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PubMed2005

Short-term effect of transdermal estrogen on autonomic nervous modulation in postmenopausal women.

OBJECTIVE: To evaluate the effect of short-term transdermal estradiol-l7b on cardiac autonomic nervous modulation in postmenopausal women. DESIGN: Prospective study. SETTING: A tertiary medical center. PATIENT(S): Twenty-one postmenopausal women. INTERVENTION(S): Transdermal estradiol or placebo therapy for 3 weeks in randomized, double-blinded, crossover fashion. MAIN OUTCOME MEASURE(S): Heart rate variability measures in both time and frequency domains, serum biochemistry, and climacteric symptoms were compared among baseline, placebo and transdermal estrogen therapies. RESULT(S): Plasma concentration of estradiol rose significantly from 11.0 +/- 5.2 pg/ml to 48.2 +/- 34.0 pg/ml after transdermal estrogen. The standard deviation of RR-interval increased significantly from 30.3 +/- 9.9 ms (placebo) to 31.3 +/- 7.4 ms (transdermal estrogen), and the coefficient of variation of RR-interval increased significantly as compared with the baseline session. The total power was marginally increased as compared among baseline, placebo, and transdermal estrogen sessions. The irritability symptom decreased significantly after transdermal estrogen therapy, as compared with baseline and placebo treatment. CONCLUSION(S): Transdermal estradiol for 3 weeks could significantly increase the global heart rate variability and reduce the irritability symptom in the postmenopausal women. Short-term transdermal estrogen for 3 weeks could improve cardiac autonomic nervous modulation and climacteric symptoms, and might have some cardioprotective effect in postmenopausal women.

Administration, Cutaneous↗

PubMed2006

Effect of vitamin E supplementation with and without hormone therapy on circulatory inflammatory markers in postmenopausal women.

OBJECTIVE: To investigate the effect of vitamin E with and without estrogen replacement therapy or hormone therapy (HT) on inflammatory markers in postmenopausal women. DESIGN: Prospective, observational study, followed by a randomized, prospective, double-blind study. SETTING: Healthy volunteers in an academic medical referral center in Dallas, Texas. PATIENT(S): Seventy-five postmenopausal healthy women, ages 40 to 65 years, with follicle-stimulating hormone (FSH) levels greater > or =30 mIU/mL and a serum estradiol level < or =30 pg/mL. INTERVENTION(S): After enrollment, all women were studied at baseline and received vitamin E for 4 weeks. They were then randomized from week 4 to week 12 to receive vitamin E in conjunction with conjugated equine estrogen (CEE) (0.625 mg), CEE (0.625 mg) plus medroxyprogesterone acetate (MPA) (2.5 mg), or placebo. MAIN OUTCOME MEASURE(S): Change from baseline and between groups effects of vitamin E with and without estrogen or hormone therapy on seven circulatory inflammatory markers in postmenopausal women. RESULT(S): Vitamin E levels increased to a similar extent in all three groups compared with baseline at weeks 4 and 12. Vitamin E increased serum interleukin-6 levels. Combination CEE plus MPA significantly increased C-reactive protein levels. However, there were no consistent statistically significant effects on six other inflammatory markers. CONCLUSION(S): Vitamin E attenuated C-reactive protein increases in postmenopausal women treated with estrogen replacement therapy but not with HT. Because there was no other persistent effect on six additional inflammatory markers, it can be concluded that vitamin E and HT do not play a major role in promoting a change in cardiovascular inflammatory markers.

Adult↗

PubMed2006

Effects of treatment with testosterone alone or in combination with estrogen on insulin sensitivity in postmenopausal women.

OBJECTIVE: Little is known about metabolic effects of testosterone treatment in postmenopausal women. The aim of the study was to compare the treatment effects of testosterone, estrogen, and testosterone plus estrogen on insulin sensitivities, body compositions, and lipid profiles in healthy postmenopausal women. DESIGN: An open, randomized clinical study with parallel group comparison. SETTING: Women's health clinical research unit at a university hospital. PATIENT(S): Sixty-three naturally postmenopausal women participated in the study. INTERVENTION(S): The participants were randomly assigned to 3 months of treatment with testosterone undecanoate (40 mg every second day), estradiol valerate (2 mg daily), or the combination of both. MAIN OUTCOME MEASURE(S): Insulin sensitivity assessed by euglycemic hyperinsulinemic clamp, body composition, and serum lipids. RESULT(S): Insulin-induced glucose disposal was reduced by approximately 20% after treatment with testosterone alone, and after the combined treatment, but not by estrogen alone. Body weight, but not total body fat, increased significantly by about 1 kg in all groups. Lean body mass was significantly increased in the group of combined treatment and tended to be increased by testosterone alone. High-density lipoprotein (HDL)-cholesterol decreased significantly by testosterone treatment. In contrast, HDL-cholesterol increased, whereas low-density lipoprotein (LDL)-cholesterol and lipoprotein-(a) [Lp(a)] decreased with estradiol treatment. CONCLUSION(S): We conclude that 3 months of treatment with testosterone undecanoate in postmenopausal women induces insulin resistance and an adverse serum lipid profile but may increase lean body mass.

Adult↗

PubMed2006

Long-term effects of tibolone on circulating levels of vascular cell adhesion molecules and E-selectin in postmenopausal women.

OBJECTIVE: Adherence of lymphocytes and monocytes to cell adhesion molecules (vascular cell adhesion molecules [VCAMs]) expressed by activated endothelial cells is the first step in the development of atherosclerotic disease. It is known that administration of tibolone for 8 weeks reduces serum levels of VCAMs in postmenopausal women. We evaluated the effects of the administration of tibolone in postmenopausal women for 1 year. DESIGN: Randomized, placebo-controlled, crossover trial. SETTING: Healthy volunteers in an academic environment. PATIENT(S): Thirty-six healthy women in postmenopause since 1-4 years. INTERVENTION(S): Group A received 2.5 mg/d of tibolone and group B received placebo for 12 months; treatment was subsequently crossed over for 1 month. MAIN OUTCOME MEASURE(S): Serum concentrations of VCAM-1, intercellular adhesion molecule-1 (ICAM-1), and E-selectin were evaluated at baseline and at 6, 12, and 13 months. RESULT(S): Baseline concentration of VCAM-1, ICAM-1, and E-selectin were similar in both groups. At months 6 and 12, mean concentrations of VCAM-1, ICAM-1, and E-selectin decreased significantly in group A but not in group B. At month 13, levels returned to baseline in group A, whereas they decreased significantly in group B. CONCLUSION(S): Tibolone causes a rapid and sustained decrease in circulating levels of VCAMs; the effect is lost soon after stopping the treatment. Tibolone induces favorable changes in endothelial function and may exert a direct cardiovascular protective effect in postmenopausal women.

Cross-Over Studies↗

PubMed2003

Efficacy data on teriparatide (parathyroid hormone) in patients with postmenopausal osteoporosis.

Until recently, the only therapeutic agents available for postmenopausal osteoporosis acted by inhibiting bone resorption and decreased the fracture risk by no more than 50%. Teriparatide, the recombinant 1-34 fragment of human parathyroid hormone, is a bone formation enhancer that has recently been licensed for use in established postmenopausal osteoporosis. Intermittent parathyroid hormone administration preferentially stimulates bone formation. The resultant increase in bone mass and improvement in bone architecture translate into a large decrease in the fracture risk that constitutes a major advance in the treatment of postmenopausal osteoporosis. Further work is needed to define the role for teriparatide in the therapeutic strategy for postmenopausal osteoporosis and to determine whether this agent is best used alone or in synchronous or sequential combination with bone resorption inhibitors.

Bone Resorption↗

PubMed2004

Hormone replacement therapy and health behavior in postmenopausal polio survivors.

