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 addition of progestogen to estrogen replacement therapy is thought to antagonize, at least in part, the beneficial effects of estrogens on the vasculature. The aim of this study was to investigate the effect of two progestogens mostly used in clinical practice on the proliferation of vascular smooth muscle cells, which has been demonstrated to be a crucial step in the development of atherosclerosis.Material and MethodsThe effect of medroxyprogesterone acetate (MPA) and norethisterone (NET), which represent the two different classes of C21-and C19-progestogens, respectively, was investigated on proliferation of smooth muscle cells from human coronary artery in vitro. The steroids were tested in the concentration range 10−8to 10−5M, which is in the upper range of that reached during hormonal replacement therapy, and compared with control values.ResultsEstradiol significantly inhibited serum-stimulated cell growth at the concentrations 10−6and 105M by 18% and 34%, respectively. MPA significantly enhanced serum-stimulated growth at the concentrations 10−6and 10−5M by 29% and 47%, respectively. In equimolar combinations of MPA and estradiol, proliferation of the cells was significantly stimulated at the concentrations 10−6and 10−5M by 26% and 44%, respectively. In contrast, NET had no significant effect on serum-stimulated cell growth and had no impact on the estradiol-inhibited proliferation.ConclusionsThese data suggest that MPA may antagonize beneficial antiatherosclerotic estradiol effects on the vasculature, whereas NET may be neutral in this respect. However, these effects occurred at supraphysiological concentrations. Because these concentrations might be reached in the target tissues, the clinical relevance for treatment of patients with cardiovascular risk cannot be excluded.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectivesThe aim of the present study was to evaluate differences between two regimens of estrogen/progestogen replacement therapy on nocturnal sleep in postmenopausal women.MethodsTwenty-one (21) postmenopausal women were studied. They were randomized into two treatment groups: (1) estrogen (Premarin 0.625 mg) and medroxyprogesterone acetate (Provera 5 mg) (n= 11) or (2) estrogen (Premarin 0.625 mg) and oral micronized progesterone (Prometrium 200 mg) (n= 10). Postmenopausal women were recorded for two consecutive nights in the sleep laboratory at baseline and again after 6 months of treatment in a randomized trial. The women also had to fill out evening and morning sleep and vigilance questionnaires for 7 days before baseline recordings and for 23 days before month 6 recordings.ResultsSleep efficiency was found to be significantly improved in the micronized progesterone group. It increased by 8% (p= 0.014) with no such increase observed in the medroxyprogesterone acetate group. Time spent awake after sleep onset was also significantly improved in the micronized progesterone group but not in the medroxyprogesterone acetate group. On the other hand, menopausal symptoms and subjective measures of sleep (questionnaires) improved in both groups after treatment.ConclusionThis study suggests that medroxyprogesterone acetate and micronized progesterone are both effective for treating menopausal symptoms but that the latter might better improve the quality of sleep in postmenopausal women taking estrogen.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveWe examined the change in menopausal symptoms in response to 24 weeks of isoflavone-rich (80.4 mg/day) and isoflavone-poor (4.4 mg/day) soy protein isolate treatment in perimenopausal women.DesignIn this double-blind 24-week study, 69 women were randomized to treatment: isoflavone-rich soy protein (n= 24), isoflavone-poor soy protein (n= 24), or whey protein control (n= 21). AMenopausal Indexwas used to assess change in hot flushes and night sweats, as well as other symptoms, at baseline, week 12, and week 24.ResultsRepeated measures analysis of variance indicated no treatment effect on change in hot flush (p= 0.18) and night sweat (p= 0.92) frequency, whereas there was a significant decline in hot flush (p= 0.0003) and night sweat (p= 0.0007) frequency with time in all treatment groups. &khgr;2analyses indicated no treatment effect on severity of hot flushes or night sweats at any time point, as well as no treatment effect on frequency or severity of other vasomotor symptoms. At the completion of the study, we found no treatment effect on retrospective perception of frequency, duration, or severity of hot flushes or night sweats. Since time had a significant effect on symptoms with all groups reporting a decline in overall symptoms, this indicated either a placebo effect or simply an improvement in symptoms during the study.ConclusionIn this study, we found no evidence that isoflavone-rich or isoflavone-poor soy protein provided relief of vasomotor or of other menopausal symptoms.