Changes in the bone and liver isoenzymes of alkaline phosphatase in postmenopausal women being treated with norethisterone

The effects of norethisterone therapy on alkaline phosphatase isoenzyme activities were studied in a group of postmenopausal women. There was a significant fall in total alkaline phosphatase activity after 8 wk which was still in evidence after 24 wk. Both bone and liver alkaline phosphatase isoenzyme activities were decreased during the first 16 wk on treatment, but after 24 wk only the bone phosphatase activity was significantly lower than the pretreatment level. The other biochemical indices of bone metabolism and liver function were also measured during the study. The results indicate that bone specific alkaline phosphatase activity is a more sensitive index of bone activity than total alkaline phosphatase and that monitoring of total activity may in some instances be misleading.     

围绝经期和绝经后妇女应用激素替代治疗2年后血脂蛋白和载脂蛋白的变化

目的:探讨结合雌激素并醋酸甲孕酮序贯治疗对围绝经期妇女和绝经期妇女治疗2年后血脂代谢的干预效应。方法:42例围绝经期和绝经期妇女按连续序贯方案每日口服结合雌激素(倍美力)0.625mg,醋酸甲孕酮4mg,连续治疗2年,分别于用药前、用药1年、2年取静脉血测定血脂蛋白、载脂蛋白、雌二醇、促卵泡素水平。结果:用药后总胆固醇、三酰甘油、高密度脂蛋白胆固醇(high-densitylipoproteincholesterol,HDL-C)、载脂蛋白AI、载脂蛋白B、脂蛋白a()较治疗前明显升高,差异有显著性意义(P<0.01)。用药2年后HDL-C水平明显高于用药1年(P<0.05),两组低密度脂蛋白胆固醇(low-densitylipoproteincholesterol,LDL-C无显著性变化。)结论:激素替代治疗有明显调节脂代谢的作用,对心脑血管疾病的发生有一级康复干预作用。     

Serum levels of androgens and migraine in postmenopausal women

Female hormones are thought to be of importance in the aetiology of migraine, which is more common in women than in men. Little attention has been paid to androgens. This study investigates the associations between migraine and serum levels of androgens in postmenopausal women not taking oestrogens. A case-control study was carried out among women participating in a mammography screening program. A neurologist clinically assessed the participants. Headache criteria proposed by the International Headache Society were used. Each of the 15 women with migraine was matched to three controls by time since menopause and by body mass index. Serum levels of androstenedione and total testosterone were measured by radioimmunoassays. Free testosterone was calculated from total testosterone, immunoassayed sex hormone-binding globulin and albumin. The mean+/-S.D. serum level of androstenedione was 2.7+/-1.1 nmol/l and 3.4+/-1.9 nmol/l in cases and controls respectively. The mean serum level of testosterone was 0.8+/-0.4 nmol/l and 1.0+/-0.5 nmol/l in cases and controls respectively. The mean serum level of free testosterone was 12.5+/-8.5 pmol/l and 14.0+/-7.9 pmol/l in cases and controls respectively. Conditional logistic regression analysis was used to test for differences in serum levels of androstenedione, total testosterone and free testosterone between cases and controls. No statistically significant differences were found. To conclude, there was no evidence in this study that differences within normal levels of androgens play an important role in the aetiology of migraine in postmenopausal women not taking oestrogens.     

