ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo investigate the effect of soy protein supplementation with known levels of phyto-estrogens on cardiovascular disease risk factors and menopausal symptoms in perimenopausal women.MethodsA randomized, double-blind crossover trial was conducted in 51 women consuming isocaloric supplements containing 20 g of complex carbohydrates (comparison diet), 20 g of soy protein containing 34 mg of phytoestrogens given in a single dose, and 20 g of soy protein containing 34 mg of phytoestrogens split into two doses. Women were randomly assigned to one of the three diets for 6-week periods and subsequently were randomized to the remaining two interventions to determine whether differences existed between the treatment diets for cardiovascular disease risk factors, menopausal symptoms, adherence, and potential adverse effects.ResultsSignificant declines in total cholesterol (6% lower) and low density lipoprotein cholesterol (7% lower) were observed in both soy diets compared with the carbohydrate placebo diet. A significant decline in diastolic blood pressure (5 mm Hg lower) was noted in the twice-daily soy diet, compared with the placebo diet. Although nonsignificant effects were noted for a number of measures of quality of life, a significant improvement was observed for the severity of vasomotor symptoms and for hypo-estrogenic symptoms in the twice-daily group compared with the placebo group. No significant effects were noted for triglycerides, high density lipoprotein cholesterol or frequency of menopausal symptoms. Adherence was excellent in all groups.ConclusionsSoy supplementation in the diet of nonhypercholesterolemic, nonhypertensive, perimenopausal women resulted in significant improvements in lipid and lipoprotein levels, blood pressure, and perceived severity of vasomotor symptoms. These data corroborate the potential importance of soy supplementation in reducing chronic disease risk in Western populations.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo review the association between postmenopausal estrogen therapy and chronic conditions not usually considered in risk-benefit reviews.DesignTen-year literature review (1989–1998) of case series and epidemiologic studies with risk estimates and 95% confidence intervals.ResultsOsteoarthritis and rheumatoid arthritis, the most extensively studied conditions, show no consistent association with hormone therapy. Two studies of systemic lupus erythematosus show a nearly three-fold increased risk apparent after 2 or more years of hormone therapy. Single studies suggest an increased risk of pancreatitis, asthma, and Raynaud's syndrome. Evidence for a reduced risk of diabetes mellitus is not compelling. Cataracts and migraine are either increased or decreased by hormone therapy. Among the associations considered here, only an increased risk of gallbladder disease and venous thromboembolic disease have been confirmed in clinical trials of hormone replacement therapy.ConclusionsFurther studies are needed.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to determine whether estrogen could be formed locally in the coronary arteries.DesignCoronary arteries were examined from monkeys (Macaca fascicularis, one male and one female) and human subjects (one premenopausal woman, one postmenopausal woman, and one man) by immunocytochemistry, using purified antiseta against human placental estrogen synthetase (aromatase) and ER α. The arteries were graded for the amount of atherosclerosis.ResultsThere was clear immunopositivity for both aromatase and estrogen receptors in all arteries studied. Although all endothelial cells (CD31 positive) stained for both antigens, the staining in macrophages, fibroblasts, and smooth muscle cells was irregular.ConclusionThe present results provide the first evidence for the local formation of estrogen in the coronary arteries. In addition to complementing the evidence of a cardioprotective effect of estrogen on the coronary circulation, our results highlight the potential importance of local regulation of estrogen formation and the role of available precursor androgens in maintaining the cardiovascular system.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to examine age-specific population-based values for serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in women in the U.S. population.DesignData were collected from a nationally representative cross-sectional health examination survey that included measurements of follicle-stimulating hormone and luteinizing hormone and information from a personal interview. A total of 3388 women aged 35 to 60 years were examined during the third National Health and Nutrition Examination Survey, 1988–1994.ResultsAmong U.S. women aged 35–60 years, median FSH and LH levels began to increase for women in their late 40s and reached a plateau for women in their early 50s. This study supports the previously reported association between serum FSH and age (i.e., serum FSH and LH levels increase with age) and smoking (i.e., current smoking was associated with an increased level of serum FSH). At FSH levels of ≥15 IU/L or ≥ 20 IU/L, 70 and 73% of women, respectively, were postmenopausal. Our study also found an interaction between age and oophorectomy. In addition, the present data suggest that women with only one ovary may have higher FSH levels than women with both of their ovaries.ConclusionsNHANES III provides population-based data that support previously reported associations between serum FSH level and age, smoking, and menopausal status.