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe androgenic effect of progestogen, necessary in early postmenopausal hormone replacement therapy (HRT), may adversely affect insulin sensitivity as well as body fat distribution and thereby increase the cardiovascular risk profile. The impact of HRT with sequential combined oral 17&bgr;-estradiol and norethisterone acetate on insulin sensitivity and body composition in early menopause has not been studied.DesignA randomized single blind placebo-controlled 6-month study of sequential combined 17&bgr;-estradiol norethisterone acetate on insulin sensitivity and body composition was carried out. Thirty fit healthy postmenopausal women were enrolled and completed this 6-month study. Body composition was measured by dual-energy x-ray absorptiometry scanning, and insulin sensitivity was measured using the euglycemic hyperinsulinemic clamp. Studies were undertaken at baseline and after 6 months of therapy. The studies were performed during the estrogen-only phase of therapy.ResultsAll women demonstrated a degree of decreased insulin sensitivity that was not modified by 6 months of hormone replacement therapy. Body composition remained unchanged over 6 months. There was no alteration in total body fat or the distribution of body fat. The percentage of central abdominal fat (android) was not altered.ConclusionSix months of HRT with sequential combined oral 17&bgr;-estradiol norethisterone acetate does not have an adverse effect on insulin sensitivity and does not promote an increase in weight or the more android distribution of body fat, which could contribute to the increased cardiovascular risk profile that is evident in postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo identify symptoms experienced in a cohort of healthy women in the late reproductive years; to compare symptom reports between African American and Caucasian women; and to determine the extent to which other factors in reproductive health, mood and behavior, lifestyle, and demographic background are associated with the reported symptoms.DesignA cohort of women aged 35 to 47 years (mean age, 41 years) was identified through random digit dialing. This study is a cross-sectional analysis of data collected at enrollment from a subset of 308 women who completed daily symptom reports (DSR) for one menstrual cycle. Data were obtained in structured interviews and self-administered standard questionnaires. The associations of the study variables with symptoms as assessed by the DSR were examined using analysis of variance and general linear models.ResultsThe African American women were significantly more likely to report in interview that they experienced menopausal symptoms (46% vs. 30%;p< 0.001) and had significantly higher ratings on the physiological symptom factor of the DSR, which included hot flashes, dizziness, poor coordination/clumsiness, urine leaks, and vaginal dryness. The DSR yielded two other factors of psychological and somatic symptoms. Race was associated only with the physiological symptom factor in the multivariable analyses. Neither race nor age were associated with psychological symptoms, which were predicted by current or past mood problems.ConclusionsSymptoms commonly associated with the menopause are experienced in the late reproductive years before observable changes in menstrual cycles. African American women reported more physiological symptoms than white women. These data provide an essential baseline for longitudinal study of symptoms associated with the ovarian decline in the perimenopausal years.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThere is increasing evidence of a direct association between normal androgen levels and reduced cardiovascular morbidity and mortality in women. After menopause the influence of estrogens declines, whereas that of androgens increases. Therefore, we investigated the effects of androgens on atherosclerosis in postmenopausal women, by using carotid artery intimal-medial thickness as a marker of vascular damage.DesignBlood pressure, body mass index, waist-to-hip ratio, serum dehydroepiandrosterone sulfate, androstenedione, total and free testosterone, estrone, insulin, lipid profile, and glucose were evaluated in 44 women in stable physiological menopause. All subjects underwent carotid ultrasound (Biosound 2000 II s.a. high-resolution unit).ResultsSpearman correlation coefficients indicated that serum androstenedione and free testosterone were negatively associated with several carotid intimal-medial thickness measures with correlation coefficients (r) ranging from 0.477 to 0.397 (p< 0.01–0.04). Moreover, age-adjusted androstenedione and free testosterone highest tertiles showed intimal-medial thickness values significantly (p< 0.03–0.05) lower than the other tertiles. There was a favorable association between hormones and the most important cardiovascular risk factors. This association, however, did not reach statistical significance. Stepwise multiple regression analysis showed that the inverse relationships between the hormones (androstenedione and free testosterone) and several intimal-medial thickness measures were maintained (F: 4.15–6.07,p< 0.05–0.02) after adjustment for major cardiovascular risk factors.ConclusionsOur data demonstrate that in postmenopausal women endogenous steroid precursors and androgens are inversely related to carotid intimal-medial thickness, an established marker of atherosclerosis. In addition, these hormones show favorable associations with cardiovascular risk factors. Therefore, our study suggests that, after menopause, normal androgen levels may benefit the carotid artery wall.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo investigate the enzymatic activity of hepatic lipase (HL) in postmenopausal women (PMW) and reproductive age women (RAW); and to evaluate the relationship between this enzyme and the atherogenic intermediate density lipoproteins (IDL) and low density lipoproteins (LDL), and antiatherogenic high density lipoproteins (HDL) and its subfractions (HDL2and HDL3).DesignWe studied 55 PMW receiving no hormonal treatment in a cross-sectional study in comparison with a control group of 55 RAW, matched by body mass index. Follicle-stimulating hormone was > 40 mUI/ml in PMW and 3–12 mUI/ml in RAW. PMW presented at least 1 year of natural menopause and no more than 10 years of amenorrhea with E2serum concentration <15 pg/ml.ResultsHL activity was significantly higher in PMW versus RAW (14.0 ± 1.4 vs. 10.9 ± 0.4 &mgr;mol of fatty acids/ml of postheparin plasma, respectively, mean ± SEM,p< 0.001). In PMW, IDL cholesterol showed a positive correlation with LDL cholesterol (r= 0.28,p< 0.05), and HDL2cholesterol was inversely correlated with HL activity (r= 0.31,p< 0.05). HL was positively correlated with plasma concentration of LDL cholesterol in both groups (r= 0.27,p< 0.05). The higher values of HL activity and IDL cholesterol were independent of age.ConclusionsHigher HL activity is associated with a more atherogenic profile in PMW.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveLysophosphatidylcholine (lysoPC), an active component of oxidized low-density lipoprotein, stimulates proliferation of vascular smooth muscle cells (VSMC). We investigated the direct impact of 17&bgr;-estradiol (E2) on the proliferation of VSMC from rat aorta.ResultsVSMC derived from both female and male rats expressed estrogen receptors &agr; and &bgr;. Treatments with 1% fetal bovine serum or 5 &mgr;M lysoPC increased the incorporation of [3H]-thymidine in VSMC obtained from female rats. 17&bgr;-E2did not alter the response to fetal bovine serum, but significantly suppressed the enhanced deoxyribonucleic acid synthesis which had been induced by lysoPC in a dose-dependent manner (10−14–10−6M). Estrogen also inhibited the proliferation of VSMC from male animals. ICI 182,780, a specific estrogen receptor antagonist, and 17&agr;-E2, an inactive form of estradiol, also decreased the mitogenic response to lysoPC in VSMC. In addition,N-acetyl-l-cysteine, a potent antioxidant, inhibited the lysoPC effect. Flow cytometric analysis using the oxidation-sensitive probe 2´,7´-dichlorofluorescin diacetate revealed that elevated intracellular formation of reactive oxygen species elicited with lysoPC was depressed significantly by 17&bgr;-E2, ICI 182,780, or 17&agr;-E2as well as byN-acetyl-l-cysteine.Conclusion17&bgr;-E2inhibits in vitro VSMC proliferation induced by lysoPC via a nongenomic antioxidant mechanism.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID