ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo use food frequency questionnaires to summarize the macro- and micronutrient intakes of women of diverse ethnicity in the Study of Women's Health Across the Nation.DesignThe Study of Women's Health Across the Nation is a multisite, multiethnic, community-based, longitudinal study of midlife women at seven geographic locations in the USA. The cohort is made up of participants with African, Caucasian, Chinese, Hispanic, and Japanese ethnic backgrounds. The Block Food Frequency Questionnaire was modified to accommodate ethnic-specific diets and was administered by interview. Descriptive statistics for macro- and micronutrient intakes were calculated, and variation in nutrient intakes by ethnic group was assessed using multivariable models, with Bonferonni correction for multiple comparisons.ResultsThe crude and energy-adjusted distributions of all 28 nutrients studied differed statistically by ethnicity (p< 0.001). In many cases the magnitude of the variation was small. For example, the difference between the highest and lowest mean energy intakes was approximately 135 kcal (African American vs. Hispanic). Other differences were substantial: the energy-adjusted total fat intake in Chinese women was at least 10% lower than all other ethnic groups except the Japanese women (all pair-wise comparisons;p< 0.01).ConclusionsKnowledge of variation in nutrient intake is critical to the understanding of how diet and health are related. The broad range of nutrient intakes reported by these participants will permit exploration of the associations between diet, menopause, and health and consideration of the role of dietary factors in explaining health-related differences among women of diverse ethnicity.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to determine the effect of raloxifene on bone density, strength, metabolism, and histomorphometric characteristics in ovariectomized cynomolgus monkeys.DesignA prospective, longitudinal study was designed to examine the effects of conjugated equine estrogens (0.04 mg/kg, CEE) and raloxifene (1 or 5 mg/kg, R1 and R5, respectively) on bone density, biomarkers, histomorphometry, and strength. Control groups included ovariectomized and sham-operated monkeys. Treatment was initiated the day after ovariectomy and continued for 24 months. Bone biomarker data were collected at baseline and every 3 months after surgery. Bone mass was determined at baseline and every 6 months after ovariectomy. Iliac biopsies were collected at baseline and 16 months postovariectomy, and the second lumbar vertebra and left midshaft femur collected at necropsy were examined histomorphometrically. Bone biomechanical properties were determined for the right femur and vertebrae.ResultsCompared with the placebo-treated ovariectomized monkeys, the high-dose raloxifene group had lower levels of alkaline phosphatase, tartrate-resistant acid phosphatase, urinary CrossLaps (collagen degradation products), and greater bone mass in the lumbar vertebrae. In the endocortical compartment, the high-dose raloxifene group had significantly lower mineralizing surface, mineral apposition rate, and bone formation rate in the iliac biopsy collected at 16 months and lower bone formation rate in the second lumbar vertebra. Within the midshaft femur, low-dose raloxifene significantly decreased the osteonal and total bone formation rates and also prevented the decrease in Young's modulus induced by ovariectomy in the midshaft femur.ConclusionsHigh-dose raloxifene prevented the development of osteopenia in the ovariectomized monkey by reducing bone turnover, albeit to a lesser extent than CEE. Histomorphometric and biomarker data suggest that mechanisms underlying the effect of raloxifene differ somewhat from that of CEE.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo investigate the effect of an oral soy isoflavone extract (Phytosoya) on hot flushes in menopausal women.DesignThe study was conducted on outpatients according to a multicenter, randomized, double-blind, placebo-controlled, parallel-group design. A total of 75 patients in natural or surgical menopause suffering from at least seven hot flushes per day were randomized to receive during 4 months either soy isoflavone extract (total of 70 mg genistin and daidzin per day) or placebo.ResultsThere is evidence to suggest that 16 weeks of treatment with soy extract can help reduce the mean number of hot flushes per 24 hours in menopausal women. Withdrawals during this trial made it difficult to obtain an unbiased estimate of the true treatment effect, but numerous sensitivity analyses lend support to the suggestion that taking soy extract can be beneficial in the treatment of hot flushes. In particular, women taking soy extract had a 38% reduction in the mean number of hot flushes by week 4 and a 51% reduction by week 8. By the end of week 16, patients taking soy extract had a 61% reduction in their daily hot flushes versus a 21% reduction obtained with the placebo. “Responders” (defined as patients whose hot flushes were reduced by at least 50% at the end of treatment period) were 65.8% in the soy extract group and 34.2% in the placebo group (p< 0.005).ConclusionSoy isoflavone extract may help to reduce the frequency of hot flushes in climacteric women and provides an attractive addition to the choices available for relief of hot flushes.