绝经后妇女骨代谢过程中血清基质金属蛋白酶3和骨桥蛋白的变化

背景：骨桥蛋白和基质金属蛋白酶3具有高度的亲和力,此二者的表达可能与骨代谢有关。目的：观察绝经后妇女血清基质金属蛋白酶3和骨桥蛋白水平,并观察其与骨保护蛋白、骨保护蛋白配体及骨代谢指标的关系。方法：将120名绝经后妇女分为骨密度正常组、低骨量组和骨质疏松组3组,对其血清基质金属蛋白酶3、骨桥蛋白、骨保护蛋白、骨保护蛋白配体及骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C端肽和尿Ⅰ型胶原交联N端肽进行测定,计算骨桥蛋白/基质金属蛋白酶3比值。结果与结论：骨质疏松组中血清骨桥蛋白和基质金属蛋白酶3的水平高于正常组（P〈0.05）。绝经后妇女血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关（P〈0.05）,与骨保护蛋白、尿尿Ⅰ型胶原交联N端肽/肌酐比值呈明显正相关性（P〈0.05）。骨质疏松组中血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关（P〈0.05）,与骨保护蛋白、尿尿Ⅰ型胶原交联N端肽/肌酐水平比值存在明显正相关性（P〈0.05）。提示绝经后妇女血清骨桥蛋白水平和骨桥蛋白/基质金属蛋白酶3比值升高与绝经后骨质疏松症伴随骨代谢转换过程增快有关。     

绝经后妇女骨代谢过程中血清基质金属蛋白酶3和骨桥蛋白的变化

背景:骨桥蛋白和基质金属蛋白酶3 具有高度的亲和力,此二者的表达可能与骨代谢有关.目的:观察绝经后妇女血清基质金属蛋白酶3 和骨桥蛋白水平,并观察其与骨保护蛋白、骨保护蛋白配体及骨代谢指标的关系.方法:将120 名绝经后妇女分为骨密度正常组、低骨量组和骨质疏松组3 组,对其血清基质金属蛋白酶3、骨桥蛋白、骨保护蛋白、骨保护蛋白配体及骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C 端肽和尿Ⅰ型胶原交联N 端肽进行测定,计算骨桥蛋白/基质金属蛋白酶3 比值.结果与结论:骨质疏松组中血清骨桥蛋白和基质金属蛋白酶3 的水平高于正常组(P < 0.05).绝经后妇女血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3 比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关(P < 0.05),与骨保护蛋白、尿尿Ⅰ型胶原交联N 端肽/肌酐比值呈明显正相关性(P < 0.05).骨质疏松组中血清基质金属蛋白酶3、骨桥蛋白和骨桥蛋白/基质金属蛋白酶3 比值与血清骨保护蛋白配体、骨碱性磷酸酶和骨钙素水平呈明显负相关(P < 0.05),与骨保护蛋白、尿尿Ⅰ型胶原交联N 端肽/肌酐水平比值存在明显正相关性(P < 0.05).提示绝经后妇女血清骨桥蛋白水平和骨桥蛋白/基质金属蛋白酶3 比值升高与绝经后骨质疏松症伴随骨代谢转换过程增快有关.     

Estradiol treatment altered anticholinergic-related brain activation during working memory in postmenopausal women

Diffusion MRI is used extensively to investigate changes in white matter microstructure related to brain development and pathology. Ageing, however, is also associated with significant white and grey matter loss which in turn can lead to cerebrospinal fluid (CSF) based partial volume artefacts in diffusion MRI metrics. This is especially problematic in regions prone to CSF contamination, such as the fornix and the genu of corpus callosum, structures that pass through or close to the ventricles respectively. The aim of this study was to model the effects of CSF contamination on diffusion MRI metrics, and to evaluate different post-acquisition strategies to correct for CSF-contamination: Controlling for whole brain volume and correcting on a voxel-wise basis using the Free Water Elimination (FWE) approach. Using the fornix as an exemplar of a structure prone to CSF-contamination, corrections were applied to tract-specific and voxel-based [tract based spatial statistics (TBSS)] analyses of empirical DT-MRI data from 39 older adults (53-93 years of age). In addition to significant age-related decreases in whole brain volume and fornix tissue volume fraction, age was also associated with a reduction in mean fractional anisotropy and increase in diffusivity metrics in the fornix. The experimental data agreed with the simulations in that diffusivity metrics (mean diffusivity, axial and radial diffusivity) were more prone to partial volume CSF-contamination errors than fractional anisotropy. After FWE-based voxel-by-voxel partial volume corrections, the significant positive correlations between age and diffusivity metrics, in particular with axial diffusivity, disappeared whereas the correlation with anisotropy remained. In contrast, correcting for whole brain volume had little effect in removing these spurious correlations. Our study highlights the importance of correcting for CSF-contamination partial volume effects in the structures of interest on a voxel-by-voxel basis prior to drawing inferences about underlying changes in white matter structures and have implications for the interpretation of many recent diffusion MRI results in ageing and disease.     

