Serum cathepsin K as a marker of bone metabolism in postmenopausal women treated with alendronate

Context

Cathepsin K is a member of the cysteine protease family that cleaves both helical and telopeptide regions of collagen I, the major type of collagen in bone. Measurement of circulating levels of cathepsin K may be useful to assay the number or function of osteoclasts.

Objective

The aim of the study was to evaluate the role of serum cathepsin K as a biochemical marker of bone metabolism in patients with postmenopausal osteoporosis before and after treatment with alendronate.

Design, setting and participants

The study was a case–control and prospective study with postmenopausal osteoporotic women including a total number of 86 subjects. Serum cathepsin K was determined in 46 women with postmenopausal osteoporosis before and after 3, 6 and 12 months of treatment with alendronate. Basal serum cathepsin K levels were also compared between premenopausal healthy women (n = 20), postmenopausal women without osteoporosis (n = 20) and osteoporotic women. In addition, serum carboxyterminal cross-linked telopeptide of type I collagen (CTX), osteocalcin (OC) and bone-specific alkaline phosphatase (bALP) were measured.

Main outcome measure

Changes in cathepsin K serum levels after alendronate treatment.

Results

Serum cathepsin K levels were higher in postmenopausal women with osteoporosis (9.4 ± 11 pmol/L) compared with healthy postmenopausal women (6.8 ± 8.1 pmol/L; p < 0.01) and premenopausal women (6.3 ± 5.0 pmol/L, p < 0.01). Serum cathepsin K decreases gradually after alendronate treatment (17% at 3 months, 22% at 6 months and 41% at 12 months, p < 0.01). In contrast, the treatment resulted in early and sustained reductions in serum CTX.

Conclusion

We conclude that serum cathepsin K seems to provide additional information on bone metabolism in postmenopausal women treated with alendronate.     

Orange juice improved lipid profile and blood lactate of overweight middle-aged women subjected to aerobic training

Objective

This study investigated how consumption of orange juice associated with aerobic training affected serum lipids and physical characteristics of overweight, middle-aged women.

Methods

The experimental group consisted of 13 women who consumed 500 mL/d of orange juice and did 1 h aerobic training 3 times a week for 3 months. The control group consisted of another 13 women who did the same aerobic training program but did not consume orange juice.

Results

At the end of the experiment, the control group lost an average of 15% of fat mass (P < 0.05) and 2.5% of weight (P < 0.05), whereas the experimental group lost 11% of fat mass and 1.2% of weight (P < 0.05). Consumption of orange juice by the experimental group was associated with increased dietary intake of vitamin C and folate by 126% and 61% respectively. Serum LDL-C decreased 15% (P < 0.05) and HDL-C increased 18% (P < 0.05) in the experimental group, but no significant change was observed in the control group. Both groups improved the anaerobic threshold by 20% (P < 0.05), but blood lactate concentration decreased 27% in the experimental group compared to the 17% control group, suggesting that experimental group has less muscle fatigue and better response to training.

Conclusions

The consumption of 500 mL/d of orange juice associated with aerobic training in overweight women decreased cardiovascular disease risk by reducing LDL-C levels and increasing HDL-C levels. This association also decreased blood lactate concentration and increased anaerobic threshold, showing some improvement in the physical performance.     

The effect of hormone therapy on serum melatonin concentrations in premenopausal and postmenopausal women: A randomized,double-blind,placebo-controlled study

Objectives

Melatonin levels decrease physiologically with age, and possibly with the transition to menopause. The plausible influence of hormone therapy (HT) on melatonin is poorly understood. The aim of this randomized, placebo-controlled, double-blind trial was to investigate the effect of HT administration on serum melatonin concentrations in late premenopausal and postmenopausal women.

Study design

Analyses were carried out among 17 late premenopausal and 18 postmenopausal healthy women who participated in a prospective HT study in Finland. Serum melatonin was sampled at 20-min (21:00–24:00 h; 06:00–09:00 h) and 1-h (24:00–06:00 h) intervals at baseline and after 6 months with HT or placebo.

Main outcome measures

Melatonin levels and secretion profile after 6 months of HT compared to placebo.

Results

Mean melatonin levels, mean melatonin exposure level (area under curve, AUC) and mean duration of melatonin secretion did not differ after 6 months with HT vs. placebo, irrespectively of the reproductive state. However, in postmenopausal women the melatonin peak time (acrophase) was delayed by 2.4 h (2 h 21 min) on average after 6 months with HT vs. placebo (p < 0.05). No interaction between time and group was detected when melatonin level was modelled before or after treatment.

Conclusions

Administration of HT to postmenopausal women alters melatonin peak time, but not melatonin levels. Further research on larger clinical samples is needed to better understand the effects of HT on melatonin profile.     

Relationships between serum uric acid,adiponectin and arterial stiffness in postmenopausal women

Objectives

Cardiovascular disease (CVD) is a leading cause of death in postmenopausal women. Elevated serum uric acid levels, hypoadiponectinemia and arterial stiffness are strongly associated with cardiovascular diseases. We investigated the relationships among uric acid, adiponectin and arterial stiffness in postmenopausal women.

Study design

9555 subjects who had the routine health check-ups, 841 postmenopausal women aged 50 years or older who had not had a menstrual period for more than 12 consecutive months were included in this study.

Main outcome measures

BMI, WC, and serum concentrations of uric acid, adiponectin, glucose, lipids (total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol) were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Pulse wave velocity (PWV) was evaluated to assess arterial stiffness.

Results

The subjects were stratified into three groups according to uric acid values. PWV values gradually increased and adiponectin level decreased with uric acid tertiles. Serum uric acid levels in postmenopausal women correlated significantly with age, BMI, WC, TG, HDL-C, insulin, HOMA-IR, adiponectin and PWV. Multiple regression analysis showed that WC (β = 0.141, P < 0.01), HOMA (β = 0.137, P < 0.01), adiponectin (β = −0.104, P < 0.01), and PWV (β = 0.129, P < 0.01) were independently correlated with uric acid levels. In multiple logistic regression analysis after adjusting for risk factors, uric acid was a significant contributor to increased PWV.

Conclusions

These findings indicate that serum uric acid is independently associated with adiponectin and arterial stiffness in postmenopausal women.     

Effects of a nutritional intervention in obese postmenopausal women on atypical antipsychotics

Objectives

To investigate the effects of a nutritional intervention on the body weight, body composition, blood glucose and lipid levels of obese postmenopausal women taking atypical antipsychotics in Greece.

Study design

In a case–control design, 25 obese postmenopausal women treated with antipsychotic medications and 28 obese healthy comparisons were followed for 3 months. A nutritional program was individually designed for each participant.

Main outcome measures

At baseline and at 3 months of the study, anthropometric, body composition, blood glucose and lipid measurements were performed.

Results

Significant reductions in body weight, body mass index (BMI), fat and waist circumference were found both in the patients and their healthy comparisons from baseline to 3 months (P < 0.05). Patients reduced significantly less their BMI (P = 0.044) and body fat percentage compared to the healthy women (P = 0.023). Waist circumference was significantly reduced in both subject groups, with no significant difference found between them (P = 0.07). Glucose and lipid levels were not altered during the intervention in the patients’ group, while significant changes were observed in the healthy women in total cholesterol (P = 0.016), low density lipoprotein cholesterol (P = 0.022) and triglycerides (P = 0.042).

Conclusions

Obese postmenopausal women on atypical antipsychotic medication appear to respond favorably to a nutritional program. The improvements seen in BMI and body fat are attenuated in the patients compared to their healthy counterparts; moreover no change in lipid levels was found in the patients’ group. These findings suggest that atypical antipsychotics may play an adverse role in fat loss and lipid metabolism in this population.     

Effects of raloxifene and hormone replacement therapy on forearm skin elasticity in postmenopausal women

Objectives

Hormone replacement therapy (HRT) increases skin elasticity in postmenopausal women. However, the effects of raloxifene, a selective estrogen receptor modulator (SERM), on skin degenerative changes in postmenopausal women remain unknown. We investigated whether raloxifene increases skin elasticity, similar to HRT, in postmenopausal women.

Methods

In a 12-month trial, 17 postmenopausal women (mean age, 66.4 ± 7.8 years) received continuous raloxifene treatment (60 mg/day), 19 women (56.2 ± 6.4 years) received continuous 17-β estradiol treatment using a patch (0.72 mg/2 days) plus cyclic medroxyprogesterone acetate (2.5 mg/day, for 12 days/month), and 11 women (58.1 ± 7.3 years) did not receive either therapy. In each subject, the skin elasticity of the forearm was measured using a suction device at baseline and at 12 months after the start of the study.

Results

Raloxifene and HRT significantly increased skin elasticity from 52.4 ± 3.8% and 64.1 ± 7.2% at baseline to 55.1 ± 4.7% and 67.4 ± 7.4% after 12 months, respectively (P < 0.05, each), but the untreated subjects did not exhibit any significant change in skin elasticity during the study. The delta value for skin elasticity was significantly higher among the raloxifene and HRT subjects than among the untreated subjects (P < 0.05, each).

Conclusions

These findings suggest that raloxifene may have a beneficial effect on skin elasticity, which undergoes degenerative changes in postmenopausal women, in addition to its effects on bone metabolism.     

Effect of raloxifene and low-dose percutaneous 17β-estradiol on menopause symptoms and endometrium—A randomized controlled trial

Objective

To investigate the effects on climacteric symptoms and endometrium of percutaneous low-dose 17β-estradiol associated with raloxifene in postmenopausal women.

Design

randomized placebo-controlled study.

Method

Fifty-two postmenopausal women with moderate to severe hot flushes were randomized to receive either 60 mg raloxifene (RLX; n = 20), 0.5 mg percutaneous 17β-estradiol associated to 60 mg raloxifene (RLX + E₂; n = 16) or placebo (PLC; n = 16). Climacteric symptoms (Kupperman index) and vaginal bleeding were evaluated. At baseline and at the end of the study endometrial thickness was measured and endometrial samples were collected for histological study.

Results

At baseline, the mean Kupperman index was 23.7 ± 1.8 in RLX group, 22.9 ± 1.9 in RLX + E₂ group and 22.6 ± 1.9 in the placebo group (NS). After 3 months, there was a significant reduction in Kupperman index mean values in both groups, but no statistical difference was observed between groups. However, RLX + E₂ and placebo were significantly superior to RLX in reducing hot flush severity (p < 0.05). Endometrial thickness did not change in both groups. The association of percutaneous low-dose 17β-estradiol to raloxifene was not associated with proliferation of endometrium neither in hysteroscopies nor in endometrial biopsies at the third month of treatment. No vaginal bleeding was reported during the study.

Conclusions

The association of percutaneous low dose of 17β-estradiol with raloxifene exerted favorable effects on hot flushes severity of postmenopausal women, providing a safe profile in endometrium at least in short-term therapy.     

Ospemifene,a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: A randomised,placebo-controlled,phase III trial

Objective

To evaluate the efficacy and safety of ospemifene, a novel selective oestrogen receptor modulator, in the treatment of vaginal dryness in postmenopausal women with vulvovaginal atrophy (VVA).

Study design

A 12 week, multicentre, randomised, double-blind, parallel-group phase III study of women (40–80 years) with VVA and self-reported vaginal dryness as their most bothersome symptom.

Main outcome measures

The co-primary efficacy endpoints were the change from baseline to Week 12 in (1) percentage of parabasal cells in the maturation index (MI), (2) percentage of superficial cells in the MI, (3) vaginal pH, and (4) severity of vaginal dryness. Safety assessments included physical examination, cervical Papanicolaou test and clinical laboratory analyses. Endometrial thickness and histology was also assessed.