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:Estrogen-progestogen replacement therapy (HRT) may be associated with deterioration of insulin sensitivity in comparison to estrogens alone, which tend to improve insulin sensitivity in postmenopausal women. Insulin sensitivity with the use of continuous combined 17-β estradiol/norethis-terone acetate (E2/NETA) preparations has not been examined before in postmenopausal women.Design:In a double-blind randomized parallel study, we evaluated the effect of 2 mg E2/1 mg NETA (high dose E2/NETA), 1 mg E2/0.5 mg NETA (low dose E2/NETA), or placebo (P) on the insulin sensitivity index (S1) in three groups (18 women/group) of postmenopausal nondiabetic women (follicle stimulating hormone [FSH] > 40 mlU/mL, mean ± SD) aged 56 ± 3 years, BMI 25 ± 4 kg/m2, cholesterol 233 ± 42 mg/dL, and triglycerides 87 ± 36 mg/dL. Insulin sensitivity was measured by means of a two-step hyperinsulinemic euglycemic glucose clamp (insulin infusion rate, 0.25 and 1.0 mU/kg/min for 120 min each) at baseline and after 3 months of daily administration of high dose E2/NETA, low dose E2/NETA, or P. Analysis was performed assuming equivalence of start-end changes of insulin sensitivity among treatment groups (Anderson-Hauck test).Results:S1was 7.7 ± 2.9,7.5 ± 3.4, 6.8 ± 2.2 at baseline and 6.3 ± 3.0,7.9 ± 2.5, 7.1 ± 3.1 mL/min/m2per μ, U/mL 3 months after the administration of high dose E2/NETA, low dose E2/NETA, and P, respectively. The low dose E2/NETA group had start-to-end changes of S1which were equivalent to the P group (0.4 [95% confidence interval [CI] −0.8; 1.7] vs. 0.4 [-0.3; 1.0]) (p = 0.02). For the high dose E2/NETA group, equivalence could not be shown with either the P (p = 0.89) or with the low dose E2/NETA group (p = 0.90). S1within the high dose E2/NETA group decreased by —1.5 (95% CI −2.7; −0.2) mL/min/m2per μU/mL. HbA1cdecreased from 5.3 ± 0.3 to 5.1 ± 0.3% within the high dose E2/NETA group (p < 0.03) and remained unchanged within the low dose E2/NETA and P group. Fasting plasma glucose, fasting serum insulin, and C-peptide, as well as triglycerides and BMI were comparable among the groups at baseline and after 3 months. Total cholesterol decreased by 12% and 8% in women treated with high dose and low dose E2/NETA (p < 0.02), respectively, and remained unchanged within the P group.Conclusions:These results indicate that 3 months use of a low dose continuous E2/NETA preparation does not change insulin sensitivity in postmenopausal women. At high dose of E2/NETA, a modest decrease seems possible. The effects of E2/NETA on other parameters of carbohydrate and lipid metabolism are neutral or favorable.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objectives:Our aim was to assess the effects of a combined oral contraceptive (OC) preparation on bone quantitative ultrasound and biochemical markers of bone metabolism in perimenopausal women.Design:Bone biochemical markers and bone quantitative ultrasound were evaluated in a longitudinal 2-year follow-up study conducted in healthy, normally menstruating perimenopausal women, perimenopausal oligomenorrheic women, and age-matched oral contraceptive-treated women (20 μg of ethinyl estradiol plus 0.15 mg desogestrel). The results were analyzed by factorial or repeated-measures analysis of variance, as appropriate.Results:In normal women, there were no significant modifications in menstrual cycle, plasma FSH and estradiol levels, biochemical markers of bone turnover, and bone quantitative ultrasound. Conversely, in oligomenorrheic women, an increase in the cycle length with a concomitant rise in circulating plasma FSH and parallel decrease of plasma estradiol levels was evident. In this group, an increase in both urinary excretion of hydroxyproline and plasma osteocalcin levels paralleled a decrease in bone quantitative ultrasound. In perimenopausal OC-treated women, the pattern of osteocalcin and urinary excretion of hydroxyproline showed a slight decrease, whereas bone quantitative ultrasound did not show any significant modification.Conclusion:Perimenopausal OC administration can prevent the increase in bone turnover and the decrease in bone quantitative ultrasound that follow the perimenopausal impairment of ovarian function.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:The aim of the present study was to evaluate possible variations in cardiac hemody-namic parameters related to the natural changes of ovarian estrogen production.Methods:Forty postmenopausal women aged 52.7 ± 4.6 years, randomized into two groups (20 patients in each group) according to the administration (group A) or not (group B) of estroprogestin replacement therapy (ERT), were examined using thoracic electrical bioimpedence.Results:After 6 months of therapy, we observed the following: (1) the mean end-diastolic index was significantly higher in group A than in group B (70.27 and 57.13 mL/m2, respectively) (p < 0.05); (2) the mean acceleration index, indicator of heart contractility, and the mean cardiac index rate, indicators of cardiac performance, were significantly higher in group A than in group B (mean, 1.35 vs. 0.76 s [p < 0.01] and mean, 3.22 vs. 2.34 L/min/m2[p < 0.05], respectively); and (3) the patients treated with ERT showed systemic vascular resistance index values significantly lower than the controls (mean, 2280 vs. 3150 f Ohm/m2[p < 0.01]), achieving standard levels after 6 months of therapy. Furthermore, the acceleration index showed a significant increase, within group A, between the third and sixth month of ERT (0.91 vs. 1.35 s [p < 0.05]).Conclusions:Our findings suggest that postmenopausal women treated with a 6-month course of ERT have significantly improved end-diastolic index, heart contractility index, cardiac index, and systemic vascular resistance, whereas 3 months of ERT does not seem to induce the same effects. In our study, thoracic electrical bioimpedence was shown to be a sensitive and specific method of analysis with a very low cost of administration.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID