ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe cardiac syndrome X is described as the triad of angina pectoris, a positive exercise test for myocardial ischemia, and angiographically smooth coronary arteries. Although syndrome X does not result in an increased risk of cardiovascular mortality, the symptoms are often troublesome and unresponsive to conventional antianginal therapy. The majority of patients are postmenopausal, and estrogen therapy can alleviate anginal symptoms. We investigated the effect of esterified estrogens combined with methyltestosterone (Estratest) on quality of life in postmenopausal women with syndrome X.DesignPatients were withdrawn from antianginal therapy. Sublingual nitrates were allowed for treatment of anginal episodes. Patients underwent treadmill testing, and quality of life was assessed by using the Short Form-36 and Cardiac Health Profile questionnaires after the women had received 8 weeks of Estratest or identical placebo in a randomized, double-blind, cross-over study.ResultsNineteen patients were randomized, and 16 patients completed the protocol. Plasma 17&bgr;-estradiol concentrations were significantly increased by Estratest; however, total testosterone levels were not. The “emotional” score of the Cardiac Health Profile questionnaire was significantly improved after Estratest use compared with placebo (p= 0.03); however, there was no significant change in the Short Form-36 questionnaire for any variable. Estratest significantly increased systolic blood pressure and rate pressure product at rest but had no effect on exercise parameters. Time to onset of chest pain during exercise was also unaffected.ConclusionsWe have demonstrated a beneficial effect of Estratest on emotional well-being in postmenopausal women with cardiological syndrome X. There was no significant treatment effect on exercise parameters, including time to onset of chest pain.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo evaluate the influence of menopause and hormone replacement therapy (HRT) on weight and the effect of weight gain on coronary risk factors.DesignFrom 1991 to 1992 cardiovascular risk factors were assessed in 271 premenopausal women between the ages of 40 and 53 years. The women were not receiving HRT at that time. Five years later, these women were reevaluated.ResultsWeight and body mass index (BMI) increased steadily with age. During the observation period there was an average increase of 4.0 kg ± 4.6 (p< 0.0001). Women who experienced menopause and those who did not experience menopause had a similar weight increase (3.8 ± 4.4 kg vs. 4.3 ± 4.8,p= 0.37). Likewise, weight gain was similar in those who did or did not use HRT (nonusers, 4.3 ± 4.6 kg; users, 3.5 ± 3.7 kg; ex-users, 3.4 ± 5.8 kg). At their first checkups, overweight women and obese women already had significant differences in their risk factors, including higher systolic pressure (p< 0.02), diastolic pressure (p< 0.01), glucose (p< 0.02) and triglycerides (p< 0.0001), and lower high-density lipoprotein cholesterol (p< 0.004) as compared with women of normal weight. Unexpectedly, women of normal weight who became overweight or obese during the monitoring period did not show any deterioration in their risk factors.ConclusionsDuring the perimenopausal period there is a weight gain that does not seem to depend on the menopause or HRT. Being overweight or obese during the menopausal transition is not necessarily associated with deterioration in coronary risk factors. This seems to imply the existence of different metabolic populations within this group of women.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveWomen who have ever used estrogen replacement therapy (ERT), even at a low dose, have an increased incidence of endometrial cancer. The addition of a progestin to ERT reduces the incidence of endometrial cancer. The duration of progestin administration is more important than the dose.DesignA MEDLINE review of the literature was performed using the search terms endometrial cancer, epidemiology, and hormone replacement therapy (HRT).ResultsWomen who have ever used ERT have an increased incidence of endometrial cancer. The use of HRT for more than 5 years, with a progestin use of <10 days per cycle, has a relative risk = 1.8. Continuous combined HRT, or sequential or cyclic HRT with >10 days of progestin per cycle, appears to decrease the incidence of endometrial cancer to that found in nonusers of HRT.ConclusionsThe use of HRT in postmenopausal women with a uterus reduces the incidence of endometrial cancer. The duration of progestin administration should be 14 days or more per cycle based on recent epidemiologic data.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo evaluate the effect of a continuous combined oral hormone replacement therapy (HRT) on basal and post-methionine load homocysteine levels in postmenopausal women.DesignTwenty-two postmenopausal women (PMW) were randomly allocated to receive either continuous combined oral HRT (2 mg of estradiol plus 1 mg of norethisterone acetate;n= 11) or no treatment (controls,n= 11) for 6 months. A methionine oral load (0.1 g/kg body weight) was performed in each subject at time 0 and after 6 months. Serum homocysteine levels were measured by high-performance liquid chromatography in samples collected at time 0 and at 4, 8, and 24 h after the methionine load, while levels of vitamin B6(by high-performance liquid chromatography) and B12and folate (both by ELISA) were assayed in samples collected at time 0.ResultsSerum levels of glucose and body mass index increased in treated PMW, whereas folate decreased in controls. In treated PMW, basal homocysteine tended to decrease (10.6 ± 3.3 &mgr;mol/L vs. 9.62 ± 2.8 &mgr;mol/L,p= 0.062), whereas in controls it significantly increased (10.7 ± 2.65 &mgr;mol/L vs. 12.17 ± 3.89 &mgr;mol/L,p< 0.05). This increase was not significant after correction for vitamin status (p= 0.072). Homocysteine values 4 h (31.9 ± 13.53 &mgr;mol/L vs. 39.83 ± 22.53 &mgr;mol/L,p< 0.05) and 8 h (35.1 ± 13.13 vs. 43.34 ± 22.15 &mgr;mol/L) after methionine, and integrated homocysteine response to methionine (392.5 ± 133.8 &mgr;mol/24 h vs. 458.8 ± 104.8 &mgr;mol/24 h;p< 0.05), were significantly reduced in HRT-treated, but not in untreated, PMW.ConclusionsContinuous combined oral HRT with17&bgr;-estradiol plus norethisterone acetate reduces homocysteine levels, mainly after a methionine load. This effect seems to be independent of vitamin status and may have positive implications for the prevention of cardiovascular diseases in PMW.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis study was undertaken to evaluate the effects of varying doses of phytoestrogens on lipid and bone metabolism in postmenopausal women.DesignA novel red clover isoflavone preparation (Rimostil) containing genistein, daidzein, formononetin, and biochanin was administered to 46 postmenopausal women in a double-blind protocol after a single-blind placebo phase and followed by a single-blind washout phase. Patients were randomized to receive either 28.5 mg, 57 mg, or 85.5 mg of phytoestrogens daily for a 6-month period.ResultsAt 6 months, the serum high-density lipoprotein cholesterol had risen significantly by 15.7–28.6% with different doses (p= 0.007,p= 0.002,p= 0.027), although the magnitude of the response was independent of the dose used. The serum apolipoprotein B fell significantly by 11.5–17.0% with different doses (p= 0.005,p= 0.043,p= 0.007) and the magnitude of the response was independent of the dose used. The bone mineral density of the proximal radius and ulna rose significantly by 4.1% over 6 months with 57 mg/day (p= 0.002) and by 3.0% with 85.5 mg/day (p= 0.023) of isoflavones. The response with 28.5 mg/day of isoflavones was not significant. There was no significant increase in endometrial thickness with any of the doses of isoflavone used.ConclusionThese results show that the administration of an isoflavone combination extracted from red clover was associated with a significant increase in high-density lipoprotein cholesterol, a significant fall in apolipoprotein B, and a significant increase in the predominantly cortical bone of the proximal radius and ulna after 6 months of treatment. Interpretation of the results is undertaken cautiously because of the absence of a simultaneously studied control group.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveAn appropriate defense against infective agents or malignant cells is attributed to the exquisitely balanced T helper 1 type (cellular) and T helper 2 type (humoral) immune reactions. We investigated the effect of hormone replacement therapy (HRT) on postmenopausal changes in the production of interferon (IFN)-&ggr; and interleukin (IL)-10, a type 1 and a type 2 cytokine, respectively.DesignBoth cytokines were measured by ELISA in the supernatant of lipopolysaccharide-stimulated whole blood cells from 72 untreated and 44 HRT-treated women. Thirteen women were examined before and during HRT.ResultsThe production of IFN-&ggr; in women in their 40s and in postmenopausal women was significantly higher compared with that of younger women. However, IFN-&ggr; fell to the lowest level in the late postmenopausal stage, whereas the production of IL-10 increased gradually with age and in parallel with the postmenopausal period. Thus, in women in the mid-and late postmenopausal period, excessive production of type 2 cytokine (IL-10) compared with type 1 cytokine (IFN-&ggr;) occurred. The IFN-&ggr; levels of women on HRT were significantly lower than those of untreated women in the early and mid-postmenopausal stages, and IL-10 levels of women on HRT were significantly lower than those of untreated women in the mid-and late postmenopausal stages. HRT induced a significant decrease in the production of IL-10 and tended to lower the level of IFN-&ggr;.ConclusionsProduction of IL-10 is augmented in postmenopausal women. HRT probably prevents postmenopausal women from an aberration of the immune system by improving the balance of type 1 and type 2 immune reactions.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo observe whether any relationship exists between the concentration of plasma estradiol (E2) and the plasma concentrations of malondialdehyde (MDA) or whether a relationship exists between the concentration of plasma E2and the activity of the erythrocyte enzymes, superoxide dismutase (SOD) and catalase, in ovariectomized female Wistar rats (treated and untreated with E2).DesignWe used 40 ovariectomized Wistar rats randomly assigned to four groups. The first group was allowed to evolve freely with no treatment. A gel containing 17&bgr;-estradiol was administered transdermally to the other three groups at doses of 4, 8, and 16 &mgr;g/day, respectively. After 15 days of treatment, blood samples were obtained from the four groups. The concentrations of plasma MDA and E2and the activities of erythrocyte catalase and SOD were determined.ResultsThere were significant correlations between the MDA levels and the logarithm (base 10) of the plasma E2concentrations in both linear (p= 0.00093) and quadratic (p= 0.000001) regression analyses. No relationship was found between the E2concentrations and the catalase and SOD activities.ConclusionsThere was a clear relationship between the plasma levels of MDA and the logarithm of the plasma E2concentrations, which was best demonstrated with a quadratic regression. This model may explain the contradictory findings presented by estrogens with respect to their pro-or antioxidant action.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe quantity of intra-abdominal fat is highly associated with the development of diabetes mellitus. We sought to determine whether recent hormone replacement therapy (HRT) use modifies central fat and insulin sensitivity in postmenopausal women compared with women who had never used HRT.DesignWe measured intra-abdominal fat, subcutaneous abdominal fat, and sagittal diameter at the L4-L5 vertebral disc space using computed tomography imaging. Total body fat and fat-free mass were measured using dual energy x-ray absorptiometry. Insulin sensitivity was assessed using the euglycemic hyperinsulinemic clamp technique in 42 nonobese postmenopausal women, age 51 ± 4 years (12 recent HRT users plus 30 never-users). All women who were taking HRT discontinued it for 2 months before the study.ResultsAfter statistical adjustment for age, previous use of HRT was associated with decreased intra-abdominal fat (72 ± 34 cm2) compared with no HRT use (96 ± 33 cm2;p= 0.05). This difference remained significant after adjustment for time since menopause. When previous HRT users were compared with nonusers, there were no differences in subcutaneous abdominal fat, sagittal diameter, fat-free mass, total fat, insulin sensitivity, or body weight.ConclusionsRecent HRT use is associated with lower intra-abdominal fat in nonobese, early postmenopausal women. This finding suggests a carry-over effect of HRT on intra-abdominal fat. Recent HRT use does not seem to be associated with differences in glucose disposal.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID