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PubMed1990

A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women.

Background. The effectiveness of calcium in retarding bone loss in older postmenopausal women is unclear. Earlier work suggested that the women who were most likely to benefit from calcium supplementation were those with low calcium intakes. Methods. We undertook a double-blind, placebo-controlled, randomized trial to determine the effect of calcium on bone loss from the spine, femoral neck, and radius in 301 healthy postmenopausal women, half of whom had a calcium intake lower than 400 mg per day and half an intake of 400 to 650 mg per day. The women received placebo or either calcium carbonate or calcium citrate malate (500 mg of calcium per day) for two years. Results. In women who had undergone menopause five or fewer years earlier, bone loss from the spine was rapid and was not affected by supplementation with calcium. Among the women who had been postmenopausal for six years or more and who were given placebo, bone loss was less rapid in the group with the higher dietary calcium intake. In those with the lower calcium intake, calcium citrate malate prevented bone loss during the two years of the study; its effect was significantly different from that of placebo (P less than 0.05) at the femoral neck (mean change in bone density [+/- SE], 0.87 +/- 1.01 percent vs. -2.11 +/- 0.93 percent), radius (1.05 +/- 0.75 percent vs. -2.33 +/- 0.72 percent), and spine (-0.38 +/- 0.82 percent vs. -2.85 +/- 0.77 percent). Calcium carbonate maintained bone density at the femoral neck (mean change in bone density, 0.08 +/- 0.98 percent) and radius (0.24 +/- 0.70 percent) but not the spine (-2.54 +/- 0.85 percent). Among the women who had been postmenopausal for six years or more and who had the higher calcium intake, those in all three treatment groups maintained bone density at the hip and radius and lost bone from the spine. Conclusions. Healthy older postmenopausal women with a daily calcium intake of less than 400 mg can significantly reduce bone loss by increasing their calcium intake to 800 mg per day. At the dose we tested, supplementation with calcium citrate malate was more effective than supplementation with calcium carbonate.

Administration, Oral↗

PubMed1995

The use of estrogens and progestins and the risk of breast cancer in postmenopausal women.

BACKGROUND: The effect of adding progestins to estrogen therapy on the risk of breast cancer in postmenopausal women is controversial. METHODS: To quantify the relation between the use of hormones and the risk of breast cancer in postmenopausal women, we extended our follow-up of the participants in the Nurses' Health Study to 1992. The women were asked to complete questionnaires every two years to update information on their menopausal status, use of estrogen and progestin preparations, and any diagnosis of breast cancer. During 725,550 person-years of follow-up, we documented 1935 cases of newly diagnosed invasive breast cancer. RESULTS: The risk of breast cancer was significantly increased among women who were currently using estrogen alone (relative risk, 1.32; 95 percent confidence interval, 1.14 to 1.54) or estrogen plus progestin (relative risk, 1.41; 95 percent confidence interval, 1.15 to 1.74), as compared with postmenopausal women who had never used hormones. Women currently taking hormones who had used such therapy for 5 to 9 years had an adjusted relative risk of breast cancer of 1.46 (95 percent confidence interval, 1.22 to 1.74), as did those currently using hormones who had done so for a total of 10 or more years (relative risk, 1.46; 95 percent confidence interval, 1.20 to 1.76). The increased risk of breast cancer associated with five or more years of postmenopausal hormone therapy was greater among older women (relative risk for women 60 to 64 years old, 1.71; 95 percent confidence interval, 1.34 to 2.18). The relative risk of death due to breast cancer was 1.45 (95 percent confidence interval, 1.01 to 2.09) among women who had taken estrogen for five or more years. CONCLUSIONS: The addition of progestins to estrogen therapy does not reduce the risk of breast cancer among postmenopausal women. The substantial increase in the risk of breast cancer among older women who take hormones suggests that the trade-offs between risks and benefits should be carefully assessed.

Aged↗

PubMed2001

Short-term oral estrogen replacement therapy does not augment endothelium-independent myocardial perfusion in postmenopausal women.

