Diabetic Postmenopausal Women Research Articles

Effect of Adiponectin Level in Type II Diabetic Postmenopausal Women Compared to Healthy Women

Adiponectin is protein secreted from adipose tissue and plays important role in regulating glucose level as well as fatty acid breakdown. Adipose tissue has been considered an important endocrine organ. Adiponectin has been shown to completely reverse insulin resistance. A total of sixty subjects involved in this study to examine the regulatory roles of adiponectin concentration in diabetic type II postmenopausal women and to study the correlation between the parameters (serum glucose, cholesterol and triglyceride). Thirty of each diabetic women (BMI<30) and healthy postmenopausal women (BMI<30) were selected from Baghdad teaching hospital in Baghdad/ Iraq. ELISA (enzyme linked immune sorbent assay) technique was used for the measurement of serum adiponectin. Blood glucose, cholesterol and triglyceride were determined by using colorimetric method. Results showed that the level of serum adiponectin in diabetic postmenopausal women were significantly (P < 0.01) lower than that of non diabetic postmenopausal women. Serum glucose in diabetic postmenopausal women was significantly (P < 0.01) higher than non-diabetic women. The present study indicates the possibility of future development of new anti-diabetic agents that act independent of insulin action.

Evaluation of the anti-osteoporotic effects of metformin and sitagliptin in postmenopausal diabetic women

Osteoporosis is the most important metabolic bone disease in patients with diabetes mellitus. Several studies have documented that metformin is osteogenic in vitro. In contrast, others showed no effect of metformin on the osteogenic differentiation of bone marrow-derived mesenchymal stem cells. Incretin hormones have received much attention because of their beneficial effects beyond glycemia, including on bone health. The study evaluated the anti-osteoporotic effect of metformin and sitagliptin in postmenopausal diabetic women. Forty postmenopausal diabetic women were randomly divided into two equal groups. Group 1 received metformin (Glucophage(®) 500 mg) 1 tablet twice daily, and group 2 received sitagliptin (Januvia(®) 100 mg) 1 tablet/day, for 12 weeks. Fasting blood and urine samples were collected for measurement of serum total alkaline phosphatase (ALP), osteocalcin, and urinary deoxypyridinoline (DPD). Laboratory tests were measured at baseline, after 4 and 8 weeks, and at the end of the study. Bone mineral density of the anterior posterior lumbar spine was measured by dual energy X-ray absorptiometry at baseline and after 12 weeks of the intervention. In the metformin-treated group, the mean values for all markers of bone turnover at 12 weeks of treatment were not significantly different from baseline. In group 2, the mean serum total ALP was significantly decreased, serum osteocalcin levels were non-significantly decreased gradually by 10% at 12 weeks, while urinary DPD decreased significantly and was then maintained at 28% decrease at 12 weeks. In conclusion, metformin is neither osteogenic nor has anti-osteoporotic effect, while sitagliptin could positively regulate bone metabolism.

Bilateral Oophorectomy and the Risk of Incident Diabetes in Postmenopausal Women

Ovarian hormones regulate glucose uptake and insulin sensitivity. Despite the high frequency of surgical menopause, its relationship with diabetes has not been extensively investigated. We assessed the association between hysterectomy with or without bilateral oophorectomy (BSO) status, menopausal age, and reproductive life span with incident diabetes. Data were from a cohort of 2,597 postmenopausal women enrolled in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study without diabetes mellitus at baseline. Cox proportional hazards regression models were used to calculate adjusted hazard ratios (HRs) and 95% CIs. After a median follow-up time of 9.2 years, the incidence of diabetes (in cases per 1,000 person-years) was 7.4 for women with no hysterectomy or BSO, 8.2 for hysterectomy alone, and 8.5 for hysterectomy with BSO. Hysterectomy status was associated positively with diabetes (HR 1.66, 95% CI 1.23-2.23). However, the elevated risk was restricted to women with both hysterectomy and BSO after adjustment for relevant confounders (HR 1.57, 95% CI 1.03-2.41). An earlier age at menopause and a shorter reproductive life span also exhibited a linear relationship with the development of diabetes irrespective of type of menopause (P for trend = 0.001). Women with hysterectomy concomitant with BSO may represent a unique population with elevated risk for diabetes and other chronic diseases. Therefore, the decision to remove the ovaries at the time of hysterectomy for benign conditions during the premenopausal years should be balanced with the risk of diabetes and its potential complications. Furthermore, the mechanism linking BSO to diabetes mellitus needs to be clarified.

