疏松的发生关系密切,血清中P1NP、N-MID、B-Crosslaps可作为诊断绝经后妇女骨质疏松症的理想生化指标.     

Association between Serum Osteocalcin Levels and Metabolic Syndrome according to the Menopausal Status of Korean Women

BackgroundOsteocalcin is known to regulate energy metabolism. Recently, metabolic syndrome (MetS) has been found to be associated with reduced levels of osteocalcin in men, as well as in postmenopausal women. The aim of this study was to investigate the association between serum osteocalcin and MetS in premenopausal women, compared with that in postmenopausal women.MethodsThis cross-sectional study was based on 5,896 participants who completed a health screening examination. They were classified according to their menopausal status. Each group was subdivided into non-MetS and MetS groups according to the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. Serum osteocalcin levels were measured using the electrochemiluminescence immunoassay.ResultsSerum osteocalcin level was significantly lower in women with MetS than in those without MetS, after adjusting for confounders (14.12 ± 0.04 vs. 13.17 ± 0.13 [P = 0.004] in premenopausal women, and 20.34 ± 0.09 vs. 19.62 ± 0.21 [P < 0.001] in postmenopausal women), regardless of their menopausal status. Serum osteocalcin levels decreased correspondingly with an increasing number of MetS elements (P for trend < 0.001). Multiple regression analysis demonstrated that waist circumference (β = −0.085 [P < 0.001] and β = −0.137 [P < 0.001]) and hemoglobin A1c (β = −0.09 [P < 0.001] and β = −0.145 [P < 0.001]) were independent predictors of osteocalcin in premenopausal and postmenopausal women. Triglyceride levels were also independently associated with osteocalcin levels in premenopausal women (β = −0.004 [P < 0.013]). The odds ratio (OR) for MetS was significantly higher in the lowest quartile than in the highest quartile of serum osteocalcin levels after adjusting for age, alkaline phosphatase, uric acid, high sensitivity C-reactive protein, and body mass index in all women (OR, 2.00; 95% confidence interval [CI], 1.49–2.68) as well as in premenopausal (OR, 2.23; 95% CI, 1.39–3.58) and postmenopausal (OR, 2.01; 95% CI, 1.26–3.23) subgroups.ConclusionLower serum osteocalcin concentrations were significantly associated with MetS in both premenopausal and postmenopausal women and were therefore independent of menopausal status.     

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.     

以生物电阻法检测的身体组成成分与女性骨量的关系

目的 探讨体内的体脂和非体脂对绝经前和绝经后妇女骨密度(BMD)的作用。方法 282例绝经前和205例绝经后妇女参加本研究,用双能X线骨密度仪测定腰椎和股骨颈BMD,用生物电阻法测定体脂和非体脂,同时测量身高、体重、腰围、臀围,并计算体重指数(BMI)和腰臀围比(WHR)。结果 体脂和非体脂与绝经前、绝经后妇女腰椎和股骨颈BMD均呈显著正相关(P＜0．01),多元逐步回归分析显示,在绝经前妇女中,非体脂和年龄是腰椎BMD的独立影响因素(R^2=0．077,P=0．000),非体脂、年龄和BMI是影响股骨颈BMD的决定因素(R^2=0．130,P=0．000),在绝经后妇女中,体脂和年龄是影响腰椎和股骨颈BMD的决定因素(R^2分别为0．153和0．184,P=0．000)。结论 体脂和非体脂对绝经前和绝经后妇女BMD的作用不同,非体脂是决定绝经前妇女骨量的重要因素,而体脂是影响绝经后妇女骨量的重要因素。     

绝经后阴道出血196例临床分析

目的 分析引起绝经后阴道出血的病因及诊断方法.方法 对196例绝经后阴道出血患者的临床与病理资料进行回顾性分析.结果 196例患者中良性疾病占46.94%(92/196),功能性子宫出血占34.69%(68/196),恶性肿瘤占18.37%(36/196).绝经1～4年、5～9年、10～14年、≥15年恶性肿瘤发生率分别为2.53%(2/79)、9.38%(6/64)、48.39%(15/31)、59.09%(13/22).恶性肿瘤患者的发病年龄(61.28±8.76)岁,绝经时间(9.38±6.73)年,良性疾病及功能性子宫出血患者分别为(54.73±6.72)岁和(4.12±3.54)年,两者比较差异均有统计学意义(P＜0.01).结论 绝经后阴道出血的原因以良性疾病及功能性子宫出血为主,但年龄越大、绝经时间越长,其恶性肿瘤的发生率越高.

Abstract：

Objective To analyze the cause of postmenopausal vaginal bleeding and diagnostic method. Methods The clinical and pathological data of 196 patients with postmenopausal vaginal bleeding were retrospectively analyzed. Results The benign diseases accounted for 46.94% (92/196), dysfunctional uterine bleeding accounted for 34.69% (68/196), malignant tumor accounted for 18.37% (36/196).Menopausal time 1--4 years, 5-9 years, 10-14 years, ≥ 15 years of malignant tumor incidence was 2.53%(2/79), 9.38% (6/64), 48.39% ( 15/31 ), 59.09 % (13/22). The age of onset in patients with malignant tumors was (61.28 ± 8.76) years old, menopausal time was (9.38 ±6.73) years, benign disease and dysfunctional uterine bleeding was (54.73 ± 6.72) years old and (4.12 ± 3.54) years, the differences were statistical significance (P ＜ 0.01 ). Conclusion The cause of postmenopausal vaginal bleeding bases mainlyon benign disease and dysfunctional uterine bleeding, but the older, longer menopausal time, which also increase the incidence of malignant tumors.     

绝经后女性糖尿病足患者性激素变化及与预后的相关性

目的 分析绝经后女性糖尿病足溃疡（DFU）患者内源性性激素水平与病情严重程度的相关性,探讨性激素水平对绝经后女性DFU预后的影响.方法 选取2012年1月至2013年1月在瑞金医院糖尿病足中心住院治疗的绝经后女性DFU患者158例和高危DFU患者162例,收集其基本临床资料,评估足溃疡严重程度,测定这些患者入院后48 h内静脉血中卵泡刺激素（FSH）、黄体生成素（LH）、催乳素（PRL）、雌二醇（E2）、孕酮（P）、睾酮（T）、游离睾酮（FT）、硫酸脱氢表雄酮（DHEAS）、雄烯二酮（AD）和性激素结合球蛋白（SHBG）水平,采用多元线性回归分析不同严重程度的DFU患者体内性激素指标的变化;随访观察DFU患者6个月溃疡愈合、复发及非致死性心脑血管事件的发生情况,采用logistic回归探讨性激素相关指标与DFU预后的关系.结果 随着Wagner级别增加,绝经后女性糖尿病足病患者体内E2、T、FT水平上升（t值分别为4.47、2.03、2.16;趋势P值分别为＜0.0001、0.041、0.035）;随着DFU感染程度加重,E2呈上升趋势（t值为2.41,趋势P值为0.02）;E2水平与非致死性心脑血管事件的发生呈正相关（OR=1.019,95％CI：1.002～1.037,P＜0.05）.结论 绝经后女性DFU患者内源性E2、T/FT水平与病情、感染程度相关,E2水平对心脑血管事件的发生具有一定提示意义.