Results

A total of 314 women were randomised to once-daily ospemifene 60 mg/day (n = 160) or placebo (n = 154). Significant improvements in the percentages of parabasal and superficial cells in the MI and vaginal pH were observed with ospemifene compared with placebo (p < 0.001 for all parameters). The mean change from baseline in severity score of vaginal dryness reported by women receiving ospemifene compared with those receiving placebo approached statistical significance (p = 0.080). Improvements in each of the four co-primary endpoints with ospemifene were statistically significant compared to placebo in the per protocol population. The majority of treatment-emergent adverse events were considered mild to moderate in severity.

Conclusions

Once-daily oral ospemifene 60 mg was effective for the treatment of VVA in postmenopausal women with vaginal dryness.     

Influence of number of deliveries and total breast-feeding time on bone mineral density in premenopausal and young postmenopausal women

Objectives

Pregnancy and lactation have been associated with decline in bone mineral density (BMD). It is not clear if there is a full recovery of BMD to baseline. This study sought to determine if pregnancy or breast-feeding or both have a cumulative effect on BMD in premenopausal and early postmenopausal women.

Study design

We performed single-center cohort analysis. Five hundred women aged 35–55 years underwent routine BMD screening from February to July 2011 at a tertiary medical center. Patients were questioned about number of total full-term deliveries and duration of breast-feeding and completed a background questionnaire on menarche and menopause, smoking, dairy product consumption, and weekly physical exercise. Weight and height were measured. Dual-energy X-ray absorptiometry was used to measure spinal, dual femoral neck, and total hip BMD.

Main outcome measures

Associations between background characteristics and BMD values were analyzed.

Results

Sixty percent of the women were premenopausal. Mean number of deliveries was 2.5 and mean duration of breast-feeding was 9.12 months. On univariate analysis, BMD values were negatively correlated with patient age (p = 0.006) and number of births (p = 0.013), and positively correlated with body mass index (p < 0.001). On multiple (adjusted) logistic regression analysis, prolonged breast-feeding duration, but not number of deliveries, was significantly correlated to a low BMD (p = 0.008). An effect was noted only in postmenopausal women. The spine was the most common site of BMD decrease.

Conclusions

Prolonged breast-feeding may have a deleterious long-term effect on BMD and may contribute to increased risk of osteoporosis later in life.     

The safety of 52 weeks of oral DHEA therapy for postmenopausal women

Objective

The aim of this study was to evaluate the safety of 52 weeks of DHEA 50 mg daily oral dose given to postmenopausal women with low libido to improve sexual function.

Method

93 postmenopausal women were enrolled in a 52-week randomised, double-blind, placebo-controlled trial and received either DHEA 50 mg or placebo (PL) daily. The effects of DHEA versus placebo on lipid profile, insulin–glucose homeostasis and the endomentrium were assessed over 52 weeks.

Results

Oral DHEA, 50 mg/day, was not associated with any effects on blood lipids or insulin resistance. The pattern of breakthrough bleeding did not substantially differ between the DHEA and PL groups and no significant adverse endometrial effects were apparent.

Conclusions

The use of 50 mg oral DHEA did not significantly alter lipid profile, insulin sensitivity or adversely affect the endometrium in postmenopausal women.     

Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life

Objective

To use the Menopause-Specific Quality of Life Questionnaire (MENQOL) to assess the impact of menopausal symptoms on health-related quality of life in a large US population-based study.

Methods

Participants were recruited from the US population through random-digit-dialing and probability sampling. Analyses included 2703 postmenopausal women 40–65 years old in our Menopause Epidemiology Study. Respondents answered a 30-min questionnaire, including the MENQOL.

Results

Scores for each domain were: vasomotor: 3.2 ± 2.2; psycho-social: 3.3 ± 1.8; physical: 3.5 ± 1.5; sexual: 2.9 ± 2.1. There were significant differences in the MENQOL scores by age, smoking, exercise, education, employment status and BMI. Women aged 60–65 years (p < 0.0001), with a bachelor’s degree or higher level of education (p < 0.0001), who exercised at least 3 days a week (p < 0.0001), who had never smoked (p < 0.0001), with a body mass index ≤25 kg/m² (p < 0.0001), and who had significantly lower scores indicating better quality of life. Hot flashes affected work (46.0%), social activities (44.4%), leisure activities (47.6%), sleep (82.0%), mood (68.6%), concentration (69.0%), sexual activity (40.9%), total energy level (63.3%) and overall quality of life (69.3%).

Conclusion

Symptoms experienced during menopause and socio-demographic characteristics affect the quality of life in postmenopausal women. Hot flashes impact the daily activities of most postmenopausal women, especially those with more frequent/severe symptoms. Treatments that safely and effectively treat these symptoms could improve quality of life among postmenopausal women.     

Association of the (TAAAA)n repeat polymorphism of SHBG gene with the age at menopause in Greek postmenopausal women

Objective

To assess the potential association of the pentanucleotide (TAAAA)n repeat polymorphism in the promoter of SHBG gene with the age at menopause in a Greek female population.

Study design

Cross-sectional study. Two hundred and ten postmenopausal women aged 46–63 years were enrolled. The age at the last menstrual period and anthropometric parameters were recorded in all participants. Blood sampling for genotyping of the (TAAAA)n polymorphism of SHBG gene was performed.

Main outcome measure(s)

Frequency and association of the (TAAAA)_n alleles with age at menopause.

Results

The alleles with seven and eight TAAAA repeats were associated with the age at menopause. The age at menopause was higher in carriers than in non-carriers of the (TAAAA)₇ allele (50.2 ± 3.1 years vs. 48.0 ± 4.8 years, p = 0.026). Furthermore, the age at menopause was lower in women carrying the (TAAAA)₈ allele (47.5 ± 4.8 years) than in women not carrying this allele (48.8 ± 4.4 years, p = 0.048).

Conclusions

The (TAAAA)₇ and (TAAAA)₈ alleles of the SHBG (TAAAA)_n polymorphism may contribute to variation in the timing of natural menopause in postmenopausal women of Northwestern Greece.     

Human SA gene polymorphisms are associated with non-high-density lipoprotein cholesterol in postmenopausal women: A pilot study

Objective

The purpose of the study is to evaluate the associations between polymorphisms of the human SA (SAH) gene, an acyl-CoA synthetase gene, with dyslipidemia and phenotypes of the insulin resistance syndrome in postmenopausal women.

Methods

One hundred and forty-two postmenopausal women were recruited for the study. Each subject received anthropometric and blood pressure measurements, fasting sampling for lipids, and a 75-g oral glucose tolerance test for insulin resistance. Genotypes of two polymorphisms in the promoter region (c.-962ins/del, c.-451G > A), one missense variant (c.1077G > C, p.K359N) in exon 8, and one in intron 12 (A > G) of the SAH gene, were determined.

Results

There were significant differences in genetic distribution of the SAH gene promoter I/D polymorphism between the two groups of subjects by non-high-density lipoprotein cholesterol (non-HDL-C) levels (p = 0.004). The subjects with the DD genotype was associated with high levels of non-HDL-C (>160 mg/dL) as compared with the ID or II genotypes (p = 0.002). Furthermore, three haplotypes were constructed based on the promoter I/D and the exon 8 G/C polymorphisms. Homozygosity for SAH haplotype 3 was associated with increased adiposity, insulin resistance, and elevated levels of non-HDL-C in the post menopausal women. The subjects with haplotype 3 had double the risk to have higher non-HDL-C levels than those with haplotype 1.

Conclusion

Our results suggest that the polymorphisms of the SAH gene are associated with non-HDL-C levels in postmenopausal women. Further studies with larger sample sizes or different populations are warranted to confirm our preliminary findings.     

Effects of interactions between ApoE polymorphisms,alcohol consumption and obesity on age-related trends of blood pressure levels in postmenopausal women: The Bambuì cohort study of aging (1997–2008)

Objectives

To evaluate the effects of interactions between ApoE genotypes, alcohol consumption and obesity on the age-related trends of blood pressure (BP) levels in postmenopausal women.

Study design

A population-based prospective cohort study of all residents in Bambuì, south-eastern Brazil, aged 60 years or older. Repeated BP measurements were obtained in four waves from 851 women who underwent ApoE genotyping at baseline (88.3% of those enrolled), and multi-level random-effects pattern-mixture models were used to evaluate the age-related BP trajectories, while accounting for non-ignorable dropouts/deaths and handling heterogeneities as random parameter variations. The few measurements (2.1%) made during hormone replacement therapy were excluded from the analysis.

Results

Alcohol consumption was associated with high levels of systolic and diastolic BP in an age × genotype-dependent manner only in the non-obese women (BMI < 27 kg/m²). Among those with the ?3/3 genotype, the differences in systolic and diastolic levels between drinkers and non-drinkers estimated at the age of 60 years were respectively 13.7 mmHg (p = 0.022) and 10.7 mmHg (p = 0.002), and disappeared in the older age groups, in which drinking was associated with systolic/diastolic hypertension if the non-obese women were ?4 carriers.

Conclusion

In non-obese postmenopausal women, alcohol consumption is associated with systolic and diastolic hypertension early in those with the ?3/3 ApoE genotype, and late in ?4 carriers. We hypothesize the mediation of androgen hormones and the influence of ApoE genotypes on age at natural menopause. A better understanding of these mechanisms may guide better preventive choices.     

Ultra low dose continuous combined hormone replacement therapy with 0.5 mg 17β-oestradiol and 2.5 mg dydrogesterone: Protection of the endometrium and amenorrhoea rate

Objectives and study design

The aim of this open, multicentre study was to demonstrate the endometrial safety and assess the bleeding pattern of ultra low dose continuous combined hormone replacement therapy with 0.5 mg 17β-oestradiol and 2.5 mg dydrogesterone in 446 healthy, non-hysterectomised, postmenopausal women with symptoms of oestrogen deficiency.

Main outcome measure

Aspiration endometrial biopsies were performed at baseline and after 1 year of treatment to assess the incidence of endometrial hyperplasia or a more serious endometrial outcome.

Results

The only adverse endometrial outcome at the end of the study was one case of simple hyperplasia. This gives an overall incidence of 0.27% (95% CI: 0.01–1.48%) in the per protocol sample (n = 395). The overall rate of amenorrhoea in the full sample (n = 446) was 68% and 14% had only one or two bleeding/spotting episodes. The rate of amenorrhoea in months 10–12 (n = 413) was 88%. The number of bleeding/spotting days per cycle fell during the study. The mean number of bleeding/spotting days was 5.8 and the mean number of days without bleeding was 358.2. Spotting alone was the most prevalent bleeding intensity, whilst heavy bleeding was rare.

Conclusions

In conclusion, 2.5 mg dydrogesterone continuously combined with 0.5 mg 17β-oestradiol effectively protects the endometrium in postmenopausal women in accordance with the guidelines of the Committee for Medicinal Products for Human Use (CHMP). It has a favourable amenorrhoea rate and is well tolerated by the majority of women.     

Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth Sleepiness Scale

Background

Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning.

Objective

To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS).

Methods

In this cross-sectional study 149 women aged 40–59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data.

Results

Mean age of surveyed women was 47.6 ± 5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe–very severe in 42.8% of cases. Regarding the partner (n = 132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8 ± 4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score ≥10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51–17.23], p = 0.001), sedentarism (OR 3.43, CI 95% [1.14–10.26], p = 0.02) and hot flush presence (OR 2.61, CI 95% [1.02–6.65], p = 0.04) among women were risk factors for increased daytime sleepiness (ESS total score ≥10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24–0.90], p = 0.02).

Conclusion

Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.     

Psychological factors and subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong

Background

Substantial evidence shows that psychological factors are associated with cardiovascular diseases. However, data on the association between psychological factors and subclinical atherosclerosis is lacking in postmenopausal Chinese women.

Objectives

To examine the associations of perceived stress and trait anxiety with subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Their relationships with biological and behavioral risk factors were also examined.

Methods

Between 2002 and 2004, we recruited 518 postmenopausal women aged 50–64 years. Perceived stress and trait anxiety were evaluated by the perceived stress scale and the state-trait anxiety inventory, respectively. Subclinical atherosclerosis was determined by measuring carotid intima-media thickness (IMT) and plaque using B-mode ultrasonography.

Results

Perceived stress and trait anxiety showed no significant association with IMT or plaque. Multivariate analyses showed high perceived stress scores were associated with an increased risk of elevated total cholesterol (OR = 2.10; 95% CI = 1.17–3.77) and elevated low-density lipoprotein cholesterol (LDL-C) (OR = 2.39; 95% CI = 1.36–4.21). High trait anxiety scores were associated with a 2.7-fold risk of elevated LDL-C (OR = 2.74; 95% CI = 1.56–4.80). Women with high perceived stress or trait anxiety scores were more likely to be physically inactive.

Conclusions

Perceived stress and trait anxiety were associated with atherogenic lipid levels, but not subclinical atherosclerosis. Maintaining high physical activity may help alleviate psychological stress and anxiety.     

Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia

Purpose

The aim of the study was to determine the relationship between the components of clinical sarcopenia and osteoporosis in postmenopausal women.

Methods

A population-based cohort of 590 Finnish postmenopausal women (mean age 67.9; range 65–72) was selected from the Osteoporosis Fracture Prevention (OSTPRE-FPS) study in 2002. Bone mineral density (BMD) and lean tissue mass were assessed by dual X-ray absorptiometry (DXA). The study sample was divided into three categories according to the WHO BMD classification: normal, osteopenia and osteoporosis. The study sample was divided into non-sarcopenic, presarcopenic, sarcopenic and non-classified groups according to quartiles of RSMI i.e. relative skeletal muscle index (appendicular muscle mass (kg)/square of height (m)), hand grip strength (kPa) and walking speed.

Results

In logistic regression analysis sarcopenic women had 12.9 times higher odds of having osteoporosis (p ≤ 0.001, OR = 12.9; 95% CI = 3.1–53.5) in comparison to non-sarcopenic women. In comparison to women in the highest grip strength quartile, women within the lowest quartile had 11.7 times higher odds of having osteoporosis (p = 0.001, OR = 11.7; 2.6–53.4). Sarcopenic women had 2.7 times higher odds of having fractures than their non-sarcopenic counterparts (p = 0.005, OR = 2.732; 1.4–5.5). Sarcopenic women had also 2.1 times higher risk of falls during the preceding 12 months compared to non-sarcopenic women (p = 0.021, OR = 2.1; 1.1–3.9). Adjustment for age, body mass index (BMI), physical activity and hormone therapy (HT) did not significantly alter these results.

Conclusions

The components of clinical sarcopenia are strongly associated with osteoporosis. Grip strength is the most significant measurement to reveal the association between sarcopenia and osteoporosis, falls and fractures.     

Association of estrogen receptor 2 gene polymorphisms with obesity in women (obesity and estrogen receptor 2 gene)

Objective

Few studies have examined the association between genetic variants of the estrogen receptor β (ESR2) and obesity in postmenopausal women.

Methods

The relationship of three polymorphisms (rs1271572, rs1256049 and rs4986938) and their associated haplotypes in the ESR2 gene with obesity and overweight were evaluated in 561 apparently healthy women (median age 63 years) from the Women's Health Study. Most of the women were postmenopausal (99.1%). The associations between genotypes and haplotypes with obesity (BMI ≥ 30 kg/m²) and overweight (BMI ≥ 25 kg/m²) were evaluated by logistic regression, assuming an additive model.

Results

No association was observed for any of the three polymorphisms with BMI, overweight or obesity. In haplotype analyses, one haplotype (major allele for all polymorphisms) was associated with a borderline inverse association with overweight but not obesity (OR = 0.62, 95% CI = 0.39–0.98).

Conclusions

An inverse and borderline significant association was found between the ESR2 G-G-G haplotype and overweight in postmenopausal women. Further investigation regarding the association between ESR2 and adiposity should be performed to confirm these findings.