OBJECTIVES: Little is known about menopause and hormone replacement therapy (HRT) use in women with disabilities. The objectives of this study were to explore the health behaviors, health outcomes, and efficacy of HRT in a group of postmenopausal polio survivors and to compare selected outcomes to nationally representative cohorts. METHODS: One hundred and thirty-one postmenopausal polio survivors completed self-report surveys on health behaviors, HRT use, functional status, and psychosocial well-being. During a physical examination, fasting cholesterol and body mass index (BMI) were collected. Independent sample t-tests and Chi-square analysis were used to compare HRT users and non-users on health behaviors and health outcomes; logistic regression was used to predict HRT use. RESULTS: Prevalence of HRT use was 58%. Only BMI predicted HRT use (OR = 0.30, CI: 0.11-0.81). HRT users had better high density lipoprotein (HDL), low density lipoprotein, total cholesterol/HDL ratios, lower BMIs, were more confident when communicating with their physicians, more likely to discuss menopause with their physician, and experienced greater overall stress. HRT was not associated with health behavior, health-related quality of life, mood, or life satisfaction. Compared to non-disabled women, more of these women had higher total cholesterol, obesity, more sleeping problems, and were less likely to vigorously exercise or smoke. CONCLUSIONS: HRT did not confer substantial benefits in these postmenopausal polio survivors to warrant them using HRT at a higher rate than their non-disabled peers. Comparisons to their non-disabled peers suggested they may be at higher risk for adverse health problems associated with postmenopause.

Adult↗

PubMed2004

Female suprasegmental speech parameters in reproductive age and postmenopause.

During the female vital cycle verbal processes are influenced by secondary effects of steroid hormones. Verbal expression abilities favor more effective interpersonal communications. Verbal motor fluency is produced by the synchronization among voice, resonance and articulation. The present study compared phono-articulatory characteristics between women in reproductive age and postmenopause. Acoustic variations in vocal intonation, speed of the speech and the pause pattern were measured. Forty-five reproductive age women with regular menstrual cycles and taking no hormonal contraceptives and 45 postmenopause women receiving no hormonal replacement therapy for at least 3 years were interviewed and their verbal productions were recorded. Acoustic analyses were performed using the Kay Elemetrics Motor Speech Profile. Student's t-test was employed to compare data between the two groups when they presented normal distribution, and Mann-Whitney test when they were asymmetrical. Results showed that in the postmenopause group pause pattern was longer, the speed of the speech was slower, there was a vocal deepening without reduction of the vocal extension and there was also less vocal stability. A better understanding in this field will make possible to elaborate strategies to offer a better life quality for postmenopausal women.

Adult↗

PubMed2005

Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in postmenopausal women with abnormal uterine bleeding.

OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic endometrial thickness and outpatient hysteroscopy, to establish the most appropriate exam for the diagnosis of endometrial cancer in postmenopausal women with abnormal uterine bleeding (AUB). The secondary aim was to develop a multivariable approach considering clinical history as an added value for these diagnostic procedures. METHODS: This prospective study was conducted on 220 consecutive postmenopausal patients with AUB, who underwent ultrasonographic evaluation of endometrial thickness, outpatient hysteroscopy and endometrial biopsy. Evaluation of sensitivity, specificity, positive and negative predictive value was performed. Receiver operator characteristic curve (ROC) was calculated to assess the global performance of ultrasonographic measurement of endometrial thickness and diagnostic hysteroscopy as tests for detecting endometrial cancer and atrophy. RESULTS: Histological findings for <4 mm level revealed that atrophy was present in 48 (65%) and in 2 cases (2.7%) endometrial cancer was found; for > or = 4 mm values polyps and myomas were present in 86 (59%) and there were 11 (7.5%) endometrial cancer. Sensibility and specificity for trans-vaginal ultrasound, with a cut-off value > or = 4 mm, was 55.6% and 49.7% while positive predictive value was 83.3% and negative predictive value 98.1% (ROC curve 0.597). Hysteroscopy revealed sensitivity 100%, specificity 49.6%, positive predictive value 81.3% and negative predictive value 100% (ROC curve 0.993). CONCLUSIONS: In conclusion, endometrial thickness <4 mm can miss malignancies but trans-vaginal ultrasound remains the first line diagnostic procedure in postmenopausal women without AUB, because it is not invasive and has high sensitivity for detecting endometrial cancer and other endometrial disease; according to our experience, outpatient hysteroscopy with biopsy is mandatory in all postmenopausal women with AUB.

Adult↗

PubMed2005

HRT provides no additional beneficial effect on sarcopenia in physically active postmenopausal women: a cross-sectional, observational study.