绝经妇女原发性高血压性激素及血脂变化关系的研究

目的 :探讨绝经妇女原发性高血压 (EH)、性激素与血脂变化的关系。方法 :对 3 1例绝经 1a以上妇女原发性高血压患者 (A组 )、2 5例绝经 1a以上无高血压健康妇女 (B组 )的血清雌二醇 (E2 )、孕酮 (P)、睾酮 (T)、血浆总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -C)及低密度脂蛋白胆固醇 (LDL -C)进行检测。结果 :A组E2 、HDL -C水平较B组显著降低 ,P、TC、TG、LDL -C水平显著增高。线性相关分析显示 ,E2 与TC、TG、LDL -C呈显著负相关 ,而E2 与HDL -C呈显著正相关。结论 :绝经后妇女原发性高血压患者存在严重的性激素失调及脂代谢异常 ,可能为绝经后妇女高血压发病的原因之一     

Serum asymmetric dimethylarginine and nitric oxide levels in obese postmenopausal women

Background: It has been reported that estrogen deficiency after menopause might cause a decrement in nitric oxide (NO) bioavailability by increasing the level of asymmetric dimethylarginine (ADMA), a major endogenous nitric oxide synthase inhibitor, thus leading to abnormalities in endothelial function. Because NO plays an important role on feeding behavior, ADMA may be involved in the pathogenesis of obesity, too. This cross‐sectional study aimed to evaluate the relations of ADMA and NO with the obesity‐linked peptides, such as ghrelin, leptin, and adiponectin in postmenopausal women free of hormone replacement therapy. Methods: Adiponectin, ghrelin, leptin, ADMA, and NO_x (total nitrite/nitrate) were measured in 22 obese (BMI: 30–47 kg/m²) and 19 normal weight (BMI: 21.5–26 kg/m²) postmenopausal women.Anthropometric measurements (height, weight, BMI, waist, and hip circumferences) were recorded. Statistics were made by the Mann–Whitney U‐test. Results: Ghrelin and adiponectin levels were significantly lower (P<0.001), whereas ADMA and leptin levels were higher in obese women than in normal weight controls (P<0.01 and 0.001, respectively). BMI was correlated negatively with adiponectin and ghrelin and positively with ADMA and leptin levels. No correlation existed between ADMA and NO. Conclusion: Estrogen deficiency alone may not cause an increase in ADMA levels unless the women are prone to disturbances in energy homeostasis. In spite of the high ADMA levels, the unaltered NO levels in plasma may be owing to ongoing inflammatory conditions. J. Clin. Lab. Anal. 25:174–178, 2011. © 2011 Wiley‐Liss, Inc.     

机械振动治疗绝经后女性膝骨性关节炎

目的:适宜频率的机械振动可以促进血液循环,促进关节软骨及软骨下骨细胞的再生和修复。观察机械振动对膝骨性关节炎患者的症状、膝关节功能、关节活动范围和下肢肌力的影响。方法:①对象:选取2005/2006居住在北京理工大学,并且患有膝骨性关节炎的绝经妇女116例。材料:ZD-10全身振动治疗仪(北京迈达康医疗设备制造有限公司)。②分组:愿意接受振动治疗且能按照试验要求完成者103例为振动组,年龄(61.23±8.20)岁;不能按照试验要求完成者13例为非振动组,年龄(63.73±5.45)岁。③干预:振动组接受振动治疗,振动频率30Hz,振幅5mm,5次/周,10min/次,1个月为1个周期,共3个月。非振动组不接受振动和其他治疗。④评估:于试验开始前、实验1,2,3个月时分别观测膝关节功能Lysholm评分;膝关节疼痛程度目测类比评分;采用运动功能分析仪测定下肢最大肌力、膝关节活动范围和膝关节活动有效范围;对比体质量指数变化。结果:振动组98例、非振动组11例进入结果分析。振动组受试者于试验前后膝关节功能Lysholm评分、下肢最大肌力、膝关节活动范围、膝关节活动有效范围均得到明显改善(P<0.05或0.01),疼痛程度目测类比评分明显降低(P<0.01),体质量指数没有明显变化(P>0.05)。非振动组受试者的所有观察指标于试验前后均无明显变化(P>0.05)。结论:振动治疗可以改善绝经妇女膝骨性关节炎患者的膝关节功能,提高下肢最大肌力,增大膝关节活动范围及有效活动范围,减轻疼痛症状。     

Betaxolol treatment of hypertension in postmenopausal women]

AIM: The study of hypotensive efficacy of high-cardioselective beta-blocker betaxolol, its effects on lipid and carbohydrate metabolism, menopausal syndrome in females with mild and moderate arterial hypertension. MATERIALS AND METHODS: 20 postmenopausal 45-59-year-old women entered the trial of betaxolol. They had diastolic blood pressure 90-114 mm Hg. Beta-blockers were not contraindicated. Arterial pressure, heart rate, body mass, blood lipid spectrum, glucose and insulin levels were evaluated before the treatment, 1, 3 and 6 months after it. RESULTS: Betaxolol safely and effectively lowered blood pressure. Blood lipid spectrum remained unchanged. A transitory rise in fasting insulin levels did not worsen glucose tolerance despite a small gain in body mass. Menopausal syndrome relieved due to good effect of betaxolol on vasomotor disorders. CONCLUSION: Betaxolol has a good hypotensive effect in the absence of adverse effects on lipid and carbohydrate metabolism. A reduction of menopausal syndrome was also achieved.     

Low free testosterone levels are associated with all-cause and cardiovascular mortality in postmenopausal diabetic women

OBJECTIVE

Hyperandrogenemia is associated with cardiovascular risk factors in women but evidence about the relationship of testosterone levels with mortality is sparse. We aimed to evaluate whether total testosterone (TT), free testosterone (FT), and sex hormone–binding globulin (SHBG) are associated with all-cause and cardiovascular mortality in a cohort of postmenopausal women.

RESEARCH DESIGN AND METHODS

We measured TT and SHBG levels in 875 postmenopausal women who were referred for coronary angiography (during 1997–2000). FT was calculated according to the Vermeulen method. The main outcome measures were Cox proportional hazard ratios (HRs) for mortality from all causes and from cardiovascular causes.

RESULTS

After a median follow-up time of 7.7 years, 179 women (20.5%) had died. There were 101 deaths due to cardiovascular disease (56.4% of all deaths). We found no association of FT, TT, and SHBG levels with mortality in all postmenopausal women. In postmenopausal diabetic women, multivariable-adjusted HRs (with 95% CIs) in the fourth compared with the first FT quartile for all-cause and cardiovascular mortality were 0.38 (0.08–0.90), P = 0.025, and 0.28 (0.08–0.90), P = 0.032, respectively. We found no association of TT and SHBG with mortality in diabetic postmenopausal women.

CONCLUSIONS

In postmenopausal diabetic women referred for coronary angiography, low FT levels are independently associated with increased all-cause and cardiovascular mortality.Hyperandrogenemia is associated with adverse metabolic features, including insulin resistance, central obesity, dyslipidemia, and chronic inflammation in premenopausal women, which might lead to an increased cardiovascular risk (1). Hyperandrogenemia in premenopausal women is most frequently caused by polycystic ovary syndrome (PCOS). In a recent meta-analysis (2), a twofold increased risk for arterial disease was observed in patients with PCOS relative to women without PCOS. BMI adjustment did not affect this finding, suggesting that the increased risk for cardiovascular events in PCOS might rather be a consequence of hyperandrogenemia than of obesity per se. High testosterone levels, which indicate an increased risk of type 2 diabetes in postmenopausal women (3), may underlie this association when considering that type 2 diabetes is associated with a 3.5-fold increased mortality (4). On the other hand, low levels of testosterone have been reported in women with atherosclerotic disease (5). Little is known about the association of androgen levels with mortality in pre- as well as postmenopausal women. The few studies conducted so far revealed conflicting results. Results from the Rancho Bernardo Study (6) indicate no association of testosterone levels with mortality, whereas Shaw et al. (7) demonstrated that hyperandrogenemia and a history of irregular menses were associated with angiographic coronary artery disease and increased mortality. In contrast, Sievers et al. (8) demonstrated that low total testosterone (TT) levels were associated with increased all-cause mortality and incident cardiovascular events in a primary care cohort of 2,914 female patients. These latter studies were, however, limited by use of TT for assessment of androgen status. This may not be the best approach because free testosterone (FT), and not TT, is the biologically active form.Hence, our aim was to study the association of TT, sex hormone–binding globulin (SHBG), and FT levels with all-cause as well as cardiovascular mortality in postmenopausal women referred for coronary angiography. Considering previous data suggesting a possible association of testosterone status and type 2 diabetes, we performed analyses stratified by diabetes status.     

绝经后妇女雌激素水平与腹主动脉粥样硬化的关系

目的:研究绝经后妇女雌激素水平与腹主动脉钙化的关系,寻求干预动脉粥样硬化的可能性。方法:使用渡边弘美计算方法,收集了137例绝经后妇女腹部CT扫描中3126帧图像资料,测量腹主动脉钙化体积,并与患者近期的血雌二醇(estradiol,E2)、睾酮(testosterone,T)、促卵泡激素(follicle-stimulatinghormone,FSH)、促黄体生成素(follicle-luteinizinghormone,FLH)比较。结果:137例绝经后妇女中,63例CT图像上出现腹主动脉钙化,钙化率(incidencesofcalcifiedlesion,ICL)为45.9%,平均每位患者的平均钙化体积(meancalcifiedvolume,MCV)为(0.68±0.32)cm3。按绝经年限分组后,6～15年组和>16年组的ICL和MCV均明显大于绝经年限<5年组(ICL依次为50.8%,65.7%和21.4%;χ2分别为7.856和13.669,P分别为<0.02和0.01)。63例有钙化者按钙化体积分组后,体积大组(≥1.5cm3,21例)和体积小组(<1.5cm3,35例)的E2和T均明显低于无钙化组(74例),而前者的FSH和LH则明显高于后者(t=2.047～2.407,P均<0.05)。结论:绝经后妇女雌激素水平与动脉粥样硬化的发生和进展密切相关。     

Fasting plasma glucose levels and endogenous androgens in non-diabetic postmenopausal women.

1. The clinical association between glucose intolerance, hyperinsulinaemia, insulin resistance and hyperandrogenism is well recognized in premenopausal women with polycystic ovarian disease. We examined the hypothesis that fasting plasma glucose levels might be related to endogenous androgen levels in postmenopausal women in the absence of overt clinical disease. 2. In a Southern Californian cohort of 848 nondiabetic postmenopausal women aged 50-79 years, fasting plasma glucose levels positively correlated with levels of the endogenous androgens dehydroepiandrosterone sulphate and free testosterone and negatively with sex-hormone-binding globulin across the whole range of glucose and hormone levels. Mean dihydroepiandrosterone sulphate and free testosterone levels were 16% and 46% higher, respectively, and mean sex-hormone-binding globulin levels 27% lower in the top compared with the bottom quartile of fasting plasma glucose levels. This relationship was independent of age, body mass index, cigarette smoking habit and exogenous oestrogen use. 3. These findings raise questions about the possible physiological role of androgens in the regulation of glucose metabolism and insulin resistance and, possibly, in the mediation of the some of the cardiovascular consequences of diabetes in women.     

Plasma levels of cyclic GMP and endothelin in postmenopausal women with unstable coronary artery disease.

Many women with typical anginal chest pain have normal coronary angiograms, which may be due to altered endothelial function. We evaluated the endothelial markers cyclic GMP (cGMP) and immunoreactive endothelin (ir-ET) regarding presence of coronary atherosclerosis in women with clinical signs of unstable coronary artery disease (CAD). Plasma levels of cGMP and ir-ET were determined in 118 patients and 84 controls. Ischaemia was evaluated at an exercise test. Of the patients 20% had normal vessels, 14% insignificant CAD and 66%, significant stenosis at coronary angiography. Mean (95% CI) concentration of cGMP (nmol/l) was higher in patients than in controls (5.05 (4.53; 5.58) vs. 3.79 (3.34; 4.23)). Separating patients according to daily intake of nitroglycerin, only patients with this medication had significantly higher cGMP level (5.73 (4.88; 6.58)), whereas the difference between those without (4.35 (3.76; 4.94)) and controls disappeared. Patients with ischaemia at exercise test had higher cGMP level than those without (6.01 (5.13; 6.88) vs. 4.30 (3.66; 4.94)), even after adjusting for nitroglycerin treatment. ir-ET (pmol/l) was lower in patients with normal vessels than patients with coronary atherosclerosis (0.83 (0.78; 0.88) vs. 0.98 (0.92; 1.04)) and than the control group (0.91 (0.87; 0.94)). The difference between the control group and patients with atherosclerosis was also significant. Patients with unstable CAD and long-term nitroglycerin treatment have increased cGMP level. Patients with exercise-induced ischaemia have higher cGMP level than those without, irrespective of nitroglycerin treatment, which may reflect a general compensatory mechanism. Patients with normal vessels have low level of ir-ET, indicating different mechanisms for ischaemia/angina in these patients compared with patients with atherosclerosis.     

血清基质金属蛋白酶13及其抑制因子在绝经后妇女骨代谢中的浓度变化

目的 测定绝经后妇女血清基质金属蛋白酶-13 (MMP-13)和组织金属蛋白酶抑制因子1(TIMP-1)浓度,并探讨其与骨密度数值和骨代谢指标的关系.方法 选取武汉地区120名48 ～ 65岁绝经后女性,用酶联免疫吸附试验(ELISA)测定血清MMP-13、TIMP-1以及雌二醇(E2)、骨保护蛋白(OPG)、骨保护蛋白配体(OPGL),Ⅰ型原胶原N端前肽(PINP)和Ⅰ型胶原交联C末端肽(CTX)的浓度,计算MMP-13/TIMP-1比值,用双能X线吸收法(DEXA)测定腰椎正位、股骨颈、华氏区和大粗隆的骨密度(BMD).同时,按照WHO标准将入选女性分为骨密度正常组(n=28)、低骨量组(n=36)和骨质疏松组(n=56).结果 骨密度正常组、低骨量组和骨质疏松组MMP-13浓度比较差异有统计学意义[(27.08±1.41) μg/L、(45.64±1.62)μg/L及(44.25±1.21) μg/L;F=110.314,P=0.000],且低骨量组、骨质疏松组血清MMP-13均高于正常组(P均＜0.05),低骨量组MMP-13略高于骨质疏松组,但差异无统计学意义(P＞0.05);而TIMP-1在3组间差异无统计学意义(F=10.721,P=0.801).MMP-13/IIMP-1比值分别为0.185±0.062,0.311±0.053,0.332±0.063,3组差异有统计学意义(F=137.771,P =0.000),且低骨量组与骨质疏松组均高于骨密度正常组(P均＜0.05),但两组间差异无统计学意义(P＞0.05).骨质疏松组中血清MMP-13与骨密度(腰椎正位、股骨颈、华氏区)、血清E2、OPGL数值存在明显负相关性(r值分别为-0.296、-0.198、-0.301、-0.298、-0.233,P均＜0.05),和OPG、PINP和CTX存在明显正相关性(r值分别为0.228、0.315、0.312,P均＜0.05).低骨量组MMP-13与骨密度(腰椎正位、华氏区)和E2、CTX存在明显相关性(r值分别为-0.188、-0.196、-0.235、0.289,P均＜0.05).结论 血清MMP-13和MMP-13/TIMP-1比值与绝经后骨质疏松症妇女和绝经后低骨量组妇女骨代谢指标具有关联性.血清MMP-13浓度升高和MMP-13/TIMP-1比值升高可能为绝经后骨质疏松症和绝经后妇女早期骨代谢转换过程增快的表现.     

Elevated levels of plasma homocysteine in postmenopausal women in Burkina Faso.

BACKGROUND: Low levels of plasma homocysteine have been found in children and adult populations living in Burkina Faso in association with a low prevalence of coronary heart disease. METHODS: Based on this finding, the levels of plasma homocysteine and other thiols (cysteine, cysteinylglycine, glutathione) in postmenopausal women living in Burkina Faso were evaluated with the aim of investigating whether age and life conditions influence plasma homocysteine and other thiol levels. RESULTS: It was found that in older postmenopausal women the mean level of homocysteine was higher (16.4+/-6.6 micromol/L) than in fertile women (6.8+/-1.2 micromol/L) and that this increase was correlated with cysteine levels (166.6+/-44.6 micromol/L). While the glutathione level in postmenopausal women was lower (3.6+/-2.3 micromol/L) compared with fertile women (7.0+/-1.7 micromol/L), cysteinylglycine levels were within the normal range (29.9+/-9.3 micromol/L). No correlation was found between homocysteine levels and serum folate, vitamin B(12), vitamin B(6), cystatin C and serum creatinine levels. The older the women were, the higher were their plasma homocysteine levels: levels up to 20.2+/-9.1 micromol/L were found in those >70 years old. CONCLUSIONS: The elevated levels of homocysteine in the postmenopausal women of Burkina Faso must be viewed as a characteristic of older age and its metabolic consequences.     

Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women.

The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (> or = 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.     

Lipoprotein modifications during dietary treatment in patients with primary type V hyperlipoproteinaemia

Type V hyperlipoproteinaemia is a disorder of lipid transport characterized by the accumulation in serum of chylomicrons and very low density lipoproteins. The purpose of the study was the analysis of serum lipids and lipoproteins by ultracentrifugation in nine patients with primary type V hyperlipoproteinaemia before and during dietary treatment. After 30 days of balanced isocaloric diet mean serum triglycerides fell from 25.4 +/- 15.0 (mean +/- SD) to 2.8 +/- 1.7 mmol l-1. At the same time the chylomicrons and the very low density lipoproteins of flotation rate higher than 100 disappeared from the serum while the remaining very low density lipoproteins maintained unaltered their normal protein-lipid composition. After 30 days the low density lipoproteins increased significantly in concentration (from 1.6 +/- 0.8 to 4.1 +/- 1.1 mmol l-1 cholesterol) and their percentage content of cholesterol and triglyceride was increased and reduced, respectively. The highest concentration of intermediate density lipoprotein cholesterol was observed after 15 days of treatment (1.2 +/- 0.6 mmol l-1. The abnormally low concentrations and the physicochemical properties of the high density lipoproteins remained unchanged throughout the study (from 0.6 +/- 0.2 to 0.8 +/- 0.2 mmol l-1 cholesterol concentration) and no high density lipoproteins two (HDL2) were observed at any time. The effects of this treatment were an increase in low density and marginal change in high density lipoproteins which are considered, respectively, a positive and a negative risk factor for atherosclerosis.