OBJECTIVES: The purpose of this study was to determine the effect of usual-dose estrogen replacement therapy (ERT) on myocardial perfusion and myocardial perfusion reserve (MPR) (evoked by an endothelium-independent vasodilator) in healthy postmenopausal women. Postmenopausal women have a decreased myocardial perfusion reserve compared with younger women. Estrogen infusions are known to enhance endothelium-dependent vasodilation of the epicardial coronary arteries in postmenopausal women, but whether ERT also enhances endothelium-independent myocardial perfusion and perfusion reserve is unclear. METHODS: In 24 healthy postmenopausal women who were not taking ERT, myocardial perfusion at rest, perfusion during the infusion of adenosine (a primarily endothelium-independent vasodilator), and MPR were determined by positron-emission tomography (PET) and oxygen 15-labeled water. The women were then randomly assigned in a double-blind fashion to receive either 0.625 mg of oral conjugated estrogens (Premarin) or placebo per day for 4 to 6 weeks, after which they underwent a repeat cardiac PET study. RESULTS: There was no statistical difference between those assigned to ERT and those assigned to placebo in the measurement of myocardial perfusion at rest (1.21 +/- 0.31 vs 1.16 +/- 0.18 mL/g/min, respectively) in response to adenosine (2.66 +/- 0.96 vs 3.3 +/- 0.45 mL/g/min) or MPR (2.24 +/- 0.83 vs 2.88 +/- 0.64 mL/g/min) after 4 to 6 weeks of oral ERT. There was also no difference between the groups in any of the myocardial perfusion measurements after correction for the rate-pressure product. CONCLUSIONS: Short-term oral ERT does not affect myocardial perfusion at rest in response to adenosine or MPR in healthy postmenopausal women. Thus potential beneficial effects of ERT on vasomotor function may be limited to enhancement of endothelium-dependent vasodilative mechanisms affecting conduit vessels.

Adenosine↗

PubMed2002

Blood pressure control and hormone replacement therapy in postmenopausal women at risk for coronary heart disease.

BACKGROUND: Coronary heart disease (CHD) in women is strongly associated with estrogen deprivation. For example, risk for CHD increases dramatically after menopause. However, the role of hormone replacement therapy (HRT) in CHD prevention currently is unresolved. To better understand CHD in women, the precise mechanisms by which estrogen affects circulatory function require clarification. Evidence suggests that exogenous estrogen may affect blood pressure (BP) control, but its interaction with other CHD risk factors has not been systematically characterized. The present study examines the role of mildly elevated resting BP, family history of CHD, and HRT on BP responses to stress in postmenopausal women. METHODS: Postmenopausal women on long-term HRT were recruited along with a control group of postmenopausal women not on HRT. These women were divided into higher versus lower risk for CHD on the basis of resting BP and family history of CHD. BP control mechanisms were assessed before, during, and after a computer-controlled laboratory stressor. RESULTS: Results indicate that women with elevated resting BP and positive family history of CHD have exaggerated BP reactivity to stress and that HRT inhibits this effect. CONCLUSIONS: This study suggests that unmedicated postmenopausal women with mildly elevated resting BP and positive family history of CHD have altered BP control as indicated by exaggerated BP responses to stress. HRT eliminates the cumulative effect of resting BP and family history on BP reactivity, suggesting that the circulatory effects of estrogen replacement may operate, at least in part, through normalization of BP reactivity in higher-risk postmenopausal women.

Adult↗

PubMed2003

Effects of oral soy protein on markers of inflammation in postmenopausal women with mild hypercholesterolemia.

BACKGROUND: Nitric oxide (NO) may protect arteries against atherosclerosis, as suggested by experimental studies. Estrogen therapy enhances the bioactivity of NO in the vasculature of healthy postmenopausal women, but is not acceptable for long-term use by many women. Observational studies have demonstrated beneficial cardiovascular effects of soy protein in premenopausal and postmenopausal women. We examined whether the consumption of isolated soy protein may improve markers of vascular inflammation in postmenopausal women with hypercholesterolemia. METHODS AND RESULTS: In a randomized, double-blind, placebo-controlled, crossover study, 24 postmenopausal women with hypercholesterolemia received 25 g of soy protein or a placebo daily for 6 weeks, with treatment periods separated by 1 month. Markers of vascular inflammation were measured by enzyme-linked immunosorbent assay methods, including: soluble interleukin-2 receptor (sIL-2r), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1). There was no effect of soy protein in comparison with placebo on the inflammatory markers: the sIL-2r level was 942.2 +/- 335.3 pg/mL with soy protein and 868.5 +/- 226.9 pg/mL with placebo (P =.311); E-selectin was 39.6 +/- 16.5 ng/mL with soy protein and 42.1 +/- 17.6 ng/mL with placebo (P =.323); P-selectin was 157.9 +/- 67.9 ng/mL with soy protein and 157.5 +/- 47.6 ng/mL with placebo, (P =.977); ICAM-1 was 266.0 +/- 81.3 ng/mL with soy protein and 252.5 +/- 82.7 ng/mL with placebo (P =.435); VCAM-1 was 402.7 +/- 102.1 ng/mL with soy protein and 416.4 +/- 114.8 ng/mL with placebo (P =.53). CONCLUSIONS: Consumption of 25 g of isolated soy protein daily for 6 weeks does not substantially affect markers of vascular inflammation in postmenopausal women with hypercholesterolemia.

Biomarkers↗

PubMed2000

Uterine effects of raloxifene in comparison with continuous-combined hormone replacement therapy in postmenopausal women.

OBJECTIVE: We sought to compare the uterine effects of raloxifene with those of continuous-combined hormone replacement therapy. STUDY DESIGN: This randomized, double-blind 24-month study involved 136 postmenopausal women who received raloxifene 150 mg/d or conjugated equine estrogens 0.625 mg/d with medroxyprogesterone acetate 2.5 mg/d. After baseline evaluations, endometrial biopsy specimens were obtained, and endometrial thickness was measured annually by means of transvaginal ultrasonography. Statistical analyses were performed with an intention-to-treat approach. RESULTS: In the raloxifene group at the end point of the study 94.4% of biopsy specimens showed normal benign postmenopausal endometrium and 5.6% were classified as benign stimulatory endometrium. In the continuous-combined hormone replacement therapy group at the end point of the study 78.7% of biopsy specimens showed normal benign postmenopausal endometrium, 19. 1% were classified as benign stimulatory endometrium, and 2.1% showed benign abnormal postmenopausal endometrium. Mean endometrial thickness was unchanged from baseline with raloxifene and was increased significantly by 0.5 mm at 12 months with continuous-combined hormone replacement therapy. CONCLUSION: Raloxifene 150 mg/d did not increase endometrial thickness or cause endometrial proliferation in healthy postmenopausal women.

Biopsy↗

PubMed2001

Postmenopausal changes in serum cytokine levels and hormone replacement therapy.

OBJECTIVE: Our purpose was to investigate the effect of hormone replacement therapy on the postmenopausal changes in serum cytokine levels. STUDY DESIGN: Fifteen cytokines were measured by an enzyme-linked immunosorbent assay in 97 untreated and hormone replacement-treated women. Thirteen women were examined before and during hormone replacement therapy. RESULTS: Serum concentrations of macrophage colony-stimulating factor were significantly (P < .05) lower during the early postmenopausal period (< or = 10 years) than the values in premenopause and the elevated levels in the late postmenopausal period (< or = 30 years). A significant increase in tumor necrosis factor alpha and a decline in transforming growth factor beta1 were found in late postmenopausal women. Serum levels of macrophage colony-stimulating factor in women receiving hormone replacement therapy were significantly higher than those in untreated postmenopausal women. Furthermore, hormone replacement therapy induced a significant (P < .01) increase in serum levels of macrophage colony-stimulating factor, whereas serum levels of other cytokines were not affected. CONCLUSION: It is well documented that macrophage colony-stimulating factor lowers serum cholesterol concentrations and prevents atherosclerosis. Inducing the production of macrophage colony-stimulating factor is a possible additional mechanism of hormone replacement therapy in mediating the antiatherogenic effect.

Adult↗

PubMed2001

Expression of estrogen receptor isoforms alpha and beta messenger RNA in vaginal tissue of premenopausal and postmenopausal women.

OBJECTIVE: To determine the messenger RNA expression patterns of estrogen receptor (ER)alpha and ER beta in human vaginal tissue. STUDY DESIGN: Reverse transcriptase-polymerase chain reaction was performed on tissue samples of 75 patients having anterior colporrhaphy (25 premenopausal, 25 postmenopausal receiving estrogen replacement therapy [ERT], 25 postmenopausal not receiving ERT). Levels of mRNA were normalized and ratios were calculated to assess relative levels of expression. RESULTS: All samples showed expression of the ER alpha isoform. Significant differences existed in ER alpha expression among the 3 cohorts (P =.023). Greater differences (P <.001) existed in ER beta expression. For both isoforms, the premenopausal group had the highest level, and the postmenopausal group receiving ERT had the lowest level. No significant difference in ER beta expression existed between postmenopausal groups. CONCLUSION: Significant differences exist between premenopausal and postmenopausal women in presence and expression of ER alpha and ER beta in vaginal tissue. Expression of ER beta markedly declines in menopause, regardless of ERT use.

Adult↗

PubMed2003

Assessment of trabecular bone structure in postmenopausal and senile osteoporosis in women by image analysis.

OBJECTIVE: The aim of the study was to assess bone trabecular structure in postmenopausal and senile osteoporosis. METHODS: The study was performed on transiliac specimens obtained from women with postmenopausal (n=10) and senile osteoporosis (n=10) and on normal autopsy bone (n=7). Digitalized microradiographs were analysed using dedicated software allowing for selection of longitudinal and transversal elements. RESULTS: Significant differences between transversal and control, as well as between longitudinal and control trabecular areas were observed in senile osteoporosis (p<0.005). In postmenopausal osteoporosis, such differences were found for longitudinal trabeculae only (p<0.005). Mean longitudinal trabecular area loss in senile and postmenopausal osteoporosis as compared to control group was 57.2% and 25.7%, respectively. Respective values for transversal trabecular area were 35.0% and 59.4%. CONCLUSION: Structural anisotropy of trabecular bone is greater in postmenopausal than in senile osteoporosis and control group. The method developed allows the evaluation of bone structures in radiographs with uneven exposure.

Aged↗

PubMed1993

Alcohol and nutrition in postmenopausal women.

The estrogenization of postmenopausal women is of major importance for their health status, particularly with respect to risks of osteoporosis and coronary heart disease. Thus the factors which influence endogenous postmenopausal estrogen levels are receiving increasing attention. There are three major determinants of endogenous estrogen levels; two are well established, while the third is of fairly recent vintage. Two of the three are nutritionally based. A long-recognized nutritional determinant is body fat mass; a newly recognized determinant is that of moderate alcoholic beverage consumption. Another recognized but non-nutritional postmenopausal estrogen determinant is the presence of the ovaries. This review will examine these three determinants of endogenous postmenopausal estrogen levels. Further, data will also be presented to indicate that nationality may be a fourth factor, and may involve a potential nutritional component. Finally, to explore more deeply the nutritional aspects of alcoholic beverage consumption, the effects of phytoestrogen congeners of alcoholic beverages on the estrogenization of postmenopausal women will be reviewed.

Adipose Tissue↗

PubMed2006

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 >or=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 >or=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.

Adult↗

PubMed2006

Assessing the content and quality of information on the treatment of postmenopausal osteoporosis on the World Wide Web.

OBJECTIVE: To evaluate the content and quality of currently available Internet-based information on the treatment of postmenopausal osteoporosis. DESIGN: A sample was obtained comprising the 75 top sites retrieved with the Google search engine using 'treatment of postmenopausal osteoporosis' and then evaluated according to predefined general and specific criteria, content type, language and quality. Using a systematic scoring tool, each site was assessed for factual information provided and site quality. RESULTS: The sites studied were heterogeneous in content and quality. The most frequent type of website corresponded to non-profit organizations (n = 40), followed by commercial sites (n = 19), professional sites (n = 8) and government sites (n = 8). There were no significant differences in the popularity index, medical content score or quality score among the four groups of sites. Twelve websites were papers published in peer-reviewed medical journals. Few sites provided comprehensive medical and complete information on the treatment of postmenopausal osteoporosis oriented towards consumers. The consumer-oriented webpage with the most balanced and complete information was that of the National Osteoporosis Foundation which, at the same time, had the highest popularity index of all the resources studied. CONCLUSION: The content and quality of websites concerning the treatment of postmenopausal osteoporosis are highly varied and sometimes biased. The most frequent high-quality information corresponds to peer-reviewed medical journals. It is necessary to increase the number of resources, with rigorous language that is understandable for consumers, in relation to the treatment of postmenopausal osteoporosis.

Databases, Factual↗

PubMedDate not supplied

Moderate alcohol consumption and changes in postprandial lipoproteins of premenopausal and postmenopausal women: a diet-controlled, randomized intervention study.