Impact of Age at First Childbirth on Glucose Tolerance Status in Postmenopausal Women: The 2008–2011 Korean National Health and Nutrition Examination Survey

The objective of the current study was to determine whether there was an association between age at first childbirth and glucose tolerance status in postmenopausal women. This study was based on the data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008-2011. Of 37,753 participants, data for 4,965 postmenopausal women were included in the analysis. Subjects were subdivided according to the age at first childbirth as follows: ≤19, 20-24, 25-29, and ≥30 years. Multivariate logistic regression analyses were used to identify whether there was an independent association between age at first childbirth and glucose tolerance status by adjusting for potential confounding factors. The prevalence of impaired fasting glucose (IFG) and diabetes was 21.8% (1.066 of 4.965) and 15.3% (774 of 4,965), respectively. Diabetes prevalence differed significantly between the subgroups and was higher with earlier age at first childbirth: it was 10.9% in subjects aged ≥30 years and 23.8% in subjects aged ≤19 years at first childbirth. After fully adjusting for potential confounding factors, including lifestyle, sociodemographic factors, known diabetes risk factors, and reproductive factors, age at first childbirth ≤19 years was significantly associated with diabetes (odds ratio 1.492 [95% CI 1.005-2.215]). No significant associations were found between age at first childbirth and IFG. Age at first childbirth influenced diabetes risk in postmenopausal women, and adolescent pregnancy was independently associated with a higher risk of diabetes in postmenopausal women.

Role of adiponectin in mediating the association of osteocalcin with insulin resistance and type 2 diabetes: a cross sectional study in pre- and post-menopausal women

Objective: To analyse the association of osteocalcin with insulin resistance and type 2 diabetes and assess the role of adiponectin in these relationships. Methods: This study comprised 98 newly diagnosed type 2 diabetic women (51 pre-menopausal and 47 post-menopausal) and 102 age and BMI matched controls (53 pre-menopausal and 49 post-menopausal). Insulin resistance was calculated by homeostasis model assessment-insulin resistance (HOMA-IR). Results: Osteocalcin was significantly positively correlated with adiponectin in both pre-menopausal (p = 0.0026) and post-menopausal diabetic women (p = 0.0357). Significant negative association between osteocalcin and HOMA-IR was observed only in pre-menopausal diabetic women (p = 0.0019), but the association was partially reduced (p = 0.0219) after additional adjustment for adiponectin. Adiponectin slightly attenuated the inverse association between osteocalcin and presence of type 2 diabetes in both pre- and post-menopausal women. Conclusion: The protective action of osteocalcin against the development of insulin resistance and type 2 diabetes in women may be partially mediated through up-regulation of adiponectin secretion.

Coronary Heart Disease in Postmenopausal Women with Type II Diabetes Mellitus and the Impact of Estrogen Replacement Therapy: A Narrative Review.

Coronary heart disease is the main cause of death in postmenopausal women (PMW); moreover its mortality exceeds those for breast cancer in women at all ages. Type II diabetes mellitus is a major cardiovascular risk factor and there is some evidence that the risk conferred by diabetes is greater in women than in men. It was established that the deficiency of endogenous estrogens promotes the atherosclerosis process. However, the impact of estrogen replacement therapy (ERT) on cardiovascular prevention remains controversial. Some authors strongly recommend it, whereas others revealed a concerning trend toward harm. This review tries to underlines the different components of cardiovascular risk in diabetic PMW and to define the place of ERT.