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo evaluate the modification of lipid and lipoprotein by use of low doses of continuous-combined formulations of 17&bgr;-estradiol (E2) and norethisterone acetate (NETA) in healthy postmenopausal women.DesignThe study was designed as a double-blind, randomized, placebo-controlled trial. A total of 120 healthy postmenopausal women were randomized to one of three treatment arms: (1) placebo group (n= 40); (2) E2/NETA 0.25-mg group—subjects receiving oral continuous-combined E21 mg and NETA 0.25 mg (n= 40); (3) E2/NETA 0.5-mg group—women who were treated with E21 mg and NETA 0.5 mg (n= 40). The duration of study was 12 months. Plasma levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) cholesterol, triglycerides, lipoprotein(a), apolipoprotein A and apolipoprotein B were determined on four occasions (i.e., baseline, 3-, 6-, and 12-month visits).ResultsThere were no differences in the baseline characteristics among the three groups. A total of 102 women completed the study, resulting in a compliance rate of 85%. There was a significant reduction of total cholesterol, LDL cholesterol, and lipoprotein(a) in both combined groups when compared with placebo. The level of apolipoprotein B declined significantly only in the E2/NETA 0.25-mg group. Decrements were observed within 3 months of treatment and maintained thereafter. No significant changes were found in triglycerides, VLDL cholesterol, HDL cholesterol, apolipoprotein A, and LDL/HDL ratio. Between the two active combined groups, no statistically significant differences were noted.ConclusionFavorable changes in lipids and lipoproteins were associated with the low dose of E2/NETA combinations. These effects may contribute to the reduction or prevention of atherogenesis in postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo determine the lowest effective dose of an estradiol (E2) matrix-type transdermal delivery system (EMTDS; Alora) for preventing bone loss in postmenopausal women.DesignThis double-blind, double-dummy, randomized, placebo-controlled, multicenter study enrolled 355 nonosteoporotic postmenopausal women who had been hysterectomized with or without oophorectomy at least 12 months earlier. Participants were randomly assigned to one of three doses of the EMTDS (0.025, 0.05, or 0.075 mg/day) or placebo administered twice weekly. Lumbar bone mineral density (LBMD) was measured by dual-energy x-ray absorptiometry at screening and after 1 and 2 years of treatment. Safety was assessed at regularly scheduled visits.ResultsEMTDS provided statistically significant and clinically meaningful changes in LBMD relative to placebo. At 2 years, LBMD declined from baseline by 0.59% in the placebo group, but it increased from baseline by 1.65% (p= 0.0065), 4.08% (p= 0.0001), and 4.82% (p= 0.0001) in the EMTDS 0.025, 0.05, and 0.075 mg/day groups, respectively. The corresponding responder rates (defined as no change or increase in LBMD at endpoint) were 39.7% for placebo, 59.6%, 79.3%, and 83.9% in the EMTDS 0.025, 0.05, and 0.075 mg/day groups, respectively. Mean serum E2concentrations were proportional to the dose of the E2transdermal system and did not accumulate over the course of the study. Adverse events were generally comparable across treatment groups, with the majority being mild or moderate in severity and unrelated to study medication. Mammogram findings and other safety assessments were also comparable across groups and did not reveal any safety concerns with 2-y transdermal E2treatment.ConclusionsThe EMTDS (Alora) administered twice weekly improves lumbar bone mineral density in healthy postmenopausal women, with the benefit of treatment evident by 1 year. The lowest effective dose is 0.025 mg/day.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo examine the attitudes and prescription practices of gynecologists in the United States and Israel with regard to hormone replacement therapy (HRT) for postmenopausal women. The current recommendations for the use of HRT for menopausal symptoms were reviewed.DesignAn eight-item questionnaire was sent by electronic mail or posted to randomly selected members of The North American Menopause Society (n= 250) and the Israeli Menopausal Society (n= 250), all of whom were physician gynecologists.ResultsEighty-seven percent of the questionnaires (n= 435) were completed and were eligible for analysis. Results showed that 400 physicians (92%) routinely offered HRT to their menopausal patients. For women with an intact uterus, 72.5% preferred to use a continuous estrogen-progesterone regimen, and 27.5% preferred to use a sequential combined regimen. The treatment was prescribed for 10 years or more