Moderate alcohol consumption is associated with a reduced risk of coronary heart disease. Earlier studies in men have shown that moderate alcohol consumption affects lipoprotein metabolism and hemostasis. In this diet-controlled, randomized, crossover trial, we investigated the effect on lipoprotein metabolism of moderate consumption of red wine or red grape juice with evening dinner for 3 weeks in premenopausal women using oral contraceptives and in postmenopausal women. After 3 weeks, blood samples were collected 1 hour before dinner up to 19 hours after starting dinner at 2-hour or 4-hour intervals. Plasma triglyceride concentrations and very low density lipoprotein (VLDL) triglyceride levels peaked 3 hours after dinner with wine in both premenopausal and postmenopausal women. After wine consumption, the overall high-density lipoprotein (HDL) cholesterol level was increased in postmenopausal women (mean increase 0.17 mmol/L, or 12%, p = 0.03), and the plasma low-density lipoprotein (LDL) cholesterol level was reduced in premenopausal women (mean reduction 0.35 mmol/L, or 12%, p = 0.01) as compared with grape juice consumption. The findings suggest that postprandial lipoprotein metabolism after moderate alcohol consumption differs between oral contraceptive-using premenopausal women and postmenopausal women. The response of postmenopausal women to alcohol resembled the response found in earlier studies in men.

Adult↗

PubMed1998

Impairment of autonomic function induced by posture change in postmenopausal women.

This study was designed to determine if there is a difference in autonomic regulation induced by posture change between postmenopausal and young women. To evaluate autonomic nervous system function, spectral analysis of heart rate variability (HRV) was done in postmenopausal women (n = 13, 46-59 years of age), age-matched men (n = 8, 45-55 years of age), and young women (n = 10, 20-37 years of age) for 3-min periods of controlled frequency breathing (15 breaths/min) in supine followed by sitting positions. In the supine position, the R-R interval variation in older persons decreased significantly compared with that during the follicular phase in young women. Furthermore, the high-frequency (HF) components of HRV, which reflect only parasympathetic activity, were lower in older subjects than in young women. Following a change of position from supine to sitting, the HF component did not change significantly in the postmenopausal women or the men, but the low/high frequency (LF/HF) component ratio, which reflects the balance of autonomic nerve activities, increased significantly in the men. These results suggest that cardiac parasympathetic tone may be reduced in older persons in comparison with young women. Furthermore, arterial baroreflex control of parasympathetic nerve activity caused by posture changes is impaired in the postmenopausal women and aged-matched men. The baroreflex control of the sympathetic component is maintained in the men but not in the postmenopausal women. These differences might result in part from changes in the level of female hormones.

Adult↗

PubMedDate not supplied

Moderate alcohol consumption and bone density among postmenopausal women.

Chronic alcohol abuse is associated with low bone density and high risk of fracture. However, moderate alcohol consumption may help to maintain bone density in postmenopausal women by increasing endogenous estrogens or by promoting secretion of calcitonin. We conducted a prospective study among a sample of 188 white postmenopausal women (ages 50-74) from the Nurses' Health Study who participated in a health examination between 1993 and 1995 that included bone density assessments of the lumbar spine and proximal femur. Long-term alcohol intake was calculated as the average of the 1980 and 1990 measures from a food frequency questionnaire. Women who consumed 75 g or more of alcohol per week had significantly higher bone densities at the lumbar spine compared with non-drinking women (0.951 vs. 0.849 g/cm2, p = 0.002) after adjusting for age, body mass index (kg/m2), age at menopause, use of postmenopausal estrogens, and smoking status. Further adjustment for physical activity and daily intakes of calcium, vitamin D, protein, and caffeine did not alter the results. We also observed a linear increase in spinal bone density over increasing categories of alcohol intake (p = 0.002), suggesting that alcohol intakes of less than 75 g/week may also be of benefit. This positive association was observed among both current users and never users of postmenopausal estrogens. In contrast to the lumbar spine, femoral bone density was not higher among drinkers compared with nondrinkers, although density did increase among drinkers with increasing level of alcohol consumption. Further research is needed to determine whether moderate alcohol consumption can help to protect against spinal fractures in postmenopausal women. This finding must also be evaluated within a larger scope of the risks and benefits of alcohol on heart disease, breast cancer, and hip fractures.

Aged↗

PubMed2004

The hypoglycemic effects of soy isoflavones on postmenopausal women.