OBJECTIVES: Physical activity can prevent or retard the loss of muscle mass associated with aging. On the other hand, it has been suggested that HRT may also help prevent sarcopenia in postmenopausal women. We thus examined if HRT provides additional beneficial effect in physically active postmenopausal women. METHODS: Forty postmenopausal women aged between 55 and 65 years old (normal weight, healthy and no medication) were recruited. Seventeen women were already taking HRT for at least one year whereas 23 were never submitted to HRT. Body composition was measured by DXA and physical activity metabolism was obtained by the use of accelerometry. Subjects were divided in tertile groups based on their daily physical activity energy expenditure (PAEE). RESULTS: Physical activity groups were similar for age, HRT users distribution, BMI, trunk fat-free mass (FFM), and all fat mass (FM) components. The group of women who were the most physically active significantly displayed greater total FFM, appendicular FFM, and muscle mass index (MMI) compared to the group of less active women (P < 0.05) whereas HRT added no additional effect on any FFM components. CONCLUSIONS: Our results suggest that in active postmenopausal women, HRT does not provide any additional beneficial effect on body composition.

Aged↗

PubMed2005

Attitudes and practices about postmenopausal hormone therapy among female gynecologists in Brazil.

OBJECTIVES: The aim of this study was to investigate the attitudes and practices of Brazilian female gynecologists surrounding their personal use of menopausal/postmenopausal hormone therapy (HT). METHODS: This study was conducted in February 2001 using a mail survey. Three thousand eighty nine (n = 3089) female gynecologists over the age of 35 years and affiliated with the Brazilian Federation of Obstetricians and Gynecologists (FEBRASGO) were sent a questionnaire inquiring about their demographic, professional, medical, and behavioral background as well as their personal use of HT. RESULTS: The response rate was 56.3%. Information on the menopausal status was available for 1655 respondents: 755 (45.7%) were postmenopausal, 172 indicated that they had irregular menses cycles (9.2%), and 728 (44.1%) underwent regular menses. Approximately, 47% of the postmenopausal respondents had been subject to a hysterectomy and were above the age of 50 years or had undergone bilateral oophorectomy. When asked about personal HT use, 61.1% and 10.3% of the respondents indicated that they were current or former users, respectively. 28.6% of the respondents had never used HT. The highest frequency of use occurred during their fifth decade. The main reasons for their use of HT included the attenuation of vasomotor symptoms, the prevention/treatment of osteoporosis, or the prevention of cardiovascular disease. Combined estrogen/progestin therapy was the preferred choice for postmenopausal gynecologists with an intact uterus. Family or personal histories of breast cancer or smoking were reported as deterrents against HT use for the female gynecologists. CONCLUSION: Brazilian postmenopausal gynecologists engage in a high frequency of HT use. High levels of personal use may influence the general population towards HT prescription and compliance.

Adult↗

PubMed2005

Fracture risk and bone density of peri- and early postmenopausal women with uterine leiomyomas.

OBJECTIVES: Fracture risk and bone mineral density (BMD) among peri- and early postmenopausal women with leiomyomas requiring hysterectomy was evaluated. METHODS: We counted fractures among women with or without leiomyomas using data from the Kuopio Osteoporosis Study. The study population consisted of 6086 women aged 47-56 years with never-use of hormone replacement therapy (HRT) responding to the baseline and 5-year follow-up inquiries. Part of the sample (n=1271) underwent bone densitometry. RESULTS: Hysterectomy was carried out in 927 women, and 59% reported that this was attributable to leiomyomas. The hazard ratio (HR) was 0.68 (95% CI 0.49-0.94) for any and 0.73 (95% CI 0.43-1.26) for distal forearm fracture among women with leiomyomas compared to those without any. Among women postmenopausal at baseline, the corresponding HRs were 0.62 (95% CI 0.44-0.87) and 0.54 (95% CI 0.31-0.96); after adjusting for age, time since menopause weight, height and previous fracture 0.69 (95% CI 0.49-0.97) and 0.63 (95% CI 0.35-1.11). The baseline BMDs were 1.15 g/cm2 among hysterectomized leiomyoma and 1.12 g/cm2 (ns) among non-hysterectomized women at lumbar (L2-L4), and 0.94 and 0.93 g/cm2 (ns) at femoral sites. The follow-up lumbar BMDs were 1.13 and 1.09 g/cm2 (p<0.001) and the corresponding femoral values were 0.90 and 0.89 g/cm2 (ns), respectively. Among postmenopausal women, the corresponding baseline lumbar BMDs were 1.15 and 1.08 g/cm2 (p<0.001), femoral 0.93 and 0.90 g/cm2 (p=0.003); the follow-up lumbar BMDs 1.13 g/cm2 versus 1.07 g/cm2 (p<0.001); femoral BMDs 0.89 versus 0.87 (ns). CONCLUSIONS: Peri- and early postmenopausal women with a history of leiomyomas seem to have better BMD and less fractures compared with those without leiomyomas. This may be mediated through higher estrogen levels leading to higher BMD and the growth of leiomyomas.