STUDY OF ENDOGENOUS SEX HORMONES AND INFLAMMATION IN ELDERLY WOMEN WITH DIABETES MELLITUS

Background .C-Reactive Protein (CRP), an acute phase reactant has long been considered as a classic marker of inflammation. Ageing is characterized by a chronic, low-grade inflammatory status, the so-called “inflame-ageing”. Diabetes is known to be also associated with low-grade inflammation .The normal process of reproductive ageing is characterized by marked hormonal changes, during menopause, estradiol (E2) level decreases dramatically, whereas testosterone level presents a small decline or remain unchanged. A large body of clinical data suggests the important roles of endogenous sex hormones in the pathogenesis of type 2 diabetes. In many studies in women, plasma estradiol and testosterone have been positively associated with glucose intolerance and insulin resistance, independently of adiposity. Objective .The aim of this study was to assess serum levels of endogenous sex hormones (estrogen and testosterone) as well as high sensitive C -Reactive protein ( hs-CRP) in elderly women with and without type 2 diabetes. Research Design. This study was done in the period between august 2009 to august 2011, The study population included a total number of 60 post menopausal elderly females, 20 healthy non diabetic elderly females as control group and 40 diabetic females. The diabetic females were further divided into two groups according to presence or absence of complications cardiovascular diseaes complicated group and non complicated group. They were also divided into two groups according to glycosylated hemoglobin level (HbA1c) to controlled group and non controlled group. Methods. Total testosterone, total estradiol, hs-CRP and HbA1c were measured in diabetic and non diabetic elderly women. Results. As regard hs-CRP there was a high significant difference between patients(2,2±,56 mg/L) and control group(1.60  0.39 mg/L) and also there was a significant difference between complicated(2.160.51 mg/L) and non complicated group(2.080.76 mg/L) and no significant difference among diabetics whether controlled or non controlled . As regard the serum estradiol, there was a high significant difference between patients (22.513.9 pg/ml) and control group (12.92.71 pg/ml). While there was no significant difference as regard presence or absence of complication and diabetes control. As regard the serum testosterone, there was no significant difference between patients and control group, presence or absence of complication and control of diabetes. Conclusion. In type 2 diabetic postmenopausal elderly women there was significant association between inflammation and serum estradiol while there was no association between inflammation and serum testosterone. As regarding presence or absence of cardiovascular complication and diabetes control neither of two hormones were associated with inflammation. Keywords: Sex hormones, Postmenopausal women, Inflammation, Elderly, Diabetes.

Racial/ethnic disparities in association between dietary quality and incident diabetes in postmenopausal women in the United States: the Women's Health Initiative 1993–2005

Objective. To examine the association of dietary quality and risk of incident diabetes overall and by race/ethnicity among postmenopausal women enrolled in the Women's Health Initiative (WHI).Research methods and procedures. The WHI recruited 161,808 postmenopausal women between 1993 and 1998, and followed them until 2005. Incident diabetes was determined annually over an average of 7.6 years from enrollment. At baseline, all participants completed a Food Frequency Questionnaire (FFQ). Dietary quality was assessed by the Alternate Healthy Eating Index (AHEI), calculated from the baseline FFQ responses.Results. There were 10,307 incident cases of self-reported treated diabetes over 1,172,761 person-years of follow-up. Most participants did not meet the AHEI dietary goals; that is, only 0.1% of women met or exceeded the recommended consumption of vegetables, and few (17.3%) met or exceeded the recommended level for total fiber. After adjusting for potential confounders, women in the highest quintile of the AHEI score were 24% less likely to develop diabetes relative to women in the lowest quintile of AHEI [hazard ratio (HR) = 0.76 (95% CI: 0.70–0.82)]. This association was observed in Whites [HR = 0.74 (95% CI: 0.68–0.82)] and Hispanics [HR = 0.68 (95% CI: 0.46–0.99)], but not in Blacks [HR = 0.85 (95% CI: 0.69–1.05)] or Asians [HR = 0.88 (95% CI: 0.57–1.38)].Conclusion. These findings support a protective role of healthful eating choices in reducing the risk of developing diabetes, after adjusting for other lifestyle factors, in White and Hispanic postmenopausal women. Future studies are needed to investigate the relationship between dietary quality and risk of diabetes among Blacks and Asians in relationship to other lifestyle factors.

Cellular Mechanism by Which Estradiol Protects Female Ovariectomized Mice From High-Fat Diet-Induced Hepatic and Muscle Insulin Resistance

Estrogen replacement therapy reduces the incidence of type 2 diabetes in postmenopausal women; however, the mechanism is unknown. Therefore, the aim of this study was to evaluate the metabolic effects of estrogen replacement therapy in an experimental model of menopause. At 8 weeks of age, female mice were ovariectomized (OVX) or sham (SHAM) operated, and OVX mice were treated with vehicle (OVX) or estradiol (E2) (OVX+E2). After 4 weeks of high-fat diet feeding, OVX mice had increased body weight and fat mass compared with SHAM and OVX+E2 mice. OVX mice displayed reduced whole-body energy expenditure, as well as impaired glucose tolerance and whole-body insulin resistance. Differences in whole-body insulin sensitivity in OVX compared with SHAM mice were accounted for by impaired muscle insulin sensitivity, whereas both hepatic and muscle insulin sensitivity were impaired in OVX compared with OVX+E2 mice. Muscle diacylglycerol (DAG), content in OVX mice was increased relative to SHAM and OVX+E2 mice. In contrast, E2 treatment prevented the increase in hepatic DAG content observed in both SHAM and OVX mice. Increases in tissue DAG content were associated with increased protein kinase Cε activation in liver of SHAM and OVX mice compared with OVX+E2 and protein kinase Cθ activation in skeletal muscle of OVX mice compared with SHAM and OVX+E2. Taken together, these data demonstrate that E2 plays a pivotal role in the regulation of whole-body energy homeostasis, increasing O(2) consumption and energy expenditure in OVX mice, and in turn preventing diet-induced ectopic lipid (DAG) deposition and hepatic and muscle insulin resistance.

Insulin-Like Growth Factor-1 and Osteocalcin Are Correlated with Markers of Osteoporosis in Postmenopausal Women with Type-2 Diabetes

Objective: The study was conducted to evaluate the relation between insulin-like growth factor-1 and osteocalcin and markers of bone modulation (osteoprotegerin; OPG, receptor activator nuclear kappa B; RANK and RANK ligand; RANKL) in postmenopausal Type 2 diabetic women with and without osteoporosis. Methods: The study was conducted on 90 female divided into three groups (30 each). Group I included healthy postmenopausal women as a control, Group II included diabetic postmenopausal women without osteoporosis Group III included diabetic postmenopausal women with osteoporosis. Fasting blood samples were obtained for the determination of blood glucose, HbA1c, total and ionized calcium, OPG, RANK and RANKL. Also the levels of IGF-1 and osteocalcin were assessed. Results: In postmenopausal Type 2 diabetic women, the osteoporosis resulted in derangement in OPG/sRANKL system. The serum level of OPG was elevated while sRANKL declines in osteoporotic postmenopausal Type 2 diabetic women. IGF-1 level decreased in diabetic postmenopausal women but those women with osteoporosis showed a great decline by about 60%. IGF-1 level in osteoporotic diabetic postmenopausal women was correlated with BMD and most bone turnover markers (OPG, sRANKL, OPG/sRANKL). Osteocalcin declined significantly only in those women with osteoporosis not without osteoporosis. Conclusions: The circulating levels of OPG and sRANKL were not useful markers for bone status in postmenopausal women while the circulating levels of IGF-1 and osteocalcin might give useful information about bone status in postmenopausal diabetic women.

When do we need a prophylactic treatment for asymptomatic bacteriuria?

Asymptomatic bacteriuria (AB) is a risk factor for severe infections, especially for postmenopausal women with diabetes mellitus. It is still a problem to find a solution for a reason to treat AB in these cases. The literature shows that particularly antibacterial therapy shows only a limited efficacy in such patients. Kasyan et al. performed an interesting study to find answers to these questions. The aim of that study is quite interesting: looking for the need of a prophylactic treatment with Estriolin. The role of estrogen in the treatment of postmenopausal patients with urinary tract infections is known, and the sense of that treatment in combination with antibiotics for symptomatic infections is in use. Beside that, it would be interesting to know if a local application of estrogen could reduce the incidence of asymptomatic urinary tract infections. Not only the design of the study by Kasyan et al. is fine, but much more the results are important, although the group of treated patients is not as big as it could be. The meaning of that problem is determined, first of all, both by high prevalence of AB among women and also by high prevalence of type 2 diabetes among postmenopausal women. Whether this kind should be treated or not, is dependent on the risk to get a symptomatic infection and / or development of upper urinary tract infections. Regarding the current data on development of complications in AB, the need to treat AB for prevention and especially perform prevention in general should be actively discussed. Boyoko et al. presented a representative serial of diabetic and non–diabetic postmenopausal women looking for the risk of urinary tract infection and AB. They could conclude that postmenopausal women with diabetes have higher risks of urinary tract infection and / or AB in relation to diabetes duration and severity. In this actual study Kasyan et al. found that a significant reduction in the incidence of AB in patients receiving local estradiol could be observed. In conclusion this prophylactic treatment should be in mind especially in risk patients. As far as we know that diabetes mellitus is a risk factor for AB and according to that for symptomatic infections of the lower or upper urinary tract in general, the results of this study underline the importance of such a treatment. Haring read recent literature and considering all the information and the results of this actual study, a prophylactic application of estradiol could be recommended.

Hypoglycemia perception: Cross-cultural differences in Punjabi and Hindi speaking postmenopausal women

Introduction:The cross cultural differences in perception of menopausal symptoms are well known and these differences in perception of hypoglycemic symptoms in Russian-speaking and Caucasian postmenopausal women have been reported.Aims and objectives:This study assessed cross – linguistic and cross – cultural differences in symptomatology of self reported hypoglycemia, between Punjabi and Hindi speaking diabetic post menopausal women.Material and Methods:Thirty Punjabi speaking and 20 Hindi speaking diabetic postmenopausal women aged over 50 years, were recruited for this study. Each subject was asked, what happens to you when you have low sugar? in the language of her choice, and spontaneous answers were recorded verbatim.Statistical analysis:The data so obtained was analyzed by paper and pen method to obtain an understanding of the frequency of self reporting of various symptoms and then analyzed using Statistical Package for Social Science ver.19.0.Results:Symptoms of hollowness, cold sweats and headache correlated significantly (P < 0.0001, P = 0.0001 and P = 0.03 respectively). One difference was noted in women from rural vs. urban background: Inability to concentrate was more frequent in urban women (4/23) vs rural women (0/27) (P < 0.0001).Discussion:To our knowledge, this is the first exploratory work highlighting the differences in self reported hypoglycemia symptomatology, based on linguistic background. In India and other countries with multi ethnic, multi linguistic societies, linguistic competence in hypoglycemia history taking is important.Limitations:Incidence of hypoglycemia in the subjects enrolled was not assessed. Many of the subjects in the Punjabi speaking cohort were bilingual. Some symptoms of hypoglycemia may have been missed or over-reported by participants.Conclusion:Diabetes care professionals should be aware that persons with diabetes from varying linguistic backgrounds may report symptoms of hypoglycemia differently.

A Prospective Study of Leukocyte Telomere Length and Risk of Type 2 Diabetes in Postmenopausal Women

Telomere length (TL) has been implicated in the pathogenesis of age-related disorders. However, there are no prospective studies directly investigating the role of TL and relevant genes in diabetes development. In the multiethnic Women’s Health Initiative, we identified 1,675 incident diabetes case participants in 6 years of follow-up and 2,382 control participants matched by age, ethnicity, clinical center, time of blood draw, and follow-up duration. Leukocyte TL at baseline was measured using quantitative PCR, and Mendelian randomization analysis was conducted to test whether TL is causally associated with diabetes risk. After adjustment for matching and known diabetes risk factors, odds ratios per 1-kilobase increment were 1.00 (95% CI 0.90–1.11) in whites, 0.95 (0.85–1.06) in blacks, 0.96 (0.79–1.17) in Hispanics, and 0.88 (0.70–1.10) in Asians. Of the 80 single nucleotide polymorphisms (SNPs) in nine genes involved in telomere regulation, 14 SNPs were predictive of TL, but none were significantly associated with diabetes risk. Using ethnicity-specific SNPs as randomization instruments, we observed no statistically significant association between TL and diabetes risk (P = 0.52). Although leukocyte TL was weakly associated with diabetes risk, this association was not independent of known risk factors. These prospective findings indicate limited clinical utility of TL in diabetes risk stratification among postmenopausal women.

Determinants of Racial/Ethnic Disparities in Incidence of Diabetes in Postmenopausal Women in the U.S.