by 86.4% of the American gynecologists, compared with only 66.3% of the Israeli gynecologists (p= 0.001). Overall, the majority of physicians recommended alendronate for recalcitrant osteoporosis and dietary supplements for all women. However, significant differences were found between the American and Israeli groups: 71% of the Americans versus 55.6% of the Israelis prescribed alendronate (p= 0.02); 97.8% versus 71.33% recommended calcium and vitamin D; and 51.6% versus 38.8% recommended multivitamins (p= 0.001 for both groups). Phytoestrogens, alone or in combination with HRT, were recommended by 57.5% (p= NS between groups), and antidepressive drugs were prescribed by only 11% (15.1% of the Americans and 6.3% of the Israelis;p= 0.001).ConclusionMost gynecologists recommend HRT during menopause. For women with an intact uterus, the preferred regimen was continuous-combined HRT with estrogen and progesterone. The treatment duration is subject to wide variations, from no time limit to discontinuation after 5 to 10 years. Dietary supplements as well as alendronate, alone or in combination with HRT, are popular for severe osteoporosis. We suggest that, until definitive guidelines become available, an individualized approach should be applied, with careful consideration of both the benefits and risks of treatment.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveWe investigated whether low-dose medroxyprogesterone acetate (MPA) combined with oral estrogen had adverse effects on endothelial function compared with oral estrogen alone in postmenopausal women with mild hypercholesterolemia.DesignSubjects were divided into two groups. One group received conjugated equine estrogen (CEE, 0.625 mg daily) orally for the first 3 months, followed by estrogen combined with MPA (2.5 mg daily) orally for an additional 3 months (n= 26). The other group received no treatment (control group,n= 12). Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin administration was measured by strain-gauge plethysmography. Nitrite/nitrate, angiotensin-converting enzyme, and lipid concentrations were measured in the serum.ResultsBoth CEE and CEE combined with MPA significantly increased the FBF during reactive hyperemia. This increase was similar in both active treatment phases. No changes were seen in controls. FBF after sublingual nitroglycerin did not change over 6 months in either group. Significant and similar increases in serum concentration of nitrite/nitrate and plasma renin activity as well as decreases in angiotensin-converting enzyme activity were found in both treatment phases. No such changes occurred in the control group. There was no significant increase in high-density lipoprotein cholesterol or decrease in low-density lipoprotein cholesterol between the treatment phases. Likewise, no such changes were observed in the control group.ConclusionsOur 6-month study suggests that the addition of low-dose MPA with CEE had no adverse effects on forearm resistance artery endothelial function compared with CEE alone.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo measure hot flashes by sternal skin conductance in an urban Mexican population and to determine variables associated with hot flash reporting and measurement.DesignFrom June 1999 to August 2000, 67 perimenopausal women aged 40 to 65 years participated in interviews, anthropometric measures, and a 2-h recording of sternal skin conductance. Changes in sweating were used to demonstrate the presence/absence of a hot flash. During the test, women were asked to report if they experienced a hot flash.ResultsDuring the study period, 10 women reported and demonstrated every hot flash, 24 women never reported or demonstrated a hot flash, 7 demonstrated hot flashes but did not report any of them, 7 reported hot flashes but did not demonstrate any of them, and 19 showed a mixture of responses. Women who demonstrated hot flashes by sternal skin conductance were measured in a warmer room, had more years of education, consumed more eggs as a child, recalled a heavier weight at age 18, and had a lower body mass index at interview compared with women who did not demonstrate hot flashes by sternal skin conductance. Women who subjectively reported hot flashes were measured in a warmer room, were more likely to be postmenopausal, reported more frequent consumption of coffee, and spent fewer months breast-feeding their last child compared with women who did not report the experience of hot flashes during the testing period.ConclusionRoom temperature explained part of the variation between women who did and did not demonstrate hot flashes via sternal skin conductance, between women who did and did not report the experience of hot flashes, and between women who did and did not demonstrate concordance in objective and subjective measures. In addition to room temperature, coffee intake, months spent breast-feeding the last child, and recalled weight at age 18 were important variables predicting hot flash experience.

ISSN:1072-3714    

出版商:OVID    

年代:2002

数据来源: OVID