OBJECTIVES: Soy isoflavones have many effects similar to those of estrogen and have become popular among postmenopausal women as an alternative for hormone replacement therapy (HRT). The purpose of this study was to determine the effects of soy isoflavones on glucose, insulin, and lipid profiles in postmenopausal Taiwanese women. METHODS: We conducted a randomized, double-blind, active placebo-controlled clinical trial to compare the effects of isoflavones with estrogen replacement therapy (ERT) on blood glucose, insulin, and lipid profiles in postmenopausal Taiwanese women. Thirty postmenopausal Taiwanese women were randomly assigned to two groups, and each received treatment for 6 months. The isoflavone group received 100 mg isoflavone soft capsules, 300 mg calcium, and a blank vitamin capsule per day. The estrogen active control group received 0.625 mg conjugated estrogen, 300 mg calcium, and blank isoflavone soft capsules per day. We measured baseline levels of fasting blood sugar, insulin, lipid profiles, and isoflavone concentrations prior to the study and repeated the same measurements every 3 months for a total duration of 6 months. RESULTS: Two-way ANOVA revealed that fasting glucose (p < 0.001) and insulin (p < 0.005) levels were significantly affected by estrogen and isoflavone treatments after 6 months. For the isoflavone group, the average blood genistein concentration was 6-10 times higher than those of the estrogen group. Within the same periods, the fasting blood glucose was reduced to 83% and 85% of the baseline levels, and insulin was reduced to 56% and 67% of the baseline levels, respectively, in the estrogen and isoflavone groups. CONCLUSIONS: Soy isoflavones (100 mg) and 0.625 mg conjugated estrogen equally lower fasting blood glucose and insulin levels in postmenopausal women.

Aged↗

PubMed2005

Association between VDR ApaI polymorphism and hip bone mineral density can be modified by body mass index: a study on postmenopausal Chinese women.

Osteoporosis is a major public health problem for old people. Genetic factors are considered to be major contributors to the pathogenesis of postmenopausal osteoporosis. The vitamin D receptor (VDR) gene is a prominent candidate gene for the regulation of postmenopausal bone mass; however, despite extensive studies, controversy remains regarding its association with postmenopausal body mineral density (BMD) variation. In this study, a total of 260 healthy postmenopausal Chinese women were genotyped at the VDR ApaI locus using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Raw hip BMD was significantly associated with VDR ApaI polymorphism with and without adjusting for age (P=0.015 and 0.040, respectively). This genetic effect can explain 3.32% of hip BMD variation. However, the significant association vanished after correcting for both age and body mass index (BMI) (P=0.169). In addition, we observed a significant association between VDR ApaI polymorphism with unadjusted BMI (P=0.042) or BMI adjusted for age (P=0.049). The raw hip BMD was also found to be significantly correlated with BMI (r=0.517, P=0.0001), with BMI explaining 26.35% of the variation of hip BMD. All of these facts prompt us to conclude that the significant association between the VDR ApaI genotype and hip BMD may be modified by BMI in postmenopausal Chinese women. Our findings may partially explain the earlier inconsistent association results concerning the VDR gene and BMD, and highlight the importance of incorporating covariates such as BMI into osteoporosis association studies.

Aged↗

PubMed1997

Relation between anthropometric measures of fat distribution and cardiovascular risk factors in overweight pre- and postmenopausal women.

This study compared three different measures of central adiposity: waist-to-hip ratio (WHR), waist-to-height ratio (WSHT), and waist circumference with cardiovascular risk factors, including serum lipoproteins and blood pressure in overweight pre- (n = 115) and postmenopausal (n = 46) women. Premenopausal women had a mean age of 35.6 +/- 6.79 y and a mean body mass index (BMI; in kg/m2) of 37.08 +/- 6.01. Postmenopausal women had a mean age of 52.5 +/- 8.19 y and a mean BMI of 38.75 +/- 6.9. Although several correlations between central adiposity and serum lipoproteins and blood pressure were significant, they were unaffected by menopausal status. There were also no significant differences among the three measures of central adiposity in relation to cardiovascular risk factors within premenopausal and postmenopausal groups. An analysis of covariance controlling for BMI showed that after stratifying WSHT into tertiles, a significant interaction of WSHT group by menopausal status was found for systolic blood pressure (SBP) (P = 0.019). Postmenopausal women had a significantly greater SBP than premenopausal women in the lowest and highest tertiles (P = 0.001); however, this pattern was not shown in the middle WSHT tertile. The relation between central adiposity and cardiovascular risk factors appears to be unchanged after menopause, except when WSHT is used to indicate SBP. Because increased central adiposity may also indicate an increase in cardiovascular risk factors, measurements of central adiposity can be used to supplement the routine clinical evaluation of cardiovascular risk factors in both pre- and postmenopausal overweight women.

Adult↗