OBJECTIVETo examine determinants of racial/ethnic differences in diabetes incidence among postmenopausal women participating in the Women’s Health Initiative.RESEARCH DESIGN AND METHODSData on race/ethnicity, baseline diabetes prevalence, and incident diabetes were obtained from 158,833 women recruited from 1993–1998 and followed through August 2009. The relationship between race/ethnicity, other potential risk factors, and the risk of incident diabetes was estimated using Cox proportional hazards models from which hazard ratios (HRs) and 95% CIs were computed.RESULTSParticipants were aged 63 years on average at baseline. The racial/ethnic distribution was 84.1% non-Hispanic white, 9.2% non-Hispanic black, 4.1% Hispanic, and 2.6% Asian. After an average of 10.4 years of follow-up, compared with whites and adjusting for potential confounders, the HRs for incident diabetes were 1.55 for blacks (95% CI 1.47–1.63), 1.67 for Hispanics (1.54–1.81), and 1.86 for Asians (1.68–2.06). Whites, blacks, and Hispanics with all factors (i.e., weight, physical activity, dietary quality, and smoking) in the low-risk category had 60, 69, and 63% lower risk for incident diabetes. Although contributions of different risk factors varied slightly by race/ethnicity, most findings were similar across groups, and women who had both a healthy weight and were in the highest tertile of physical activity had less than one-third the risk of diabetes compared with obese and inactive women.CONCLUSIONSDespite large racial/ethnic differences in diabetes incidence, most variability could be attributed to lifestyle factors. Our findings show that the majority of diabetes cases are preventable, and risk reduction strategies can be effectively applied to all racial/ethnic groups.

Increased cortical porosity in type 2 diabetic postmenopausal women with fragility fractures

The primary goal of this study was to assess peripheral bone microarchitecture and strength in postmenopausal women with type 2 diabetes with fragility fractures (DMFx) and to compare them with postmenopausal women with type 2 diabetics without fractures (DM). Secondary goals were to assess differences in nondiabetic postmenopausal women with fragility fractures (Fx) and nondiabetic postmenopausal women without fragility fractures (Co), and in DM and Co women. Eighty women (mean age 61.3 ± 5.7 years) were recruited into these four groups (DMFx, DM, Fx, and Co; n = 20 per group). Participants underwent dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) of the ultradistal and distal radius and tibia. In the HR-pQCT images volumetric bone mineral density and cortical and trabecular structure measures, including cortical porosity, were calculated. Bone strength was estimated using micro-finite element analysis (µFEA). Differential strength estimates were obtained with and without open cortical pores. At the ultradistal and distal tibia, DMFx had greater intracortical pore volume (+52.6%, p = 0.009; +95.4%, p = 0.020), relative porosity (+58.1%, p = 0.005; +87.9%, p = 0.011) and endocortical bone surface (+10.9%, p = 0.031; +11.5%, p = 0.019) than DM. At the distal radius DMFx had 4.7-fold greater relative porosity (p < 0.0001) than DM. At the ultradistal radius, intracortical pore volume was significantly higher in DMFx than DM (+67.8%, p = 0.018). DMFx also displayed larger trabecular heterogeneity (ultradistal radius: +36.8%, p = 0.035), and lower total and cortical BMD (ultradistal tibia: -12.6%, p = 0.031; -6.8%, p = 0.011) than DM. DMFx exhibited significantly higher pore-related deficits in stiffness, failure load, and cortical load fraction at the ultradistal and distal tibia, and the distal radius than DM. Comparing nondiabetic Fx and Co, we only found a nonsignificant trend with increase in pore volume (+38.9%, p = 0.060) at the ultradistal radius. The results of our study suggest that severe deficits in cortical bone quality are responsible for fragility fractures in postmenopausal diabetic women.

Polychlorinated biphenyl exposure, diabetes and endogenous hormones: a cross-sectional study in men previously employed at a capacitor manufacturing plant

BackgroundStudies have shown associations of diabetes and endogenous hormones with exposure to a wide variety of organochlorines. We have previously reported positive associations of polychlorinated biphenyls (PCBs) and inverse associations of selected steroid hormones with diabetes in postmenopausal women previously employed in a capacitor manufacturing plant.MethodsThis paper examines associations of PCBs with diabetes and endogenous hormones in 63 men previously employed at the same plant who in 1996 underwent surveys of their exposure and medical history and collection of bloods and urine for measurements of PCBs, lipids, liver function, hematologic markers and endogenous hormones.ResultsPCB exposure was positively associated with diabetes and age and inversely associated with thyroid stimulating hormone and triiodothyronine-uptake. History of diabetes was significantly related to total PCBs and all PCB functional groupings, but not to quarters worked and job score, after control for potential confounders. None of the exposures were related to insulin resistance (HOMA-IR) in non-diabetic men.ConclusionsAssociations of PCBs with specific endogenous hormones differ in some respects from previous findings in postmenopausal women employed at the capacitor plant. Results from this study, however, do confirm previous reports relating PCB exposure to diabetes and suggest that these associations are not mediated by measured endogenous hormones.

Androgens and cardiovascular risk1)

Abstract Testosterone concentrations in men gradually decrease with age. Whether this reduction in androgen levels is a pathological process or a physiological event remains to be determined. The age-related decrease in testosterone levels is, however, frequently accompanied by adverse health consequences including low bone and muscle mass, increased fat mass, type 2 diabetes mellitus and the metabolic syndrome. Moreover, low androgen levels are associated with increased mortality. Testosterone treatment should be performed in men with low androgen levels as well as clinical signs and symptoms of hypogonadism. In premenopausal women, hyperandrogenemia is associated with several cardiovascular risk factors. The most common cause of hyperandrogenemia in women is polycystic ovary syndrome (PCOS). PCOS women are affected by hyperandrogenism, infertility and metabolic disturbances, such as insulin resistance, central obesity and dyslipidemia. Androgen levels decrease with menopausal transition in women. Hyperandrogenemia is associated with insulin resistance and type 2 diabetes in postmenopausal women. Whether this hyperandrogenemia results in increased mortality is, however, less clear. Moreover, the impact of androgen supplementation in postmenopausal women with hypoandrogenemia is open.

Swimming’s Prevention of Ovariectomy-Induced Obesity Through Activation of Skeletal-Muscle PPARα

Ovariectomy leads to weight gain primarily in the form of adipose tissue in rodents. The authors investigated whether swimming improves ovariectomy-induced obesity through activation of peroxisome proliferator-activated receptor α (PPARα) in the skeletal muscle of female ovariectomized (OVX) mice, an animal model of postmenopausal women. Female mice were randomly divided into 3 groups (n=8/group): a sedentary sham-operated group, a sedentary OVX group, and a swim-trained OVX group. After mice were subjected to swim training or kept sedentary for 6 wk, the authors studied the effects of swimming on not only bodyweight gain, white adipose tissue (WAT) mass, adipocyte size, and skeletal-muscle lipid accumulation but also the expression of skeletal-muscle PPARα target genes. Sedentary OVX mice had significantly higher body weight and WAT than sedentary sham mice. However, swim training reduced body-weight gain, WAT mass, and adipocyte size of OVX mice. Swim-trained OVX mice had significantly lower levels of serum triglycerides and total cholesterol than sedentary OVX mice. Lipid accumulation in skeletal muscle was also markedly decreased by swimming. Concomitantly, swim training significantly increased mRNA levels of skeletal-muscle PPARα and its target enzymes, as well as uncoupling protein 3 (UCP3) responsible for fatty-acid oxidation. These results suggest that swimming can effectively prevent weight gain, adiposity, adipocyte hypertrophy, and lipid disorders caused by ovariectomy, in part through the activation of PPARα and UCP3, in the skeletal muscle of female mice and may contribute to the alleviation of metabolic syndrome, including obesity, hyperlipidemia, and Type 2 diabetes in postmenopausal women.

Diabetes, Overweight and Risk of Postmenopausal Breast Cancer: A Case-Control Study in Uruguay

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

Comment on: Wehr et al. Low Free Testosterone Levels Are Associated With All-Cause and Cardiovascular Mortality in Postmenopausal Diabetic Women. Diabetes Care 2011;34:1771–1777

We have read with immense interest the recent article by Wehr et al. (1) showing that low free testosterone concentrations in postmenopausal diabetic women are associated with increased all-cause and cardiovascular mortality. We wish to comment on the concentrations of total and free testosterone of the study subjects. The overall mean or median total and free testosterone concentrations were not mentioned. However, according to quartiles based on free testosterone, the mean free testosterone was 0.93 ng/mL (equivalent to 93 ng/dL). The total testosterone at the intersection of second and …