Absorptiometry, Photon↗

PubMed2005

An immunohistochemical comparison of endometrial polyps from postmenopausal women exposed and not exposed to HRT.

OBJECTIVE: Our study set out to test the null hypothesis that oestrogen containing continuous combined hormone replacement therapy (HRT) would not affect the hormone receptor expression (oestrogen and progesterone receptors-ER, PR) or markers of cell proliferation/apoptosis (Ki67 and Bcl-2) in endometrial polyps from postmenopausal women exposed and not exposed to HRT. DESIGN: Immunohistochemical staining for ER, PR, Ki67 and Bcl-2 was performed on polyps obtained from two groups of postmenopausal women. SETTING: Polyps were obtained from postmenopausal women attending an outpatient hysteroscopy clinic in a district general hospital (Bradford Royal Infirmary, UK). POPULATION: Twenty-five postmenopausal women presenting with abnormal bleeding subsequently diagnosed with endometrial polyps (16 from women not exposed to HRT, 9 from women exposed to HRT). METHODS: Semiquantitative immunohistochemistry was performed. MAIN OUTCOME MEASURES: Significant differences or correlations in either hormone receptor expression or markers of cell proliferation/apoptosis between the two groups of polyps. RESULTS: There were no significant differences for hormone receptor expression (ER and PR) between endometrial polyps exposed and not exposed to HRT. Bcl-2 expression was higher than Ki67 in both groups, but polyps from HRT users had increased levels reflecting decreased apoptosis in these polyps. CONCLUSIONS: HRT has no demonstrable effect on polyp ER and PR expression. However, HRT does appear to inhibit apoptosis and cell proliferation in endometrial polyps, which may affect polyp growth.

Endometrial Neoplasms↗

PubMed2005

Plasma adiponectin levels in postmenopausal women with or without long-term hormone therapy.

OBJECTIVE: Recent large, prospective, randomized studies show that hormone therapy (HT) does not confer a protective effect against cardiovascular disease (CVD) but may in fact increase cardiovascular events. Low plasma adiponectin levels are considered to be related to the development of atherosclerosis and CVD. The purpose of this study was to determine the effect of long-term hormone therapy on plasma adiponectin levels in postmenopausal women. METHODS: We recruited a total of 88 postmenopausal women aged 55-69 years old. Our sample consisted of 44 women who had undergone estrogen plus progestogen therapy (EPT) for more than 5 years and 44 age-matched women who had not received HT. We measured plasma adiponectin levels, the serum levels of their lipid profiles, high-sensitivity C-reactive protein (hs-CRP), fasting glucose levels, fasting insulin levels and estradiol levels. Their medical histories including their age at menopause, vitamin use, exercise, alcohol ingestion and cigarette smoking were also assessed by a questionnaire. RESULTS: The mean duration (mean+/-S.D.) of HT was 8.4+/-2.4 years. The mean serum estradiol level (mean+/-S.D.) of the HT group was 47.9+/-36.8 pg/L, significantly higher than that of the non-HT group (p<0.01). Plasma adiponectin levels were significantly lower in the HT group than in the non-HT group (p<0.05). Plasma adiponectin levels were inversely correlated to cholesterol, triglycerides and HOMA-IR (r=-0.33, p<0.05; r=-0.40, p<0.01 and r=-0.30, p<0.05, respectively) in the non-HRT group, but such correlations were not seen in the HT group. In the multivariate analysis, hormone therapy and serum estradiol levels were the independent factors associated with plasma adiponectin levels after adjustments were made for potential confounders. CONCLUSION: Plasma adiponectin levels were significantly lower in postmenopausal women with long-term HT than in those without HT, suggesting that long-term HT may modulate plasma adiponectin level in postmenopausal women.

Adiponectin↗

PubMed2006

Circadian variation in endothelial function is attenuated in postmenopausal women.

OBJECTIVE: The present study was undertaken to investigate the possible existence of an endogenously generated circadian rhythm in endothelial function in women and whether this rhythm is altered after the menopause. METHODS: Healthy non smoking women (11 pre-menopausal and 13 postmenopausal women) were studied during a 22 h period under constant routine conditions; endothelium-dependent (flow-mediated dilation (%FMD)) and -independent (glyceryl-trintrate (GTN)-mediated) function was assessed every 2 and 4 h, respectively, by high-resolution ultrasound of the brachial artery. RESULTS: %FMD and %GTN was significantly higher in pre-menopausal women (9.9+/-1.0%FMD (mean+/-S.E.M.); 18.2+/-1.8%GTN; P<0.01) compared with postmenopausal women (6.5+/-0.5%FMD; 11.5+/-1.6%GTN). A significant day-night variation in %FMD was observed pre-menopausal women (day 9.2+/-0.8%; night 10.4+/-1%; P<0.05) with an attenuated rhythm in postmenopausal women (day 6.8+/-0.6%; night 6.0+/-0.4%). CONCLUSIONS: The findings show a circadian rhythm in %FMD in pre-menopausal women, which disappears after the menopause. The reduction in %FMD and an absence of a day-night variation in %FMD in postmenopausal women may have important implications for the incidence of coronary heart disease in women after the menopause.

Adult↗

PubMed2006

Quality of life among postmenopausal Ecuadorian women participating in a metabolic syndrome screening program.

BACKGROUND: Quality of life decreases after the menopause as it has been assessed by several designed tools. Despite this, few studies have reported correlations between quality of life and the metabolic syndrome and its determinants. OBJECTIVE: Evaluate quality of life and determine factors related to its impairment among postmenopausal Ecuadorian women. METHODS: Postmenopausal women that participated in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador were interviewed using the Menopause-Specific Quality of Life Questionnaire (MENQOL). Mean domain scores as well as factors associated to higher scores within each of the domains of the questionnaire (vasomotor, psycho-social, physical and sexual) were determined. RESULTS: Three hundred twenty-five postmenopausal women (n=325) were surveyed. Mean age of participants was 55.9+/-8.1 years (median: 54 years). Women presented metabolic syndrome, hypertension, hyperglycemia, hypertriglyceridemia and abdominal obesity in 41.5%, 38.8%, 16.6%, 56.9% and 54.2% respectively. Mean scores obtained for each domain were: vasomotor: 3.5+/-2.5 (median 3); psycho-social: 3.7+/-1.5 (median 3.6); physical: 3.8+/-1.2 (median 3.8); sexual: 4.9+/-2.3 (median 5.3). More than 50% of women had scores above the median for each domain of the questionnaire. Logistic regression determined that vasomotor score decreased with age. Abdominal obesity increased the risk of having vasomotor, psycho-social and physical scores above the median. Hypertension and hyperglycemia increased the risk for higher scores within the psycho-social and sexual domain respectively. CONCLUSION: In this postmenopausal Ecuadorian population, impairment of quality of life was found to be associated to age and related conditions such as abdominal obesity, hypertension and hyperglycemia.

Adult↗

PubMed2004

Androgenicity and obesity are independently associated with insulin sensitivity in postmenopausal women.

An increase in androgenicity may contribute to the development of insulin resistance in postmenopausal women. Increased androgenicity in women has been found to be associated with the development of type 2 diabetes. In addition, obesity and central obesity are associated with greater androgenicity. Insulin sensitivity, androgenicity, and body composition were characterized in 34 nondiabetic postmenopausal women age 72 +/- 1 years (mean +/- SEM) to test the hypothesis that androgenicity is a predictor of insulin sensitivity independent of measures of obesity. Androgenicity was measured using levels of sex hormone-binding globulin (SHBG), total and free testosterone, dehydroepiandrosterone sulfate (DHEA-S), androstenedione, and free androgen index (FAI). Insulin sensitivity (S(I)) was determined from a frequently sampled intravenous glucose tolerance test. Body composition measures included body mass index (BMI) and dual energy x-ray absorptiometry measurements of total and central fat mass. S(I) was found to be associated with total fat mass (r = -.51, P =.002), central fat mass (r = -.62, P =.0001), BMI (r = -.55, P =.0008), SHBG levels (r =.65, P =.0001), and FAI (r = -.41, P =.01). SHBG levels were inversely correlated with central fat mass (r = -.59, P =.0002). Using multiple regression, SHBG and central fat mass were the only significant independent predictors of S(I), accounting for 50% of its variance (r =.71, P =.0001); total fat mass, BMI, total and free testosterone, DHEA-S, androstenedione, and FAI did not enter the model. We conclude that there is a significant association between insulin sensitivity and androgenicity in postmenopausal women that is independent of obesity. Interventions to decrease androgenicity may therefore be useful in improving insulin sensitivity in postmenopausal women.

Aged↗

PubMed2005

Effects of alendronate on bone mineral density and bone metabolic markers in postmenopausal asthmatic women treated with inhaled corticosteroids.

We have recently shown that long-term use of inhaled corticosteroids decreases bone mineral density (BMD) of the lumbar spine in postmenopausal asthmatic women. The present study aimed to evaluate the efficacy of alendronate in comparison with that of alfacalcidol (1-alpha-hydroxyvitamin D(3)) for the treatment of BMD reduction in postmenopausal asthmatic patients who had inhaled corticosteroid therapy without regular use of systemic corticosteroids. Twenty-eight postmenopausal asthmatic patients with BMD T score of -1.0 or less were randomized to receive alendronate (5 mg/d) or alfacalcidol (1 microg/d). Bone mineral density was determined at baseline and 12 months after the treatment, and biochemical markers of bone metabolism were measured at baseline and after 6 and 12 months of treatment. The mean (+/-SD) BMD values at the lumbar spine, the total hip, and the Ward's triangle significantly increased by 4.9 +/- 4.5% (P = .0005), 2.4 +/- 2.2% (P = .0005), and 3.6 +/- 5.2% (P = .02) at 12 months in the alendronate group, whereas the corresponding values did not significantly change in the alfacalcidol group. In the alendronate group, urinary N-telopeptide (NTx), serum osteocalcin, and serum alkaline phosphatase concentrations significantly decreased, and serum intact parathyroid (PTH) level significantly increased, from baseline at both 6 and 12 months. In the alfacalcidol group, urinary NTx showed modest but significant decrease, although the extent of the change was smaller than that in the alendronate group. We concluded that alendronate was effective to improve reduced BMD in postmenopausal asthmatic patients on inhaled corticosteroid therapy through the mechanism of inhibiting bone resorption.

Administration, Inhalation↗

PubMed2006

Hormonal, subjective, and neurocognitive responses to brief hypoglycemia in postmenopausal women and age-matched men with type 2 diabetes mellitus.

Sexual dimorphisms in hypoglycemic counterregulation are well documented in young healthy and type 1 diabetic subjects. Here, we questioned whether sex differences in counterregulation are present also in type 2 diabetic patients who are in a postmenopausal state. In an attempt to answer this question, we examined hormonal responses to a single-step hypoglycemic clamp (50 mg/dL) in 15 postmenopausal women and 15 age-matched men. Patients were also matched for body mass index, HbA(1c), diabetes duration, and diabetes therapy. In addition to hormonal counterregulation, perception of symptoms as well as aspects of neurocognitive function (short-term memory of words and reaction time on an auditory vigilance task) was assessed at baseline and during the hypoglycemic clamp. Hypoglycemia induced a profound rise in almost all counterregulatory hormones, that is, epinephrine, norepinephrine, corticotropin, cortisol, and growth hormone (all P < .007), except for glucagon, which slightly decreased (P = .014). However, none of the responses differed between sexes (all P > .256). In addition, perceived symptoms (P < .001) as well as reaction time on the vigilance task (P < .001) increased, and short-term memory performance tended to deteriorate (P = .091) during hypoglycemia. Again these changes did not differ between the sexes (all P > .370). In sum, data suggest that, in contrast to previous observations in young, healthy, and type 1 diabetic subjects, sex does not represent an important determinant of hormonal, subjective, and neurocognitive responses to hypoglycemia in postmenopausal type 2 diabetic patients. However, the women in our study were all postmenopausal and not receiving hormone replacement therapy. Therefore, our results cannot be generalized to female patients with type 2 diabetes who are premenopausal or on hormone replacement therapy, that is, conditions characterized by increased blood estrogen levels.

Adrenocorticotropic Hormone↗